Abstract

Background The successful treatment of cancer is a major health and political issue in England & Wales and also in the Major Developed Countries (MDC). All Malignancy deaths by age and gender are analysed to determine how successful the MDC were in reducing cancer deaths between 1979-2002 within the context of the each nations Gross-Domestic-Product-Expenditure-on-Health’ (GDPEH) over the period. Method Incidence rates of new cancers in England & Wales are examined for 1979-80 to 2003-04 to highlight extent of the problem. Set in the context of GDREH for each MDC 1980-2002 as an indicator of how each nation has responded to the challenge of cancer. The changing cancer mortality rates for England & Wales are compared with each MDC by age and sex using WHO All Malignancies mortality rates over the period 1979-81 to 2000-02. Chi square tests are used to compare outcomes between England & Wales with each MDC. Results 1] Men’s All Age malignancy incidence in England & Wales rose 48% and women’s 51% with notable rises for females aged 15-34 and 55-74years. 2] Every MDC increased GDPEH substantially UK up to 9.3% but remains 8th of ten MDC and still below the MDC average (9.85%). 3] England & Wales men’s average (15-74years) deaths were 3rd highest in 1979-81 but fell to 8th by 2000-02 declining significantly more than 7 other MDC. England & Wales women’s average (15-74 years) rates were highest in 1979-81 and in 2000-02 but declined significantly more than most MDC in every age band from 35-74 years. 4] Most MDC countries men’s rates declined significantly more than their women’s except Japan and Spain but the improvements in men’s cancer death were not matched in women’s rates especially the 35-54’s. Conclusions: Rising incidence poses problems for every MDC but especially for England & Wales as does the relatively low Anglo-Welsh GDPEH whilst poorer women’s results should be a matter of concern for most MDC. The reductions in cancer deaths reflects well on all front-line services indicating what can be achieved with improved GDDPEH but should not obscure the challenge of the rising incidence of cancer.