Cancer Survival Improves In Deprived Areas, UK

Main Category: Cancer / Oncology
Article Date: 27 Feb 2009 - 6:00 PDT

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New figures from the Office for National Statistics show that cancer survival is generally improving for people living in the most deprived areas of England.

In 2004, the Government targeted the Primary Care Trusts (PCTs) with the most health-deprived populations (the "Spearhead" group of PCTs) as the focus of attention for reducing health inequalities.

Cancer survival in Spearhead PCTs has improved, but it remains lower than in the rest of England for 10 common cancers at one year after diagnosis and for seven of these cancers at five years.

However, improvements in survival between 1998 and 2004 have been slightly greater for patients in Spearhead PCTs than for those in the rest of England, meaning that the gap has narrowed between Spearhead and other PCTs.

The largest improvement in survival between 1998-2002 and 2000-2004 in Spearhead PCTs was for prostate cancer. One-year survival rose from 89.6 per cent to 91.5 per cent, and five-year survival from 70.5 per cent to 75.4 per cent. As a result, survival is now essentially the same as in the rest of England.

In Spearhead PCTs, one-year survival for breast cancer rose from 93.4 per cent for patients diagnosed during 1998-2002, to 94.1 per cent for patients diagnosed during 2000-2004. Over the same period, five-year survival rose from 78.8 per cent to 80.5 per cent. For the rest of England, five-year survival rose from 79.8 per cent to 81.2 per cent.

For lung cancer, one-year survival for men increased from 24.2 per cent to 25.4 per cent in Spearhead PCTs. One-year survival for women increased, from 26.5 per cent to 28.2 per cent in Spearhead PCTs; and from 27.7 per cent to 29.3 per cent in the rest of England.

Oesophageal cancer survival for men after one year showed a small but statistically significant increase in Spearhead PCTs from 28.9 per cent to 31.8 per cent.

One-year and five-year survival from bladder cancer fell in both sexes, both in Spearhead PCTs and in the rest of England. However, these falls are probably due to changes in the coding and classification of bladder tumours.

Two reports are published today on cancer survival in Spearhead PCTs:

- Cancer survival in the Spearhead Primary Care Trusts of England, 1998-2005 Available on the ONS website.

- Trends in cancer survival in Spearhead Primary Care Trusts in England, 1998-2004 Available in Health Statistics Quarterly 41 spring 2009 (p7).

Background Notes

1. The 10 cancers examined were bladder, breast (women), cervix, colon, lung, oesophagus, ovary, prostate, rectum and stomach. Patients were diagnosed in three overlapping five-year periods covering the period 1998-2002, 1999-2003 and 2000-2004, with follow-up to 31 December 2005.

2. The "Spearhead Group" of local authorities and Primary Care Trusts (PCTs) was selected by the Government in 2004 to be the focus of interventions to reduce health inequalities. The 70 local authorities, and 88 Trusts which mapped to them (now 62 PCTs following NHS reconfiguration in 2006) were chosen because they were in the lowest fifth in England for at least three of five key measures of health inequality - deprivation, male and female life expectancy, and mortality from cancer and cardiovascular disease.

3. A map showing the 62 Spearhead PCTs can be found in the article on 'Trends in cancer survival in Spearhead Primary Care Trusts in England' in Health Statistics Quarterly 41 on page 8. See here.

4. The survival figures published here were produced in collaboration between ONS and a team at the London School of Hygiene and Tropical Medicine (LSHTM) which was funded in part by a grant from Cancer Research UK.

5. Changes in the classification and coding of bladder tumours in Europe were implemented progressively in the UK from 2000. Transitional cell papillomas of the bladder have high survival. They were previously classified as malignant by pathologists and most cancer registries, but are now classified as non-malignant. Only malignant tumours are included in the survival analyses. The recorded decline in bladder cancer survival results from this re-classification

6. The National Cancer Intelligence Centre at ONS, and the LSHTM, wish to acknowledge the work of the regional cancer registries in England over the years that the national cancer registration scheme has been in operation.

7. Details of the policy governing the release of new data are available from the media office.

8. National Statistics are produced to high professional standards set out in the UK Statistics Authority's Code of Practice for Official Statistics. They undergo regular quality assurance reviews to ensure that they meet customer needs. They are produced free from any politica interference.

Department of Health, UK

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