Cancer survival rates disputed

Britain's biggest cancer charity advised caution yesterday over suggestions that long-term survival rates for lung cancer patients were showing sharp improvements.

Doctors in Finland have reported that the proportion of sufferers who live for more than five years after diagnosis has trebled in two decades, possibly due to earlier diagnosis, and better surgical techniques and post-operative treatment.

But figures in Britain show little movement in the 5% to 6% of patients clearing the five-year hurdle between the early 1970s and early 1990s, said Cancer Research UK.

A report by the Finnish team, published in the European Respiratory Journal, said a comparison of its recent study of 600 lung cancer patients in the northern province of Oulu with a study of nearly 450 sufferers in the same area 20 years before indicated that 12% of sufferers were now surviving five years compared with 4% earlier.

The figures varied between different types of lung cancer. The five-year survival rate for patients with adenocarcinoma, which develops among cells lining the airways, seemed almost five times higher than it had been (19% against 4%).

However, two-year survival rates for the most vicious kind - small cell lung cancer, where the cells have a distinctive "oat" shape, had improved only slightly, from 14% to 19%.

Riitta Mäkitaro , from Oulu University, said: "Basically, whenever the disease is diagnosed early, it can be treated more effectively and the chances of survival improve."

Lung cancer deaths among men in Britain have fallen sharply since the mid 1980s, reflecting big changes in their smoking habits since the 1950s. There were still 21,130 deaths in 1999, representing more than a quarter of all deaths from cancer among men. But this was a 39% drop on 1984. The incidence in the population fell by 34% in the same period.

However, deaths from lung cancer among women have gone up 4% over the same 15 years, and the incidence by 17%. This is probably because women did not take up smoking in large numbers until the 1960s.

Trials are under way to establish whether the drug thalidomide, which 40 years ago caused birth defects in babies born to women using it against morning sickness, can prove effective in shrinking small cell cancer tumours.

Sara Hiom, science information officer at Cancer Research UK, said the Finnish results were "great news" for people in that area, but the study was unlikely to be large enough to be representative. "If only we could extrapolate that result to the rest of the world."

Early diagnosis was important and the use of scanners in the United States suggested some improvements. "These are expensive machines and it is not certain the NHS can afford many of them."

The tobacco companies were now targeting developing countries. "That is where where we are going to see serious increases in mortality. They are poor and won't be able to diagnose or treat the disease."