On the eve of the Global Innovation Summit, hosted at Queen’s University Belfast, where global leaders are convening to provide tangible, sustainable and equitable solutions to some of the greatest challenges our world has ever experienced, a significant new report has emerged in Lancet Oncology, the recognized global voice of cancer care and research. Our report, entitled “Investing in cancer care in the UK: why aren’t we acting on the evidence?” pulls no punches, providing the undeniable evidence of a cancer crisis and emphasizing the urgent need for action.
The data are particularly stark. Five year survival rates in lung and stomach cancer in the UK languish at 28th out of 33 comparable countries. A decade of mismanagement by the previous administration is reflected in the barely believable fact that the target for commencing treatment 62 days after a cancer diagnosis has not been achieved since 2015. The report emerges as the current Government announces its commitment to delivering a National Cancer Plan.
One area that is causing particular concern in relation to cancer is the cancer workforce. The 2024 workforce census by the Royal College of Radiologists warns of an impending crisis, with a 15% shortfall in clinical oncologists and 30% shortfall in radiologists. A shortfall we can ill afford. The UK has only 0.6 nuclear medicine physicians per 1 million inhabitants, compared with an average of 10.5 in similar countries – an incredible 8-fold difference that undoubtedly contributes to delays in diagnosis and treatment. Workforce shortages are also more acute in areas of the UK such as the Midlands and Northern Ireland, with less than half to a third as many consultant oncologists per 100,000 population as in London, highlighting significant geographical disparities in workforce provision that undoubtedly accentuate significant cancer disparities and inequity across the UK.
The overwhelming evidence that we highlight in the current report and in previous publications[i] of an emerging national cancer crisis has been shamefully ignored by the previous administration, a blatant disregard of the overwhelming evidence. The data in this report re-emphasise the scale of the problem. But they also illuminate a way forward. Updating our equipment and bringing our workforce into line with other similar high-income countries could prevent as many as 30,700 deaths from 11 common cancers in the UK by 2030. Crucially, this approach would also yield a return of £17.30 per £1 invested, an economic benefit of £24.4 billion, emphasising how improving our health can also yield large and sustainable societal gains, as cancer survivors return to the workforce and play an active role in society.
The economic dividend of health is further emphasized if imaging modalities including ultrasound, x-ray, CT, MRI, PET, SPECT, were scaled up to the levels of similar high-income nations. A total of 68,400 deaths from the 11 common cancers could be prevented, yielding even larger net benefits of £52.9 billion – a return on investment of £31.05 for every pound spent. So quiet clearly, our health could also be our wealth.
While it is encouraging that the Secretary of State for Health in the current government, Wes Streeting, has listened to us and taken on board our evidence, prompting his commitment to a national cancer plan, the responses of his colleague, Minister of State for Care Stephen Kinnock, at a recent Westminster Hall Debate suggest that such a plan may be as much as a year away. Sorry Mr Kinnock, we are, of course, delighted that our evidence has prompted a positive response from the new Government. But cancer doesn’t wait, patients don’t have the time to wait, so we can’t either. Heed our warning. The data do not lie. We need to deliver and implement a national cancer plan as a matter of urgency.
About Mark Lawler
The evidence that Mark presented in the House of Commons to the Health and Social Care Select Committee Future Cancer Inquiry is widely regarded as the crucial tipping point for the current Government’s commitment to deliver a national cancer plan, reversing the previous administration’s decision to subsume a cancer plan into a Major Conditions Strategy.
The featured image appears courtesy of a Creative Commons License.
[i] Lawler M, Aggarwal A, Gralow J, Sullivan R, Price P. The UK needs to be a leader, not a lagger, in the global cancer effort. Lancet Oncol 2024; S1470-2045(24)00448-0.
Nolte E, Morris M, Landon S, McKee M, Seguin M, Butler J, Lawler M.Exploring the link between cancer policies and cancer survival: a comparison of International Cancer Benchmarking Partnership countries. Lancet Oncol 2022; 23(11): e502-e514.
Aggarwal A, Choudhury A, Fearnhead N, et al. The future of cancer care in the UK – time for a radical and sustainable National Cancer Plan. Lancet Oncol 2023; S1470-2045(23)00511-9.
