Low lung cancer survival

When one is presented with a blinded report of survival rates for lung cancer across developed countries, how can one identify the result for the UK? Exactly, choose the one with the poorest outcome. You would be correct more often than not (unless Denmark was included).

In 2007 and 2009, the EUROCARE Group published results of cancer survival identifying the UK among the countries with the lowest survival rates for lung cancer in Europe.1 ,2 As expected, this was met with a degree of outrage and attribution of poor UK results to differences in population characteristics and quality of reporting. An articulate defence launched by Moller et al hypothesised ‘less favourable stage distribution in the United Kingdom’ as the likely explanation for poor UK outcomes compared with other European countries compounded by suspicion of ‘incomplete ascertainment of deaths’ in certain countries reporting high survival results.3 Apart from population characteristics and quality of reporting, socioeconomic status within Europe (a surrogate for healthcare spending for the management of lung cancer) has also been cited rendering such comparisons inequitable.4

This week in Thorax, the International Cancer Benchmarking Partnership published survivorship of patients with lung cancer in six ‘wealthy countries’, namely, Australia, Canada, Denmark, Norway, Sweden, and of course, the UK between 1995 and 2007.5 The socioeconomic status differences have been redressed and stage adjustment rectified. At last, the UK has a chance to perform on an equal footing! So, with baited breath, you ask, …