Dudley Strategy for Tackling Health Inequalities 2010-15

One of the priorities of the Cancer Reform Strategy (Great Britain. Department ofHealth, 2007) is to diagnose more cancers early. The most suitable indicator todemonstrate early presentation with signs and symptoms of cancer is the stage ofcancer at diagnosis, but this important information is not universally available atpresent.1 year cancer survival rates can be used as a surrogate measure for stage of spreadof cancer at presentation, poor survival rates associated with advanced stage atpresentation. Advanced stage presentation can be related to delayed attendance ordelayed diagnosis. 5 year survival is an indicator of outcome including stage atpresentation and the quality of care provided. Factors known to impact upon 5 yearsurvival rates are socio-economic status and uptake and compliance withappropriate high quality treatment.At PCT level the number of cases for many cancers can be small leading to sensitiveresults that require careful interpretation. Therefore it was agreed nationally that onlythe four tumour sites of breast, lung, colorectal and prostate were sufficiently largeenough at PCT level to provide robust analyses.As a comparator the Eurocare4 1 year survival rate has been incorporated into thetables as a consensus target for the four main tumour sites. The Eurocare4 project isbased on a collaboration established in 1989 between the Istituto Nazionale Tumori(Milan, Italy), the Istituto Superiore di Sanità (Rome, Italy) and a large number ofpopulation-based cancer registries, from12 European countries, with incidence andsurvival data available. However care should be taken when comparing these dataas the methodologies for collecting this information does differ across the countriesincluded.127