How many deaths have been avoided through improvements in cancer survival?

Objective To estimate holy many deaths from cancer have been avoided in Eng land and Wales because of recent improvements in survival. Design Analysis of national statistics. Setting England and Wales. Subjects 1.5 million adults with diagnosis of one of 47 different cancers d uring 1981-5 or 1986-90. Main outcome measures Reduction in number of cancer deaths within five year s of diagnosis among patients with cancer diagnosed during 1986-90 compared with patients with cancer diagnosed during 1981-5, Results 17 041 deaths were avoided within five years of diagnosis among pat ients with cancer diagnosed during 1986-90. This represents 3.3% of the can cer deaths that would have been expected if survival had been the same as f or patients with cancer diagnosed during 1981-5, Two thirds of the avoided deaths arose from improvements in survival for just five cancers: female br east cancer (4822), cancers of the colon (2560), rectum (1090), and bladde r (1157), and melanoma of the skin (1098). The largest proportionate reduct ions in excess deaths were for melanoma of the skin (23%) and cancers of th e testis (17%) and bone (17%). About 12 000 (70%) of the avoided deaths aro se among adults aged under 75 at death. Improvements in survival from cance rs of lung, prostate, stomach, ovary, and brain were small: the) accounted for 33% of all cancers but only 11% of avoided deaths. Conclusions Small gains in survival from common cancers save more lives tha n larger gains for uncommon cancers. If recent rates of improvement in canc er survival continue, about 24 000 deaths within five years of diagnosis wo uld be avoided in patents aged under 75 by the year 2010, representing abou t a quarter of the government's overall target of 100 000 fewer cancer deat hs.