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UK lung cancer patients less likely to receive advanced treatments

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A patient receives an injection of a BioNTech mRNA cancer immunotherapy for non-small cell lung cancer (NSCLC), known as BNT116, as part of the first clinical trial for the lung cancer immunotherapy in the UK in August 2024

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UK patients are less likely to receive advanced treatments for lung cancer than counterparts in similar countries, potentially contributing to Britons’ lower survival rates, according to the first study of its kind. 

The research found that in parts of Canada, just over half of patients in the later stages of the disease received chemotherapy, compared to 45 per cent in Norway but only 43 per cent across the UK. In Northern Ireland, the proportion stood at just 23 per cent.

Radiotherapy use was also lower in the UK compared to the average across all stages of lung cancer. The proportion of patients receiving the treatment ranged from 32 per cent in England to 50 per cent in areas of Canada. 

Michelle Mitchell, chief executive of Cancer Research UK, acknowledged that more research was needed to understand what had led to the treatment gaps.

But, she noted, the struggling national health service could be a factor, pointing to “the pressures that the NHS is under, with lots of challenges around staff and resources”.

The study, led by the International Cancer Benchmarking Partnership (ICBP) of international clinicians, policymakers and data experts, compared the use of chemotherapy and radiotherapy in a cohort of 280,000 patients from Britain, Australia, Norway and Canada.

People in the UK also waited longer for treatment compared with international counterparts. Fewer than 15 per cent of patients received chemotherapy within 30 days of diagnosis, compared to more than 22 per cent in Norway.  

Improvements in cancer survival across the UK have fallen sharply in recent years, according to experts, with survival rates in the country lagging peer nations for certain categories of cancer.

Cancer Research UK, which managed and part-funded the work, highlighted recent ICBP research that found five-year net survival for lung cancer in the UK stood at just 14.8 per cent.

This compared with 20.4 per cent in Norway, 21.3 per cent in Australia and 21.7 per cent in Canada. 

The study noted that “differences in non-surgical treatment use are plausibly associated with international variation in lung cancer survival”.

Another issue might be late diagnosis, suggested Mitchell. Patients might already be in such poor health when their condition was spotted that it was “not tolerable or medically advised” to undergo the rigours of more advanced treatment.

Some patients might also face a long journey to reach a specialist centre, creating another barrier to treatment.

Mitchell called on ministers to commit to rolling out lung cancer screening to all 55-74 year olds who have smoked across England by 2029, followed by the three other constituent UK nations.

The NHS 10-year plan published last week committed to a rollout but failed to give a timeframe, despite having previously said it would happen by 2030. The government has promised to produce a national cancer plan later this year.

“We need to use this opportunity of the national cancer plan to transform cancer outcomes across the board so we’re world-leading, rather than lagging behind comparative countries,” Mitchell added.

The data, the most recent available that spans multiple countries, covers the period from 2012 to 2017. But Mitchell said she did not think the overall picture had changed in recent years.

The Department of Health and Social Care said it was introducing measures to bring cancer care closer to home and to catch cancer earlier and quicker.

The reforms would “will see around 120,000 more people referred for urgent cancer checks, get a diagnosis within four weeks and start treatment within two months”, it said.

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