A “tipping point” has been reached in the war against cancer with half of newly diagnosed patients in England and Wales surviving at least 10 years, a landmark study has shown.
Many, though not all, of these patients will be no more at risk of dying than members of the general population.
Cancer survival has changed so dramatically since the 1970s that it is time to adopt a whole new way of looking at the disease, say experts.
“We think it’s time now to shift the narrative and start thinking about 10-year survival from cancer”
Forty years ago just a quarter of patients lived as long as 10 years, and people lived in dread of the “Big C”.
Dr Harpal Kumar, chief executive of Cancer Research UK, which announced the new findings, said: “It’s not very long ago that cancer used to be thought of as a death sentence.
“The reason this 50% figure is an important tipping point is it’s saying that, actually, now half of all patients will survive at least 10 years after a diagnosis and for many it will be very much longer than that.
“I think that does represent a change in the way we should be thinking about cancer.”
Currently, five-year survival is one of the main yardsticks used by clinicians and scientists when assessing cancer outcomes.
Five-year survival is often the “end point” cited in trials of new treatments. Now a more optimistic approach might be justified, said Dr Kumar.
“Up until now the predominant metric we’ve used to look at survival of cancer has been the number of patients or proportion of patients who survive five years or more after diagnosis,” he told journalists at Cancer Research UK’s headquarters in London.
“With the progress that’s been made over the last few decades, we think it’s time now to shift the narrative and to change the language we use and start thinking about 10-year survival from cancer.”
The research, which involved analysing data on more than seven million patients diagnosed with cancer since 1971, showed spectacular improvements in survival for some cancers.
Rates of 10-year survival for testicular cancer had jumped from 69% to 98%, and for malignant skin cancer from 46% to 89%.
Women with breast cancer now had a 78% chance of surviving at least a decade, compared with 40% in 1971. Similarly, the proportion of men living 10 years with prostate cancer had jumped from 25% to around 80%.
But it was not all good news. The outlook remained bleaker for patients with the deadliest forms of cancer, such as those affecting the lung, oesophagus, pancreas and brain.
Fewer than 5% of people diagnosed with lung and pancreatic cancer could expect to live 10 years, and for oesophageal and brain cancers decade-long survival was no more than 15%.
The UK continued to lag behind its comparable European neighbours when it came to cancer survival, chiefly due to GPs missing symptoms, late diagnosis and less effective treatments being offered.
“The progress reported here over the last 40 years shows we’re moving in the right direction”
Cancer Research UK plans to boost its funding by more than 50% with the ambitious goal of seeing three-quarters of cancer patients diagnosed in 20 years time survive at least 10 years.
Over the next five to 10 years, the charity will up its research spending from £350 million to around £525 million a year.
Key priority areas will be probing the root causes of cancer, improving early diagnosis and treatment, expanding personalised medicine, and focusing more on the deadliest cancers.
Professor Michel Coleman, head of Cancer Research UK’s Cancer Survival Group at the London School of Hygiene and Tropical Medicine, said: “We want to see people with every type of cancer get the same chances of living a long life.
“This won’t be easy, but the progress reported here over the last 40 years shows we’re moving in the right direction.”
The study, based on data from 7,176,795 adults in England and Wales diagnosed with cancer between 1971 and 2011, showed long-term increases in one, five and 10-year survival.
An “all-cancers survival index” was calculated, which combined figures for 21 types of cancer.
Researchers used it to plot the overall upward trend while accounting for changes in patient age and the percentage of cancers with high and low survival.
The length of time 50% of cancer patients could expect to live had risen from just one year in 1971-72, to five years in 2005-06, and 10 years in 2010-11, the study found.
Dr Kumar added: “Twenty years from now we want to see three-quarters of all patients surviving at least 10 years following a diagnosis of cancer. That’s a big step forward from where we are today. We firmly believe that’s achievable.”