Government will fall short of cancer targets by 2010

March 30, 2000

How many deaths have been avoided through improvements in cancer survival?

Cancer trends in England and Wales

The government will fall short of its target of 100,000 fewer cancer deaths among the under-75s by 2010 unless it tackles socio-economic inequalities, shows research in this week's BMJ. The target was published in July last year in the White Paper Saving lives: our healthier nation and included 60,000 fewer deaths through prevention and 40,000 as a result of better screening and treatment.

Mark Coleman of the Department of Epidemiology and Population Health at the London School of Hygiene and Tropical Medicine, and colleagues compared the survival rates five years after diagnosis of 1.5 million cancer patients between 1981-5 and between 1986-90 in England and Wales, to see how many deaths had been avoided through improvements in cancer survival. Avoided deaths were calculated as the difference between the observed and expected excess deaths from cancer.

Just over 17,000 deaths were avoided within five years of diagnosis among patients diagnosed with cancer in 1986-90, representing almost 3.5 per cent of all excess deaths if survival rates had remained at 1981-5 levels. Two thirds of the avoided deaths arose from improvements in survival for just five cancers, including those of the breast, colon, and rectum. But survival had scarcely improved at all for the common cancers of the lung, prostate, stomach, ovary and brain, which account for a third of all cancers.

Based on these survival trends, around 24,000 excess cancer deaths within five years of diagnosis among the target age group would be avoided by 2010, and not the hoped for 40,000, conclude the authors. Small improvements in survival for the common cancers would make a big impact on the figures, they say, and eliminating inequalities would save almost 13,000 lives every five years.

In an accompanying editorial, Heather Dickinson from the North of England Children's Cancer Unit at the University of Newcastle upon Tyne, points out that "Eliminating the class difference in survival would almost certainly save more lives in the next decade than innovative treatment." She also challenges the government to use reliable evidence on which to base its policy decisions and fund the accrual of this information. Data on incidence, mortality and survival by cancer type are inadequate, she says, and it takes six years to report the number of cancers occurring in a specific year.

Dr Mark Coleman, Department of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine Email:

Dr Heather O'Dickinson, Department of Child Health, Royal Victoria Infirmary, Newcastle upon Tyne Email:


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