New study highlights the ticking cancer time bomb
Professor Lawler chairs the International Cancer Benchmarking Partnership (ICBP) which has published a new study in The Lancet Oncology on international differences in emergency cancer presentations and how this impacts on survival.
The ICBP is a unique global coalition of clinicians, researchers, data experts and policymakers that collates and analyses data across different countries worldwide (including the four nations of the United Kingdom) in order to identify the key factors that drive differences in cancer survival. The ICBP works closely with Cancer Research UK, which supports the coalition through the programme management team.
The study looked at over 800,000 cancer cases diagnosed between 2012 and 2017. Cancer types included were oesophageal, stomach, colon, rectal, liver, pancreatic, lung and ovarian cancers.
It found that more cancers are being diagnosed through emergency routes in the UK than in comparable, high-income countries like Australia and Canada. The proportion of emergency presentations for all sites ranged from 24% in the Australian state of Victoria to 42.5% in New Zealand, indicating that this is a global issue. Scotland and Wales had some of the highest rates of diagnosis after emergency presentation at 38.5% and 37.4% respectively, but England wasn’t far behind at 37%.
When the researchers looked at the data on emergency presentations alongside the data on cancer survival, they saw that countries with higher levels of emergency presentation were also found to have poorer survival. For every 10% increase in emergency presentations in the countries analysed, there was a decrease in one-year survival for six of the eight cancer types.
Dr John Butler, Clinical Lead for the International Cancer Benchmarking Partnership (ICBP), said,
“Cancers diagnosed through emergency routes are often more advanced than those caught after GP referral or through screening. This can affect someone’s chances of surviving cancer, and impacts on the type of treatment they’re offered.”
Prof Mark Lawler, Scientific Director of DATA-CAN and Chair of the ICBP, said,
“COVID-19 has made the situation worse. DATA-CAN’s work at the beginning of the pandemic highlighted the impact of the pandemic, particularly in delaying cancer presentation and diagnosis. The current ICBP study on emergency presentations looked at data pre-pandemic. Unless we act quickly and decisively, the high rate of emergency presentations seen in the UK, combined with the disastrous impact of COVID will precipitate a cancer epidemic.”
Information on the route through which cancer is diagnosed is not widely collected. ICBP researchers are now calling for the collection of this data globally, for use in official cancer surveillance statistics and to inform cancer policy.
Prof Lawler added, “In the UK, and other countries with high rates of emergency presentations, improving diagnoses via non-emergency routes is critical to improving overall cancer survival. Our work emphasises the importance of the collaborative use of data to deliver the critical intelligence needed to improve cancer outcomes. It resonates strongly with Cancer Research UK’s recently refreshed strategy, in particular its focus on early diagnosis, and illuminates the path that ICBP is taking to empower a data-informed approach to improve patient survival. Data really can save lives.”
Read more about the ICBP work in this area on the Cancer Research UK website – Emergency presentations: what are they, and what do they mean for cancer survival?