Does The Early Bird Catch The Worm: Early Cancer Detection And Survival In The UK

Abstract

Cancer has a significant burden on NHS resources and there is a need to improve cancer outcomes in the UK. This analysis investigated if there is variation in the early diagnosis of breast, colorectal, and lung cancers across NHS clinical commissioning groups (CCGs) in England, and if this is associated with improved outcomes. One-year survival and percentage of breast, colorectal, and lung cancer detected at stage I–II from CCGs was extracted from the 2016 NHS England cancer and tumour focus pack tool. Linear regression analyses were conducted to determine the relationship between the percentage of cancers detected at stage I–II versus 1-year survival. Data were available from 209 CCGs. This analysis revealed significant variation in early detection of cancers across England. The percentage of cancers detected at stage I–II ranged from 36.3% to 88%, 13.5% to 54.4%, and 9.1% to 35.1% in patients with breast, colorectal, and lung cancer, respectively. Similarly, 1-year survival rates varied, and ranged from 93.2% to 98.6%, 68.2% to 85.3%, and 23.5% to 47.1% for breast, colorectal, and lung cancer, respectively. A statistically significant positive correlation between the percentage of cancers detected at stage I–II and 1-year survival for lung cancer was observed (R=0.28; p<0.001). No similar correlation was found for breast and colorectal cancer (R=0.10; p=0.15 and R=0.07; p=0.32, respectively). These data indicate that rates of detection of cancers at stage I–II vary considerably. We find that detection at stage I–II is associated with improved survival in lung cancer which has poorer outcomes at later stages of disease versus breast and colorectal cancer which have more favourable outcomes at later stages. CCGs should continue to take action to improve detection rates and thus survival outcomes in difficult-to-treat cancers.