Cancer Remission Rates
Silvina Spindler
Cancer survival is one of the key measures of the effectiveness of cancer services. Survival rates capture not only how well the healthcare system can detect the disease but also whether people have rapid access to effective treatment. In this indicator, we explore cancer survival for common cancer types and compare the UK's five-year survival rates for breast, cervical and colon cancer with other countries. We also look at trends in the stages at which cancer is diagnosed and unpack inequalities in early cancer diagnosis when categorised by levels of deprivation.
The NHS Long Term Plan set a target to increase the percentage of cancers diagnosed at stage 1 or 2 to 75% by 2028. Commitment to this target has been reiterated in the NHS priorities and operational planning guidance published in January 2023. Targets for faster cancer diagnosis have also been set which state that by March 2024 75% of patientsshould be told whether or not they have cancer within 28 days of an urgent referral from their GP or a cancer screening programme. The faster diagnosis standard was met in March 2024 with 77.3% of patients given their cancer diagnosis or having cancer ruled out after 28 days of referral (data not shown).
Early-stage diagnosis comprises cancers diagnosed at stage 1 or stage 2 of the disease progression. Individuals living in the least deprived areas have had a consistently higher rate of early cancer diagnosis than those living in the most deprived areas. In 2018 and 2019, the number of cancers diagnosed at an early stage for both groups remained roughly constant, with slightly more variation occurring for individuals living in the most deprived areas than for those living in the least deprived areas.
Between March and May 2020, following the onset of the Covid-19 pandemic, the percentage of cancers diagnosed early fell from 58% to 52% for individuals from the least deprived areas. The decline for the same period was sharper for individuals from the most deprived areas as early diagnoses fell from 53% to 41%. Since then, the percentage of early cancer diagnoses has increased to levels slightly higher than they were before the pandemic for both groups. In January 2023, 62% of cancers were diagnosed early for individuals in the least deprived areas and 53% were diagnosed early for individuals in the most deprived areas.
Early cancer diagnosis rates for both groups are less than the 75% target set for 2028 by the NHS Long Term Plan. However, it should be noted that individuals living in the least deprived areas are and have always been closer to the target than individuals living in the most deprived areas. Guidance published in February 2022 particularly emphasises the importance of early cancer diagnosis for individuals living in disadvantaged areas.
Breast cancer is the most prevalent cancer in women worldwide. Survival is related to advances in treatment, detection through screening programmes and a greater awareness of the disease. Five-year survival for breast cancer has been improving in the UK over time, reaching 86% in 2010-2014.
However, despite the relatively high breast cancer screening coverage when compared with several other countries represented in the Organisation for Economic Co-operation and Development (OECD) data, the UK continues to lag in terms of survival. There is recognition that in terms of cancer mortality, the UK performs worse than other comparable countries, and this may result from differences in access to care and delays in treatment or could be due to population-level factors. The United States reached the highest five-year breast cancer survival rate of 90.2% in 2010-2014, followed closely by Australia at 89.5% and Japan at 89.4%.
Cervical cancer is highly preventable if detected and treated before progression occurs. The main cause of cervical cancer is sexual exposure to human papilloma virus (HPV). About half of OECD countries have cervical screening programmes and around half have implemented HPV vaccination programmes.
In England, all girls aged 12 to 13 are offered the HPV vaccination, and from the 2019/20 school year the programme had been extended to all boys aged 12 to 13 years old. In 2021/22, uptake of the first dose of the vaccine was 82% and the second dose was 67%, a decrease when compared with previous years. This occurred due to disruptions in the vaccination schedule caused by school closures during the pandemic.
International trends in five-year cervical cancer survival show more variation between countries over time than for five-year breast cancer survival. While survival has been improving in the UK, it is still one of the worst performers compared with other OECD countries, with a five-year survival of only 64% in 2010-2014. This is despite relatively high cervical cancer screening coverage. In comparison, survival in Denmark in the same period was 70% while survival in Japan reached 71%.
