Cancer survival rates and GDP expenditure on health: a comparison of England and wales and the USA, Denmark, Netherlands, Finland, France, Germany, Italy, Spain and Switzerland in the 1990s

Health funding is central to public health planning and clinical practice, hence this comparison of GDP health expenditure and five year post-diagnost ic cancer survival rates of England and Wales with the USA and eight Europe an countries. The three lowest proportional GDP health expenditures over the period 1980- 1900 were Denmark, England and Wales. and Spain. The USA had the highest pr oportional GDP expenditure, followed by France, Germany, and The Netherland s. Overall the USA had the best cancer survival rates in the 14 sites reviewed , followed by Switzerland, The Netherlands. and Germany. The least successf ul were Spain, England and Wales, and Italy. In respect to the high incidence cancers, colorectal, lung, and female brea st cancers, England and Wales survival rates were the poorest of all ten co untries, followed by Denmark and Spain. Higher GDP health expenditure and longer survival rates for each gender wer e significantly correlated indicating a possible association between fiscal input and clinical outcomes, which poses problems for the development of e ffective public health.