Cancer Scotland: 'Ticking timebomb' looms as study shows treatment in Scotland lags behind rest of UK and other countries

Cancer Research UK has urged the Scottish Government to deliver on promises made in a recent strategy to tackle the disease following the study published in the Lancet Oncology.

Researchers from University College London – part of the International Cancer Benchmarking Partnership (ICBP) – studied data of more than 780,000 people between 2012 and 2017 in Australia, Canada, Norway and the UK, looking at the proportion of patients treated with chemotherapy or radiotherapy and the waiting times they face.

In Scotland, 29.3 per cent of patients were treated with chemotherapy – higher than only Northern Ireland where 28.8 per cent were recorded – and 19.9 per cent were treated with radiotherapy, the same as Northern Ireland, but 0.2 per cent higher than in England.

The UK figures were lower than the other countries studied, with 39.1 per cent of Norwegian cancer patients being treated with chemotherapy and 22.5 per cent with radiotherapy.

In the included Canadian provinces, 38.5 per cent were treated with chemotherapy and 25.7 per cent with radiotherapy and the two Australian states included – New South Wales and Victoria – boasted 42.1 per cent and 23.9 per cent respectively.

Scotland also showed the worst waiting times for chemotherapy in the UK, with patients waiting on average 65 days, compared to 58 in Wales, 57 in Northern Ireland and 48 days in England.

Waiting times for chemotherapy in Scotland were higher than all but one of the surveyed regions in other countries, with those in the Saskatchewan province of Canada waiting on average 74 days, while nearby Manitoba was also on 65 days.

In New South Wales, Australia, the wait was far lower at 43 days and 39 in Norway.

For radiotherapy, the UK fared even worse, with it taking 63 days to start treatment in England, 53 in Northern Ireland, 79 in Scotland and 81 in Wales.

In Alberta, Canada, the figure was 48 days and 53 days in British Columbia, while in New South Wales, Australia, it was 43 days.

Scottish Conservative shadow health secretary, Dr Sandesh Gulhane, said: “These damning studies exposes the ticking timebomb Scotland is facing in relation to cancer cases on the SNP’s watch. It should be a source of shame for the SNP Government that cancer patients here are waiting much longer to start treatment and have also received less treatment in the last five years.

“Across Scotland, people are facing terrifying delays in treatment, especially in our rural and island communities. Everyone knows somebody who has experienced cancer or they will have done so themselves, which makes the findings of these studies truly horrendous.

“Successive SNP health secretaries have failed to meet their cancer waiting time target for well over a decade now, so they cannot use the pandemic as an excuse for their dreadful record.

“The new health secretary Neil Gray needs to urgently get a grip of this crisis. If he wants a place to start, he should adopt the vision we set out in our new health paper, which would deliver a modern, efficient and local health service for the whole of Scotland.”

Dr Sorcha Hume, the public affairs manager for Scotland for Cancer Research UK, said the country should be “striving for world-leading cancer care”.

She said: “The Scottish Government’s new cancer strategy promises to improve cancer survival and provide excellent, equitably accessible care for all cancer patients in Scotland, so it’s crucial the Scottish Government delivers on its promises.

“A particular focus should be those set out in the strategy’s first three-year action plan, including the commitment to rolling out new pathways for patients and addressing the current workforce issues facing cancer services.”

Cancer Research UK said delays to begin treatment are partly the result of the UK government’s lack of long-term planning on cancer in recent decades. It said countries with more robust cancer strategies backed by sufficient funding have seen larger improvements in survival than in the UK.

The charity also said workforce and capacity shortages across the UK health system were barriers to delivering chemotherapy and radiotherapy.

Michelle Mitchell, chief executive of Cancer Research UK, said: “The UK should be striving for world-leading cancer outcomes. All cancer patients, no matter where they live, deserve to receive the highest quality care.

“But this research shows that UK patients are treated with chemotherapy and radiotherapy less often than comparable countries.

“When it comes to treating cancer, timing really matters. Behind these statistics are people waiting anxiously to begin treatment that is key to boosting their chances of survival. We can learn a great deal from other countries who have stepped up and substantially improved cancer services.

“With a general election on the horizon, the UK government has a real opportunity to buck the trends we see in this research and do better for people affected by cancer.”

Dr John Butler, clinical lead for the International Cancer Benchmarking Partnership and an ovarian cancer surgeon, said: “For many aggressive cancers, such as ovarian, lung and pancreatic cancer, it’s vital that people are diagnosed and start treatment as soon as possible.

“Lower use of chemotherapy and radiotherapy in the UK could impact people’s chances of survival, especially for older patients. Although we have made progress, the last benchmark showed that cancer survival in the UK is still around ten to 15 years behind leading countries.

“This study captures missed opportunities for patients in the UK to receive life-prolonging treatment.”

A Scottish Government spokesperson said: “Cancer remains a national priority for the Scottish Government and we are treating almost 50 per cent more patients on the 62-day cancer pathway than ten years ago. The 62-day standard remains challenged. However, the median wait is 50 days from urgent suspicion of cancer referral to first treatment.

“We recognise that this data cover the time period between 2012 and 2017 and there has been continued improvement to services since. We are working with Public Health Scotland to understand whether the identified differences in the use of radiotherapy and chemotherapy in Scotland compared to other countries can be explained by the different needs, and age profile, of patients in Scotland.

“Access to treatment for cancer is vital. However, it is crucial that treatment decisions are aligned to patient choice and clinical judgement on what is best for individual patient outcomes.”