It’s possible to see some of that improvement in ICBP data on bowel cancer.
Denmark and the UK had among the worst 5-year net survival for rectal cancer during the 1990s. Both have improved, but while the UK still sits at the bottom of the table, Denmark is now the second best performing country. By 2014, almost 7 in 10 people diagnosed with rectal cancer in Denmark were surviving the disease for at least five years, compared with just over 6 in 10 in the UK. Similarly, survival for colon cancer in Denmark has improved more rapidly than it has in the UK.
Now, with more people surviving, Denmark’s most recent plan has shifted to focusing on what happens after successful treatment.
“The good thing is we now have a lot more people surviving cancer,” says Fisker. “There are about 400,000 people living after cancer in Denmark, which is a lot in a population of 6 million. But that also poses new questions on the long-term effects of treatment. How do we work with that? So, the highlight of the new cancer plan is developing rehabilitation and late effect initiatives.”
A long-term research perspective
Fisker is clear that Denmark still has a long way to go – particularly in terms of preventing cancer. The success the country has seen so far is no reason for it to stop building towards something better.
“If we were only committed for a few years, we wouldn’t have made any progress at all,” he explains. “It’s the fact that we’ve had 25 years of consistent commitment, politically, economically and clinically. You have to have the long-term perspective.”
Few areas demonstrate the importance of that long-term perspective more clearly than research, where the biggest advances take years of careful work. In Denmark’s case, research showed policymakers how best to assemble the different plans and components.
“Without continuous research it would be impossible to make developments,” Fisker says. “We’ve spent a lot of money on research across this whole period, especially on research into what we do in the clinic, with treatment procedures and national guidelines. That’s played a major role in the improvement.”
What we can take from Denmark
England and Denmark are unique countries, so we’ve used our own research to advise the UK Government on the specific policies we need to make England’s National Cancer Plan a success. We’re not building exactly the same thing – England invented jigsaw puzzles rather than Lego – but we still need to commit to putting the pieces together.
“Denmark is a powerful example because we started at the same place in the league table,” says Sample. “We have very similar health systems and we have access to similar data. They saw they had a burning platform and they used it to drive change. Unfortunately, it doesn’t feel like we have consistently.”
That inconsistency is most obvious in England’s six year stretch without any dedicated cancer plan at all. But just taking the first step to changing that can help create the momentum for things to keep getting better.
“We’ve worked in an atmosphere of progress, with long-term agreement between political parties,” says Fisker. “Because we agreed to prioritise cancer, we were able to pave the way forward. If it’s the opposite then you can do absolutely nothing because then you have to justify every penny and every change individually.”
That’s why the England’s upcoming National Cancer Plan is so vital – it’s the Government’s chance to lay out a path to real and lasting change for the nearly 1 in 2 people in the UK affected by cancer.
“What we learn from Denmark is that it is achievable to do better,” says Sample. “And now we’ve got a once in a decade opportunity to follow their example, because this plan is going to set the direction of travel for cancer services and cancer care. Ultimately, it’s going to determine whether we can improve England’s cancer outcomes to be among the best in the world.”
Read here for more on what we’re calling for in the National Cancer Plan for England.