I'm a cancer doctor, these are the reasons why the UK has worse survival rates than other countries and it should not be this way

The last time these comparisons were made was in a study of bowel cancer published in the journal GUT which looked at data from patients diagnosed from 2010. It showed that UK patients did worse compared to those in Scandinavian countries, Australia and Canada. Patients from these countries were twice as likely to present with the earliest and most easily treated form of cancer (stage 1). Additionally, the UK patients had a 10% higher percentage of late stage, less-curable, at presentation (stage 4). What's more, the five year survival for people with stage 4 disease was more than double that of the UK versus Norway (8% v 17%).

This latest report from Macmillan is significant because it analysed up-to-date figures and also highlighted that improvements in cancer outcomes are improving at a much faster rate in Norway than the UK. The report was timed to be published before the general election to make an important point to political parties that they all should priorities cancer services in their plans for the UK.

The reasons for this disparity is multifactorial and not completely established. Cancer survival rates can differ significantly between Western countries due to a variety of factors, including healthcare system differences, access to and quality of medical care, early detection and screening programs, socioeconomic disparities, lifestyle factors, and variations in cancer types and stages at diagnosis.

As a UK oncologist, although clinics are regularly over booked, I do have access to similar high cost drugs as Norway via system called the Cancer Drug Fund. This is available across the whole of the UK so there is no post code lottery anymore. A bigger issue is likely to be that more people are presenting, later, with more advanced disease which requires more intensive treatments and are less likely to be cured. It is clear we need to invest in screening for cancers at a younger age where the incidence is rising fastest, promote more public awareness campaigns about cancer symptoms and the importance of early detection.

The other factors are likely to relate to the UK's poor exercise, dietary and lifestyle habits. Compared to Scandinavia, we have more type two diabetics, have a much higher obesity, our teenagers drink more alcohol and exercise less. These factors not only increase the risk of cancer they are also linked to more aggressive forms of cancer when they develop. It's a sad reality that, when I and other oncologist give chemotherapy and other biological treatments to patients with poor lifestyle habits, they tolerate them badly, require more breaks in treatment and ultimately have a reduced effectiveness and chance of cure. This may well explain the differences in survival rates between the UK and Norway for stage 4 disease. Although oncology departments would always welcome more funding, perhaps the most significant finding of this report may be not that the UK has struggling and ailing cancer services but has a struggling and ailing population. As a nation, we need to adapt better lifestyle habits particularly exercising more, eating less calories and sugar, drinking less alcohol, looking after our gut health, eating more fruit, vegetables and fibre and less processed meat.