Recent decades have been a "golden era" for cancer research and treatment that has resulted in over one million lives saved that would otherwise have been lost to the disease, according to a new data analysis from Cancer Research UK (CRUK).
The charity released the figures to coincide with the launch of a refreshed brand and a new advertising campaign aiming to maintain improvements in cancer survival in the face of an ageing population and increasing pressure on the NHS.
CRUK said that UK cancer mortality rates had fallen by a quarter from their peak, meaning that 1.2 million fewer lives were lost to the disease than if mortality had stayed at mid-1980s levels without access to new tests and treatments. Half of those who develop cancer now survive for at least 10 years, and the charity said it wanted to "accelerate progress" so that that this became three-quarters by 2034.
Cancer Mortality Peaked in 1980s
The analysis by CRUK's Cancer Intelligence Team showed that mortality rates for all cancers combined peaked in 1985 for men and 1989 for women. Deaths avoided were estimated by comparing the observed number of annual cancer deaths since then against those that would have occurred had mortality rates remained at their peak – a drop of 34% for men and 24% for women.
The researchers also calculated deaths avoided for specific cancer types:
- Lung: 560,000 fewer deaths – largely due to fewer people smoking
- Stomach: 236,000 – substantially due to H pylori eradication
- Bowel: 224,000 – due to "huge progress" in treatments, including CRUK-funded research on giving chemotherapy before surgery to shrink tumours
- Breast: 17,000 – partly due to the introduction of the national screening programme in 1988 and drug developments like tamoxifen and Herceptin
- Improvements in radiotherapy
- Screening programmes for breast, cervical, and bowel cancer
- Prevention – particularly plummeting smoking rates
- Drug development
- Gene discoveries – such as BRAF in malignant melanoma
"Cancer is a Fixable Problem"
The analysis painted "a picture of 40 years of progress and hope in cancer research", according to CRUK. However, progress was not equal and not all types of cancer had seen improvements – notably with recent increases in mortality for liver, head and neck, and uterine cancers.
Cancer remained the number one cause of death in the UK, and the NHS and research environment were under "enormous strain". With the resulting lack of access to new tests and treatments, along with an ageing population, "there is a risk that cancer survival could decline unless action is taken by governments", the charity warned.
Chief Executive Michelle Mitchell said: "Thanks to research and progress, a huge number of people in the last 40 years have reached milestones in their lives they didn’t think they’d see, and had more invaluable time with their loved ones.
"The fact that over a million lives have been saved from cancer in this time reflects the power of research. Discoveries into more effective and kinder treatments, improvements to screening programmes, and strategies to help detect and prevent cancer have all been essential to this.
"Cancer is a fixable problem," she said. However, she admonished, many people's situation remains worrying. "Long waiting times are leaving many people facing fear and uncertainty."
Professor Jean Abraham, lead of the personalised breast cancer programme at the University of Cambridge, said: "This is a golden era for cancer research. We’ve seen incredible progress in the way that we prevent, diagnose and treat cancer."
Genome sequencing that 10 years ago would have taken months can now be obtained within days. "This is a game-changer," she said, enabling both personalised treatment and assessment of the need for family screening for high-risk hereditary cancer-causing genes.
However, she also issued a cautionary note that "for all the progress we’ve made, there is so much more about cancer that we don’t know. That is why it’s crucial that we continue pioneering cancer research".
Advances Could be Unravelled by "Precarious Position"
Asked to comment by Medscape News UK, Baroness Delyth Morgan, chief executive at Breast Cancer Now, said: "That millions of lives have been saved from cancer in the last 40 years is testament to immense advances made in diagnosing and treating the disease." However, she pointed out, 11,500 women still die from breast cancer every year in the UK.
"Right now, breast cancer care is in a precarious position, and the decades of progress we have made could quickly unravel. While the breast screening programme alone prevents around 1300 breast cancer deaths every year in the UK, it has reached breaking point after years of neglect."
Baroness Morgan added that women with breast cancer "continue to experience unacceptable delays to starting their treatment following a GP referral", and that "urgent action" was needed to get breast cancer services back on track – including "making it easier for women to arrange and attend screening" as well as "modernising the programme’s failing IT systems".