Deaths from cancer will be “eliminated” for all age groups except the over-80s by 2050, if recent gains in prevention and treatment carry on apace, experts have said.
Researchers from University College London (UCL) and King’s College London said the UK was at a “special point in history” and could set a bold ambition to eradicate cancer-related mortality in people aged under 80 “during the course of the coming 20 to 30 years”.
Falling smoking rates, speedier diagnosis, and better radiological, surgical and drug treatments have led to a 1 per cent decline in cancer death rates every year since 1990, they said – a trend which would likely gather pace.
However, the researchers said investment in cancer care would have to increase and criticised decisions to ration innovative treatments, saying there should be “no question” of the NHS being able to afford world-class treatments.
NHS England announced this week that 25 life-extending treatments would no longer be available from the £280m Cancer Drugs Fund.
David Taylor, UCL emeritus professor of pharmaceutical and public health policy, said that the British economy would lose out if discoveries in the field of cancer treatment did not reach patients.
“What makes this a special point in history, is that cancers are in the process of becoming either preventable or effectively curable,” he said. “There should be no question of the NHS not being able to afford world-class cancer prevention and treatment – no health service user should feel they have to beg for the best possible therapies.”
In the report, Overcoming Cancer in the 21st Century, Professor Taylor and colleagues said that 325,000 Britons – more than ever – will be diagnosed with a potentially fatal cancer this year.
However, death rates for the most common cancers are down about a third from those recorded just 20 years ago.
While warning that there would no “magic bullet” for patients in years to come, they predict huge gains could be made if smoking rates continue to decline, drug treatments for advanced cancer continue to improve, and conditions such as bowel cancer, often diagnosed too late, continue to be picked up sooner. Advances in our understanding of the genetic basis of cancer cases will also lead to better testing and more effective drugs. The outcome within three decades, the researchers predict, would be a country where no one except those in “late old age” dies from cancer. Professor Taylor said that the target date of 2050 was “conservative”.
“In the first half of the 20th century the big gains were infectious disease… the second half has been drops in vascular disease death rates,” he said. “The next great surge will be in cancer-related death reduction. We’ve already done reasonably well. We can do much better. We shouldn’t chicken out on it.”
According to the report, spending on cancer care in the UK accounts for 7 per cent of NHS spending. Cancer drugs account for 1 per cent – or 0.1 per cent of UK GDP.
“We’re not spending too much on cancer,” Professor Taylor said. “What we probably need is an ‘Innovative Drugs Fund’ that covers all low-volume, high-unit cost drugs and probably needs to be separately funded. The scope of the Cancer Drugs Fund isn’t wide enough.”
UCL Geneticist Dr Jennifer Gill said that the genetic mutations that cause cancer, which can be both inherited or caused by lifestyle, would be better understood in the coming decades, but said “increased capacity” would be needed to make these scientific gains useful to patients.
“Present testing resources are limited,” she said. “For instance only about half the 70,000 or so people in this country with BRCA gene mutations associated with conditions such as breast and prostate cancer know that they are carrying them.”
Responding to the report, Emma Greenwood, head of policy at Cancer Research UK, said that the aim was to increase the number who survive for a decade to three quarters of all patients by 2030.
“Improved early diagnosis and ensuring patients get the best possible treatments are key ways to achieve this, and should be a focus for the NHS. Research into… new, kinder treatments is vital, as well as improving those we already have,” she said.
A Department of Health spokesperson said: “It is vital that the NHS diagnoses cancer early and we are determined to remain at the forefront of the latest developments in cancer treatment. We are on track to save an extra 12,000 lives by 2015 and survival rates are at record highs, but we will not let up in our efforts to speed up diagnosis and continue giving access to the very latest drugs and therapies.
“That is why NHS England has announced a new independent Cancer Taskforce to improve survival rates and save thousands more lives.”
Living well: 5 reasons why we're beating cancer
Reduced smoking rates
Smoking causes one in four cancer deaths. But in 2013, the number of adults smoking in the UK hit its lowest level since records began in the 1940s.
Our understanding of the genetic mutations that lead to cancers is improving, to the point that drug-makers are now working on “personalised” treatments that target particular genetic causes of an individual’s cancer.
Picking up a cancer early in its development is perhaps the most important factor determining survival chances. The UK is particularly poor at this, lagging behind many European countries. This week the NHS began work on a “five-year plan” to remedy this.
Great gains have been made in recent years in the development of drugs that keep patients alive for longer, even in the most advanced stages of cancer. One problem, however, is that these innovative drugs cost a lot to develop, and are priced very highly (some say far too highly) by pharmaceutical companies.
Although rates of obesity in the UK are still high, the link between poor diet, weight gain and a range of health risks – not least cancer – is becoming well-established and understood.
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