Britain’s cancer survival rates have improved dramatically over the last two decades but we are still lagging well behind our European and global counterparts. Why is this? Put simply, we have not done enough around early diagnosis and national screening.
Let’s look at the successes. It’s estimated that a total of 4,500 lives are saved every year through the National Cervical Screening Programme, which correlates with the 919 deaths from cervical cancer in England in 2012. The annual cost of the programme is £175m, which involves 3.2m tests being undertaken around the country. Whilst there are nuances around each disease area and how it can be detected and treated early, the success of such schemes point towards where more government investment should be heading.
The technological improvements in diagnostics and imaging has mirrored the steady rise in cancer survival rates – however, access and availability remain a concern. Focusing on early diagnosis isn’t new and the previous coalition Government’s Improving Outcomes: A Strategy for Cancer identified early diagnosis as a key driver in improving outcomes.
Now it’s clear the new Government will set its focus on out-of-hospital care, as set out in the Five Year Forward View, it must consider a radical increase in the availability of primary care diagnostics. This will not only ease pressures on hospitals but offer the personalised care that is vital for early detection and treatment. Macmillan Cancer Support is currently undertaking pilots of an electronic cancer decision support tool which helps GPs decide whether or not to refer patients for further diagnostic testing. Early diagnosis of this kind will be particularly beneficial for patients with cancers that are asymptomatic or mirror more benign conditions and has the potential to dramatically improve outcomes should it prove a success.
As an international comparison France has recently agreed to roll out a national diagnostics programme that will help determine patients with hereditary risks for both breast and ovarian cancer. To help fund this service its government has leased out data from a national database which will allow better analysis of gene mutations – a win-win situation for the government, drug development and diagnostics companies and most importantly patients.
Survival rates are, and should be, the ultimate barometer. If we want to see them keep pace with global trends we must extend our successes in national screening to all patients at all stages of their disease.