Variations in global cancer survival rates

Lung cancer and stomach cancer survival rates in the UK are among the poorest in Europe but it is better news for breast cancer patients, according to an analysis published yesterday.

The CONCORD-2 study, published in The Lancet, reports 5-year survival estimates for 25.7 million cancer patients diagnosed with 1 of 10 common cancers – stomach, colon, rectum, liver, lung, breast (women), cervix, ovary, and prostate cancer, and leukaemia – and 75,000 children with acute lymphoblastic leukaemia, between 1995 and 2009.

They found that there were huge variations in survival rates for specific cancers across the globe – and not just a gulf between developed and non-developed countries.

Dr Claudia Allemani, lead author and senior lecturer in cancer epidemiology at the London School of Hygiene & Tropical Medicine, UK, said: “Our findings show that in some countries, cancer is far more lethal than in others—in the 21st century there should not be such a dramatic gulf in survival.”

The study found that five-year survival rates for liver and lung cancer are less than 20% in both developed and developing countries. In the UK and other parts of Europe, it is less than 10%.

Over the study period, survival rates rose by more than 10% in China, Israel, Japan, and Korea.

Intensive diagnostic activity, early stage at diagnosis, and radical surgery are thought to be among the reasons why stomach cancer survival is higher in south-east Asia, with five-year survival rates at 54% in Japan; 58% in Korea; and 38% in Taiwan, 36%. In UK, it is just 18-19%, which is lower than most of Europe.

Survival rates for cervical and ovarian cancers vary widely, from more than 70% five-year survival in Mauritius, Korea, Taiwan, Iceland, and Norway to less than 40% in Libya.

It is less than 60% in the UK, which is on a par with France, Ireland, Latvia, Bulgaria, Poland, Russia, and Slovakia.

However, breast cancer survival rates improving in the UK, with the five-year survival rate at 2009 in the UK rising to 81%. France and Finland have among the highest levels of survival for breast cancer (87%).

“The majority of the variability in survival is probably due to factors that can be changed, such as the availability and quality of diagnostic and treatment services,” said Dr Allemani.

“The findings can be used to evaluate the extent to which investment in health-care systems is improving their effectiveness. We expect them to act as a stimulus for politicians to improve health policy and invest in health care.”

Allemani C, Keir H, Carreira H et al. Global surveillance of cancer survival 1995–2009: analysis of individual data for 25676887 patients from 279 population-based registries in 67 countries (CONCORD-2). Lancet. 26 November 2014 [abstract]

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