NHS England has undertaken some initial analysis of the causes of poorer survival rates in older people. This suggests that several issues contribute to poorer survival in older adults. These include the fact that the chances of diagnosis at emergency presentation increase with age and that older patients are more likely to have co-morbidity which may impact on survival during and after surgery. There is also some evidence that access to surgery, chemotherapy and radiotherapy for older patients has historically been worse than for younger patients. Previous work by the National Cancer Equality Initiative and the National Cancer Information Network has identified that cancer treatment rates decline with age.
The International Cancer Benchmarking Partnership has sought to understand how and why cancer survival varies between countries, including among older people. The partnership has generated insight and understanding that will help all partners improve cancer survival outcomes by optimising cancer policies and services.
Evidence from this initiative suggests that late diagnosis and treatment are crucial factors in England having lower survival rates than other comparable countries (i.e. countries with good data collection systems and similar levels of development). We also know that the most important reasons for late diagnosis are low awareness of the signs and symptoms of cancer; and delays in patients presenting to their doctors.