Bowel cancer is the third most common cancer diagnosis worldwide. The disease has a higher prevalence in America and Europe than Asia, however in countries where people are adopting Western diets, such as Japan, the incidence of colon cancer is increasing. There are multiple screening methods available including the faecal occult blood test, colonoscopy and flexible sigmoidoscopy. Advances in diagnosis and treatment of colon cancer have led to increased survival over the last decade.
While the five-year colon cancer survival rate in the UK has been increasing over time, in 2010-2014 survival reached only 60%. This is the lowest five-year survival rate out of the 18 OECD countries that we have included. Over the same period in Australia, it was as high as 71%, while Belgium reached a five-year colon cancer survival rate of 68%.
Five-year net survival is the cumulative probability that cancer patients survive their cancer for at least five years, after controlling for the risks of death from other causes. Net survival is expressed as a percentage. Net survival for patients diagnosed during 2000-2004 is based on a cohort approach, since all patients had been followed up for at least five years by the end of 2014. For patients diagnosed during 2010-2014, the period approach is used, which allows estimation of five-year survival, though five years of follow-up are not available for all patients. Cancer survival estimates are age-standardised with the International Cancer Survival Standard (ICSS) weights.
The OECD.Stat platform which hosted the data until June 2023 has been replaced by the OECD Data Explorer. This transfer may have affected some of the datasets, causing a delay for when numbers are updated for each country.
Our 24/7 cancer helpline provides information and answers for people dealing with cancer. We can connect you with trained cancer information specialists who will answer questions about a cancer diagnosis and provide guidance and a compassionate ear.
Our highly trained specialists are available 24/7 via phone and on weekdays can assist through online chat. We connect patients, caregivers, and family members with essential services and resources at every step of their cancer journey. Ask us how you can get involved and support the fight against cancer. Some of the topics we can assist with include:
The American Cancer Society relies on information from the Surveillance, Epidemiology, and End Results (SEER) database, maintained by the National Cancer Institute (NCI), to provide survival statistics for different types of cancer.
The SEER database tracks 5-year relative survival rates for breast cancer in the United States, based on how far the cancer has spread. The SEER database, however, does not group cancers by AJCC TNM stages (stage 1, stage 2, stage 3, etc.). Instead, it groups cancers into localized, regional, and distant stages:
If you have cancer, you may have questions about how serious your cancer is and your chances of survival. The estimate of how the disease will go for you is called prognosis. It can be hard to understand what prognosis means and also hard to talk about, even for doctors.
When you have cancer, you and your loved ones face many unknowns. Understanding your cancer and knowing what to expect can help you and your loved ones make decisions. Some of the decisions you may face include:
Many people want to know their prognosis. They find it easier to cope when they know more about their cancer. You may ask your doctor about survival statistics or search for this information on your own. Or you may find statistics confusing and frightening, and think they are too impersonal to be of value to you. It is up to you to decide how much information you want.
Doctors estimate prognosis by using statistics that researchers have collected over many years about people with the same type of cancer. Several types of statistics may be used to estimate prognosis. The most commonly used statistics include:
Because statistics are based on large groups of people, they cannot be used to predict exactly what will happen to you. Everyone is different. Treatments and how people respond to treatment can differ greatly. Also, it takes years to see the benefit of new treatments and ways of finding cancer. So, the statistics your doctor uses to make a prognosis may not be based on treatments being used today.
Still, your doctor may tell you that you have a good prognosis if statistics suggest that your cancer is likely to respond well to treatment. Or they may tell you that you have a poor prognosis if the cancer is harder to control. Whatever your doctor tells you, keep in mind that a prognosis is an educated guess. Your doctor cannot be certain how it will go for you.
NCI collects and reports on cancer statistics through its SEER Program, which stands for Surveillance, Epidemiology, and End Results. From the Cancer Stat Facts page on the SEER web site, you can find answers to the most commonly asked questions about cancer statistics for many cancer types. You can also browse the latest SEER Cancer Statistics Review.
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