Death rates from breast cancer have fallen more dramatically in the UK than any other European county, cancer researchers have said.
The study, which examined mortality rates in 30 countries over the past two decades, challenges claims that survival rates in the UK are worse than anywhere else in western Europe. Researchers, who reported a fall in death rates of about a fifth across all countries, said that the apparently poor survival rates in the UK are misleading because of the way cancer patients are registered, whereas population-based mortality rates are more reliable.
England and Wales, Northern Ireland and Scotland had the second, third, and fourth largest decreases of 35%, 29%, and 30%, coming after Iceland with a 45% drop, according to the study, published in the British Medical Journal. In France, Finland, and Sweden, death rates decreased by 11%, 12% and 16% in comparison.
Anna Gavin, one of the report's authors, said: "We were very pleasantly surprised by the outcome. Despite the fact that the number of cases are going up, and the population is getting older, deaths have still fallen."
Gavin, a public health consultant for the National Cancer Intelligence Network, said that previous studies showing poor survival rates had been a "wake-up call", but as a result there had been investment in the way services had been organised. "Someone with breast cancer is now likey to be seen by an expert, they also have a lot of input from international studies, so patients are getting the best and most up-to-date treatment and their care is monitored very carefully. We expect the next Eurocare study [European Cancer Registry Based Study] will show a much better survival rate."
The study by a team at the International Agency for Research on Cancer in Lyon, France, examined World Health Organisation data on cancer rates for all women from 1989 to 2006 in addition to country specific data. It found that the fall in death rates was greater than 30% in three countries, 20-30% in 12 countries and had increased in four countries.
In the UK, mortality rates fell by about 30%, more than in any other major European country. In France, Finland and Sweden, which have also invested in breast screening and new cancer drugs, mortality rates decreased by 10-16%.
The UK's cancer policy, including screening, had been a success, the authors said, and "the rather bleak picture of UK cancer policy portrayed using breast cancer survival is likely to be erroneous".
In an accompanying editorial, professors Valerie Beral and Richard Peto, from the University of Oxford, agreed that apparently poor UK survival rates were misleading and looked worse than they were because of the way cancers were recorded.
"In contrast with death registration, cancer registration is not statutory in the UK and is known to be somewhat incomplete," they wrote.
"Partly because of this incompleteness, survival calculations based on registry data make UK cancer survival rates seem significantly worse than they really are."
Hilary Tovey, Cancer Research UK's policy manager, said: "This research highlights the great progress we've made in reducing deaths from breast cancer over the past 20 years. The UK has seen greater decreases in the number of women dying from breast cancer than many other European countries over this period, though this is partly because death rates were relatively high in the 1980s. Reorganising breast cancer services, screening, improved awareness and better treatments made possible as a result of excellent research, have all had a role to play."
The shadow health secretary, Andy Burham, said: "These figures are a tribute to the fantastic work of NHS clinicians and a sign that the last Labour government was right to invest to give them the support and the tools they need."Meanwhile, a separate report by the NHS regulator has warned that hospitals could miss key targets for cancer care, infection control and mental health treatment as the health service prepares to make massive cuts.
In its annual review of 129 foundation trusts, the regulator Monitor found leading hospitals and mental health services in England are planning to make cuts of 4.4% – almost 50% more than they have managed before.
At the same time, more than a quarter of the trusts said they were at risk of breaching standards in cancer, superbugs such as MRSA and services for the mentally ill. Monitor warned that the years ahead would be "challenging".
Of the 34 trusts which alerted the regulator that performance could suffer next year, 23 of them identified cancer targets as at risk."For those that have declared a risk to their governance rating, the cancer service performance targets present the biggest challenge ... The 62-day cancer target is the target most at risk of breach for acute and specialist [for example, children's hospitals, women's hospitals, cancer hospitals] foundation trusts."