Britons diagnosed with cancer die sooner than patients in most other European countries, a survey has found.

League tables of cancer survival for 22 nations in Europe show England, Scotland and Wales falling below the European average for most cancers.

France and Austria top the table and Poland is at the bottom. Only eastern European countries do worse than Britain.

Overall, the chances of surviving five years with a diagnosis of any cancer in Britain are about a fifth lower for men and a seventh lower for women compared with the countries at the top of the table. But on some cancers Britain does better than the average. On melanoma, the most dangerous form of skin cancer, Scotland is ranked fourth in the table for women, with a five year survival rate of more than 90 per cent, attributed to early diagnosis and aggressive treatment. Britain also performs well on the treatment of testicular cancer and Hodgkin's disease.

The findings, for patients diagnosed between 1990 and 1994 and followed up to 1999, point to the lack of investment in cancer services and the shortage of specialists resulting from decades of under-funding in the NHS. The National Cancer Plan launched by the Government in 2000 has seen more than £1bn extra investment in cancer services, boosting total spending by almost one third in the three years to 2003-04, but the effects are only beginning to be seen.

The survey, presented to the European Cancer Conference in Copenhagen yesterday, is the third of its kind in the past decade. Called Eurocare-3 and funded by the European Union, it was based on data for 1.8 million adults and 24,000 children diagnosed with 42 types of cancer. The main finding was the gap between survival in west European nations and those in the eastern bloc where medical care and facilities are less developed. Taking all cancers combined, between a quarter and a half more patients survive five years in the west compared with the east.

Michel Coleman, professor of epidemiology and statistics at the London School of Hygiene and Tropical Medicine and lead author of the study, said this was "easily the most important" finding. "The gap is widening. It is worrying," he said.

Previous Eurocare studies have been attacked by critics who claimed that countries which found themselves at the bottom of the table, including Britain, were only at the bottom because they had more accurate ways of recording cancer related deaths.

But Professor Coleman rejected that charge. "If we are better at counting cancer cases in Britain, how come our survival rates are better for treatable cancers [such as melanoma and testicular cancer] but not for others like lung cancer?" he asked.

Department of Health figures showed Britain had fewer cancer specialists than other countries and the National Confidential Inquiry into Perioperative Deaths (deaths within 30 days of surgery) reported in 2001 that cancer was poorly treated with inadequate staging (to measure how advanced it was), wide variations in hospital caseloads and experience and poor compliance with treatment guidelines.

"When you take these factors into account it does suggest that the data we are presenting are not so off the wall as some knee-jerk clinical reactions would suggest," Professor Coleman said.

A health department spokesman said the data was old. But he added: "This study shows exactly why action was needed to improve cancer services in this country and the actions set out in the Cancer Plan mean that England will have the fastest improving cancer services in Europe."

Comments