Your article “Cancer survival in Britain the worst in Europe” (5th Dec 2013) has an alarming but misleading headline. This is not what is shown in the study on which the article is based (The Lancet Oncology, 5 December 2013, doi:10.1016/S1470-2045(13)70546-1). For many cancers, Britain has lower five-year survival rates than the mean European average, but that does not necessarily mean it is the worst. The study actually shows that for the majority of cancers analysed, the five-year survival rates in eastern Europe are the worst. The article also offers little scrutiny of the size of differences of survival rates, which in many instances are within a few percentage points – in fact, the researchers themselves note that for some common cancers, "survival in the UK and Ireland was close to the European mean".
Furthermore, given the potential discrepancies in data quality across the countries, such as registration coverage, quality of diagnostic and prognostic information, level of national coordination, and consistency of data collection and follow-up reporting, the cross-country comparisons may be subject to biases and large variances. The authors of the study addressed and mitigated these potential issues, as one would expect, but were unable to eliminate them altogether.
Whilst none of this undermines the validity of the results or denies that there are between-country discrepancies to address, it means that a more nuanced and measured interpretation is needed and that differences may be less disconcerting than the sensational tone of the article suggests.
There is also a positive note to the study – alluded to by Sean Duffy [National Clinical Director for Cancer for NHS England] whose quote was squeezed in at the end of your article – that five-year cancer survival rates have, on the whole, been getting better over time across Europe. This positive message, which has been the result of coordinated and sustained research efforts plus improvements in symptom awareness and screening programmes, is at least as important as the serious message that the UK needs to keep pace with some of our European neighbours. It is important for people reading the article that they are aware that, thanks to publicly supported research and healthcare programmes,
In summary, we are doing well but could be doing better.