Differences in staging and treatment likely to be behind UK’s low bowel cancer survival
Incomplete diagnostic investigation and failure to get the best treatment are the most likely reasons why survival for bowel cancer patients is lower in the UK than in other comparable countries, according to new research published in the journal Acta Oncologica.
The research, led by the London School of Hygiene & Tropical Medicine, was carried out in Australia, Canada, Denmark, Norway, Sweden and the UK for the International Cancer Benchmarking Partnership (ICBP). The study included more than 310,000 bowel cancer patients diagnosed during 2000-07.
Bowel cancer is sometimes called colorectal cancer, which includes cancers of the colon and rectum. This study examined both types of bowel cancer.
The researchers examined how far the patients’ cancer had spread at the time of diagnosis – from very early (localised, stage A) to very late (spread to other parts of the body, stage D). They also examined the proportion of patients at each stage of disease who survived for one year and three years after diagnosis, after correction for the impact of other causes of death.
Two-thirds (67%) of colon cancer patients in the UK survived for at least one year, compared with 80% in Sweden. Three-quarters (75%) of rectal cancer patients in the UK survived for one year or more, compared with 84% in Sweden.
Low overall survival in a particular country can arise either because the patients there tend to be diagnosed at a later stage of disease than in other countries, or because survival at each stage of disease is lower than in other countries.
Bowel cancer survival statistics
One-, five- and ten-year survival statistics for bowel, colon and rectal cancer by age and trends over time are presented here. There are also data by stage at diagnosis, deprivation and by geography. The ICD codes for bowel cancer are ICD-10 C18-C20 and C21.8. The ICD code for colon cancer is ICD-10 C18. The ICD codes for rectal cancer are ICD-10 C19-C20 and C21.8.
The statistics on these pages give an overall picture of survival. Unless otherwise stated, the statistics include all adults diagnosed with bowel, colon or rectal cancer, at all ages, stages and co-morbidities. The survival time experienced by an individual patient may be much higher or lower, depending on specific patient and tumour characteristics. If you are a patient, you will probably find our CancerHelp pages more relevant and useful.
The latest survival statistics available for bowel cancer in England are 2005-2009 (followed up to 2010). Find out why these are the latest statistics available.
One-, five- and ten-year survival
The latest age-standardised relative survival rates for bowel cancer in England during 2005-2009 show that 75.0% of men are expected to survive their disease for at least one year, falling to 54.2% surviving five years or more. The survival rates for women are similar, with 74.0% expected to survive for one year or more and 55.6% surviving for at least five years.
The latest age-standardised relative survival rates for colon cancer in England during 2005-2009 show that 73.0% of men are expected to survive their disease for at least one year, falling to 54.4% surviving five years or more. The survival rates for women are similar, with 72.2% expected to survive for one year or more and 55.1% surviving for at least five years.
The proportion of colon cancer patients diagnosed at the earliest stage (stage A) was lowest in the UK - only 8% compared with 11-17% elsewhere. But UK patients were also less likely to be diagnosed at the most advanced stage (20% at stage D, compared with 24-31% elsewhere).
As with nearly all cancers, relative survival for bowel cancer is higher in men and women under the age of 70, even after taking account of the higher background mortality in older people. The reasons for this are likely to include a combination of better general health, more effective response to treatment and earlier diagnosis in younger people overall. Differences in underlying tumour biology may also play a part for some cancer sites. Five-year survival in the age group 60-69 is slightly higher than the 40-49 and 50-59 age groups though this difference is not statistically significant. The most likely explanation for this slight increase is bowel cancer screening in this age group.
The five-year relative survival rates for bowel cancer in men in England during 2005-2009 ranged from 61.1% in 15-39 year olds to 41.6% in 80-99 year olds. Relative survival was higher (though not significantly higher) in women for most of the age groups, ranging from 65.1% in 15-39 year olds to 43.5% in 80-99 year olds.