Late Diagnosis Blamed For UK Child Cancer Survival Rates

Children with cancer in Britain have lower survival rates than in other western European countries because the NHS gives them low priority, research reveals today.

Experts in paediatrics and cancer research investigated why only 30% of children in Britain survived neuroblastoma, a tumour of the adrenal gland, compared with 46% in Germany, Belgium, the Netherlands, Luxembourg and Switzerland.

In a keynote comment for today’s issue of The Lancet Oncology, they said the most likely reason was late diagnosis caused by inadequate medical monitoring.

In Germany, most children have a primary care paediatrician and those with cancer can be identified during routine health checks. In Britain, NHS guidelines are less thorough with fewer routine examinations recommended.

“Although there is a national service framework for children, there are no targets and children continue to be a low priority for the NHS,” said Alan Craft, of the Institute of Child Health at Newcastle University, and Kathy Pritchard-Jones, of the Royal Marsden hospital in London.

The report says “survival for childhood cancer is just one example of the worse state of children’s healthcare in the UK compared with many other countries”. Mortality rates tables show the UK in 15th position in Europe.

They researchers added: “We need to persuade politicians to … make an appropriate level of investment, ensuring that the UK improves by comparison with the best-performing countries.”

The Lancet paper looked into how Wilm’s tumour, another common childhood cancer, affecting the kidney was detected in Germany and Britain between 1994 and 2001. In Germany, 27.4% of patients had the cancer first identified during a visit to a health professional for an unrelated problem or during routine surveillance. But in the UK, only 11% of children treated for the tumour at the Royal Marsden and 4% at the Newcastle hospitals had the cancer identified in this way. In Germany, early diagnosis by routine or incidental examination was linked to the increased survival, the authors concluded.

Prof Craft said last night: “Part of the concern is the whole question of children’s health being a low priority for the government. Waiting lists and hospital beds keep chief executives awake at night, but I don’t think the health of children does.”

Carole Easton, the chief executive of the childhood cancer charity CLIC Sargent, said that UK survival rates for childhood cancer had increased over the past 30 years, with seven out of 10 children now surviving the illness. Alex Markham, senior medical adviser for Cancer Research UK, said: “Five-year survival from childhood cancer in the UK has reached 77%, and for some types of the disease, survival is over 90%.”

Much of the data for the Lancet paper was collected between 1977 and 1997. “Since 1997, specialists in the UK have been working with their counterparts across Europe to standardise and improve the treatment and management of children with cancer,” said Prof Markham.

The Department of Health said that the number of children successfully treated for cancer had risen from 25% in the 1960s to about 75%.

A DoH spokeswoman said: “Children are a high priority for the NHS. We recognise there is more to do so that our services match the best in Europe.”