Was the first Cancer Plan in 2000 a flop?

No. It focused attention on cancer services and undoubtedly had some positive results, including shorter waiting times, extended screening, and reorganisation of services. Death rates are falling and survival rates improving, although this cannot wholly be attributed to the plan.

What is the change of emphasis with the new strategy?

The only really new element is the emphasis on improving the lives of people living with cancer. As treatments improve and survival lengthens, there are more such people, and they have tended to be neglected. They face difficulties in returning to work and need social, financial and emotional support. Charities who care for cancer patients have welcomed this shift.

Are British cancer survival rates lagging behind other developed nations? Why is this?

The evidence suggests that this is the case, but needs to be interpreted with great care. Few countries have such good systems for counting cancer patients. Many extrapolate from very limited sampling, and may produce false results. Diagnosis in the UK is also good, so we do not include many patients with symptoms that are on the borderline, as some countries do. That means that like may not be being compared with like. These comparisons are valuable, but can easily mislead.

Will the high profile measures on tobacco vending machines and sunbeds make much of a difference?

Not immediately. But anything that cuts smoking or the risk of skin cancers makes sense.

What does Britain really need to do to improve treatment and survival rates?

There is huge room for improvement in radiology, the neglected part of the cancer patient's journey. We have too few machines, often awkwardly located for the lengthy series of treatments that patients need. And we still fail to dispense as many of the modern cancer drugs as other countries do. It is true that these drugs are expensive and may only prolong life by a month or two, but cancer therapies advance slowly. If the NHS is always slow to prescribe the latest drugs it will tend to lag behind.

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