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Since the early 1970s, there's been significant progress in the survival rates of some cancers, in particular testicular, skin, breast, and prostate cancers where the 10-year survival rates in the UK have increased, on average from 46% to 86%.
However, the UK still lags comparable European countries in cancer survival, and for some cancers, particularly lung, esophagus, pancreas and brain, the 10-year survival rates are only about 10% or less.
Late diagnosis
In Britain 50% of cancer patients are diagnosed late. This is the result of GPs misdiagnosing, and patient's reluctance to visit their doctors.
In his book, Malignant, Stanford University professor S Lochlann Jain suggests cancer diagnosis is missed in young adults because, "doctors often work under the misguided assumption that cancer is a disease of older people." For example, 80% of lung cancers are diagnosed at advanced stages.
Cancer survival rates are expected to improve as technology, and self-education develop. This is expected to reduce the role of primary care doctors, increase patient-centered healthcare, and reduce late diagnosis.
British stiff-upper-lip
In emerging countries, cancer patients present late because of a lack of education and money. In the UK, where medicine is free at the point of care, the British stiff-upper-lip is often the cause of late diagnosis.
A 2013 comparative study published in the British Journal of Cancer found that there was little difference in the awareness of cancer symptoms among patients, yet the British were less likely to act on them. It concluded that the traditional British 'stiff-upper-lip' means cancer patients are dying unnecessarily because they don't want to waste their GP's time with their symptoms or are too embarrassed to seek help.
Genomic medicine
A number of studies suggest that doctor-patient relationships are sub-optimal and based on asymmetry of information.
Such relationships will change when patients have access to information on their own DNA. Genomic medicine is a game-changer because of its potential to personalize patient care.
It only takes a few hours to sequence a person's genome, and costs are low and falling. A recent survey suggests that 81% of all US patients would like to have their genome sequenced. Eventually, this will mean that most people will have their genome sequenced so they can be properly cared for if they get sick.
Already some scientists and clinicians have started taking advantage of genomic sequencing, to tailor their approaches to individual differences. In this personalized, patient-centred healthcare environment, primary care doctors are less important, and patients more important. As this transformation occurs, early cancer diagnosis and survival rates are expected to rise.
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