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'Considerable scope' remains to improve NHS cancer care, says NAO

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The NHS has made progress in improving cancer services over recent years, but significant socio-economic and geographical variations remain, according to the National Audit Office.

Since the NAO last reported on cancer services in 2010, it said overall outcomes for cancer patients have continued to improve.

However, it warned that “significant variations” in outcomes and access to services persist across England, indicating that there is “considerable scope” for further improvement.

In its latest report, the NAO highlighted improvements in the proportion of people surviving for one year and five years after diagnosis has increased to 69% and 49%, respectively.

But it noted that data on five-year survival rates published in 2013 showed that survival rates remained about 10% lower than the European average.

“Good progress” has also been made on collecting information about cancer, although “some data gaps” remain. For example, the proportion of newly diagnosed cancers with “staging data” – a record of how advanced a cancer is at diagnosis – increased from 33% of cases in 2007 to 62% in 2012.

However, the NAO pointed out that outcomes for cancer patients and access to services vary significantly across the country.

“We still have a long way to go if we want to make sure that everyone diagnosed with cancer has access to the highest quality care”

Juliet Bouverie

It noted that they were generally poorer for older patients, in particular, and that those from more deprived socio-economic groups are also more likely to experience worse outcomes.

In addition, while cancer awareness campaigns have increased knowledge of cancer signs and symptoms, one in five people are still diagnosed via an emergency presentation, said the NAO report.

“Of course, there will always be variations in cancer outcomes, but the significant variations across the country, and the poorer outcomes for older patients and those from more deprived backgrounds, show that there is potential for improvement,” said Amyas Morse, head of the NAO.

Juliet Bouverie, director of services and influencing at Macmillan Cancer Support, said: “There have been some considerable improvements in cancer survival rates over the past five years in England.

“Today’s welcome report highlights not only the progress that has been made but also reminds us that we still have a long way to go if we want to make sure that everyone diagnosed with cancer has access to the highest quality care and the best possible chance of surviving cancer,” she said. 

“If we want to get serious about improving our survival rates in England then we are going to have to address some of the inequalities this report highlights,” she said. “This means giving older people cancer treatment and care based on their needs, not on their age. 

She added that the general election in May was the “perfect opportunity” for political parties to commit in their manifestos to improving cancer survival rates, especially for older people.

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