Public Health Scotland (PHS) has contributed to three recently published studies on cancer – with one showing that cancer-related deaths have significantly declined over the last 25 years for middle aged men and women.

A study led by Cancer Research UK published in the British Medical Journal, shows a substantial decline in cancer-related deaths over the last 25 years in men and women aged 35-69.

In part, the researchers attributed the reduction in cancer-related deaths observed between 1993 and 2018 to successful public health work including prevention policies and screening programmes.

Catherine Thomson, Service Manager for Cancer and Adult Screening at PHS and contributing author, said:

“Results from this study note the impact and benefit of national cancer screening programmes. These have led to an increase in the numbers of cancers being picked up early, potentially, before the point where people experience symptoms.”

This research analysed cancer incidence rates and mortality trends for common cancers and found ‘significant reductions’ in morality for lung and bowel cancers for both men and women.

Reductions in mortality were also observed for breast and prostate cancers, despite an increasing number of cases reported over the time period.

Alongside smoking cessation policies and other preventative efforts, researchers say decreased mortality has resulted from screening programmes that have allowed earlier detection of some cancers, improved diagnostic tests and more effective treatments.

These longer-term findings have been published just weeks after a four-year review of Scotland’s rapid cancer diagnostic network revealed the services improve patient outcomes.

Ms Thomson said:

“For breast cancer, screening combined with the many new different treatment options now available, means more women are living longer after their cancer diagnosis.

“Smoking is the biggest preventable cause of cancer and the reduction in smoking over the 25 years has led to a fall in deaths from lung cancer, and several other cancers. We also know that the second largest cause of cancers is obesity.

“If we want to see cancer deaths continuing to fall in the future, more needs to be done to address this, much like the efforts used to tackle smoking.”

This is one of three cancer studies that Scotland’s public health body has recently contributed to. The others investigated the success of chemotherapy and radiotherapy across Scotland, the rest of the UK, Canada and Australia.

These population-based studies marked a collaboration between PHS and international researchers, looking at where improvements can be made in cancer care by understanding information from across the world.

The researchers here noted that they were limited in terms of information on the distance between nearest radiotherapy centre and a patients’ residence – a key factor in radiotherapy use, particularly for rural patients.

This echoes findings from Aberdeen researchers who found that people in Orkney and Shetland experience worse outcomes a year after diagnosis than those who live closer to their nearest cancer centre.

Published in the Lancet Oncology, these wider International Cancer Benchmarking Partnership studies found large variation in the different health systems in the frequency of use for both radiotherapy and chemotherapy, as well as waiting times.

Researchers say the reasons behind this difference across health systems and places must be investigated to improve care delivery and patient outcomes.

Professor David Morrison, Director of the Scottish Cancer Registry, PHS said:  

“These recent publications raise questions about why there are differences in the uses of radiotherapy and chemotherapy in other countries, as well as in waiting times for cancer treatment in Scotland.

“We need to understand whether differences in treatment can be explained by the differing needs of patients in Scotland.

“To help answer these questions, PHS has developed a dashboard reporting on the use of chemotherapy across NHS Scotland and is also linking data on waiting times with other measures of health and treatment to better understand any effects on patients’ outcomes.”

PHS collaborates with partners to collect, analyse and interpret comprehensive information on Scotland’s cancer pathways to better understand how to improve treatment and survival.

Read more: ‘Weaknesses' found in Scotland's cervical screening; Making cervical cancer a ‘rare disease'; Biomarkers can improve melanoma patient care; Pandemic impact on cancer incidence in Scotland; Microwaves offer less invasive cervical cancer therapy; All cancer patients to access extra support by 2024 

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