Researchers examined cancer survival trends using data from more than 10 million adults diagnosed over the last 48 years
Survival for all cancers combined has increased dramatically since the 1970s, but progress has slowed down in the past 10-15 years, according to a landmark study by the London School of Hygiene & Tropical Medicine (LSHTM).
Spanning nearly 50 years, the research included anonymised data for over 10 million adults diagnosed with cancer in England and Wales between 1971 and 2018, with follow-up to 2019. The data were provided by population-based national cancer registries.
The research was conducted by the Cancer Survival Group at LSHTM, which studies trends and inequalities in cancer survival between socio-economic, racial and ethnic groups of the population, and differences in survival between regions and countries in the UK and worldwide.
The paper, published in The Lancet Regional Health - Europe, shows that survival for all cancers combined (the Cancer Survival Index*) has increased dramatically since the 1970s. In 2018, the overall likelihood of 10-year survival for all cancers combined stands at 49.8%, compared to only 23.7% in the early 1970s.
However, the study showed that the speed of improvement in the survival index for all cancers combined has slowed - it increased nearly three times faster in the early 2000s than in the early 2010s. The authors suggest that pressures on NHS cancer services, resulting in longer waits for patients to receive diagnosis and treatment, could be contributing to the slowdown in progress.
The all-cancers survival index does not show the chances of survival for an individual patient with cancer. Instead, it is designed to help monitor long-term progress in the overall effectiveness of the healthcare system in managing all cancers. It is a crucial tool to inform priorities in the government's National Cancer Plan for England, planned for the autumn.
Breast, bowel and cervical cancers are among the cancer types that have seen large improvements in survival, partly due to effective screening programmes in which patients are often diagnosed at an earlier stage, when the cancer is easier to treat. Improved awareness of symptoms and innovations in treatment have also contributed to better outcomes for many cancers.
The remarkable progress for some types of cancer has not been seen for several of the more lethal cancers. Ten-year survival for cancers of the oesophagus, stomach, lung and brain has increased very little in the past 50 years, and remains below 20%, whilst for pancreatic cancer, survival after 10 years is still less than 5%. These forms of cancer are harder to detect and treat, which is why targeted research in this area is vital.
As a result, the difference in survival between cancer types in the UK is now bigger than it has ever been. Survival for 10 years or more ranges from 97% for testicular cancer to just 4.3% for pancreatic cancer.
Professor Michel Coleman, lead researcher and Professor of Epidemiology and Vital Statistics in the Cancer Survival Group at the London School of Hygiene & Tropical Medicine, said: "The Cancer Survival Index (CSI) is a one-number summary of net survival for all cancers combined. It is an important policy tool. Trends in the CSI provide a real-world baseline from which to develop and monitor targets for the National Cancer Plan.
"The UK cancer registries are crucial for informing cancer control priorities, such as the new National Cancer Plan for England. If the cancer registries had not collected and curated the data, over many decades, the analyses we report would be impossible."
Professor Claudia Allemani, co-author and Professor of Global Public Health at LSHTM, said: "For patients diagnosed in 2018, the CSI for all cancers combined at 10 years after diagnosis (49.8%) is now higher than the CSI at one year for those diagnosed during 1971-72 (46.5%).
"That is a remarkable improvement, but allowing this trend to stall will have devastating consequences. Pressures on NHS cancer services result in longer delays for patients to receive diagnosis and treatment. The proportion of patients who are diagnosed at stage 1 or 2 is still well below the 2028 target of 75%. The National Cancer Plan should exploit our population-based research to improve NHS cancer pathways and accelerate trends in survival. The Government must take this opportunity."
Dr Veronica Di Carlo, co-author and Research Fellow at LSHTM, said: "This study was only possible because anonymised records for millions of patients from cancer registries in England and Wales were available for our research.
"It's vital that Government provides the political and financial support to ensure that the national cancer registries can thrive. Without these crucial data, the Government will be flying blind on cancer control strategy to support all cancer patients."
Cancer Research UK funded the study. The charity's chief executive, Michelle Mitchell, said: "Thanks to research, most patients today are far more likely to survive their cancer than at any point in the past.
"But the reality is that this progress is slowing - and for some cancers, it never got going in the first place.
"The upcoming National Cancer Plan for England must include commitments to spot more cancers earlier, as well as backing research into new treatments so that each patient, regardless of their diagnosis, can hope for more moments with the people they love."
The authors acknowledged the limitation that more recent data, i.e. post-2018, were not available until very recently. Data on the stage at diagnosis and treatment of each patient were not available to help interpret the deceleration in cancer survival trends since 2010.
Publication
Coleman M et al. Trends over 48 years in a one-number index of survival for all cancers combined, England and Wales (1971-2018): a population-based registry study. The Lancet Regional Health - Europe. DOI: 10.1016/j.lanepe.2025.101385
*The Cancer Survival Index (CSI) is a standardised, one-number summary of net survival for all cancers combined. It captures trends over time and differences in survival by age, sex and type of cancer, and in the risk of death from other causes. It is designed to help monitor long-term progress in the effectiveness of the healthcare system for managing all cancers.
