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‘Little evidence’ that national cancer strategies have impacted survival

There is ‘little evidence’ that national cancer strategies have directly impacted on short-term survival, a new study has found.

Researchers from London School of Hygiene and Tropical Medicine analysed 3.5 million cancer patients aged 15 to 99 and found no evidence for a reduction in the deprivation gap in cancer survival.

The authors said that despite increasing survival and reducing inequalities being the main targets of national policy initiatives since 2000, there has been little to no direct impact.

The population-based cohort study, published in the BMJ, included people who had been diagnosed with one of the 24 most common malignant tumours between 1996 and 2013.

The team estimated one-year net survival for each cancer by sex, year of diagnosis, and deprivation category.

They found that while one-year net survival improved for 20 of the 21 cancers examined in women and 16 of the 20 cancers examined in men, it was consistently lower in deprived patients, with the deprivation gap remaining unchanged for 13 cancers in men and 17 in women.

Additionally, despite a slight decrease for six cancers among men as well as cervical and uterine for women, the gap widened notably for brain tumours in men and lung cancer in women over time.

The paper noted that the 'lack of consistent results' for both sex and cancer types provided 'little evidence for any strong impact of the national cancer policies' on short-term cancer survival.

It added that the 'evidence is even weaker for their impact on the socioeconomic inequalities in cancer survival'.

The authors said: ‘Even though increasing cancer survival and reducing inequalities in survival have been among the main targets of national cancer policy initiatives implemented since 2000, this study found little evidence of a direct impact of these strategies on one year survival, and no evidence for a reduction in socioeconomic inequalities in survival.'

They concluded that their findings should be taken into consideration by policymakers and that there is a need to shift the focus towards factors that ‘might prove to be beneficial in improving cancer outcomes among the most disadvantaged’.

In 2015, new NICE guidelines saw GPs urged to refer thousands more patients who were at a very low risk of cancer.

The move was criticised by GPs who said that the recommendations could lead to too many patients being referred, with those more likely to develop cancer being missed due to their baseline risk not being taken into account.

 

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