Building a Cancer Survival Index – Inequalities in Cancer Outcomes Network

The Cancer Survival Index is a tool that is used to output a single number that summarises the overall patterns of cancer survival for a wide range of cancers with very different outcomes. The idea is to use three-way standardisation to account for changes in incidence of different cancer types, for sex, and for age at diagnosis, to gain insight into how well we are treating cancer.

Typically, survival is only calculated for specific cancers. While this is useful for assessing specific diseases, it’s challenging to get an overall picture of how well the country is dealing with cancer. That’s why in 2010 the then National Cancer Director in the Department of Health commissioned LSHTM staff to build and deliver a tool to measure the overall state of cancer services at both a national and a local level.

The tool accounts for sex, age, and cancer type when taking in national cancer data to provide a normalised result that represents the overall effectiveness of cancer care.

The tool, whose development is now available in Cancer Epidemiology, has been used for years as an important benchmark for the Government and organisations such as Cancer Research UK. It has also been used by the ONS to evaluate regional cancer care changes via integrated care boards, which replaced clinical commissioning groups in 2022.

The index was used at a national level to support CRUK’s 2015-2030 vision, fed into numerous public funding campaigns, and informed online information blogs. Most recently, results from the index were used in national media coverage on World Cancer Day 2024, highlighting slowing improvements in cancer survival in the UK. Results from the index were also presented to the then Chair of the Cancer All-Party Parliamentary Group, John Baron.

A figure from the paper showing estimated trends in net survival.

Manuela Quaresma, who has worked on the index since its inception, said, “Now, 14 years since being first commissioned, ICON are pleased to say that all the information required to construct a similar cancer survival index are available open source, including a synthetic dataset (Replica) and R code that will enable the user to replicate the estimation of the index.

“We hope in the true spirit of science that this information sharing will enable colleagues, collaborators, and other researchers across the globe to construct their own indexes for different countries and help track and improve cancer care worldwide.”