New UCL research on public attitudes towards cancer research and treatment highlights demand for early diagnosis and access to optimal treatments for individuals of all ages.
As fear of Covid recedes New Research shows that Cancer is Britain’s Top Health Concern
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The full report can be downloaded here:
Half of all British adults say cancer is the non-infectious disease for which they most want better protection for themselves and their families. New UCL research, published today , reveals high public demand for innovative diagnostic technologies such as single blood tests for multiple forms of cancer and access to optimally effective cancer treatments. The priority given to better cancer care links to the fact that 40% of adults say their lives have been changed because people important to them have been harmed by cancer.
Three quarters of the UK population say they want to be regularly tested for cancers when blood tests become available. Almost 9 out of 10 think that people aged over 70 have as much right to effective cancer treatments as anyone else. The impacts of the Covid 19 pandemic mean that 10,000 or more people with cancer will die significantly earlier than would have been the case had the pandemic not happened. But over a third of adults think that if they or members of their families develop cancer the NHS care available will be world-class. A further 40 per cent believe their NHS care will be as good as that anywhere else after their cancer has been diagnosed. However, a fifth of the population think their NHS cancer treatment would be suboptimal and a small minority – 5% – say they fear it would be poor.
Some 70% of UK adults are satisfied with NHS services as a whole, although less than half indicate strong satisfaction. But only 27% report satisfaction with social care provisions. Report co-author Professor David Taylor said: ‘Since early 2020 most people have been primarily focused on the threat of Covid 19. But as the pandemic becomes better controlled by vaccines, medicines and other public health measures, cancer is re-emerging as the UK public’s top health priority. The immediate challenge is to reduce NHS waiting lists. Yet to retain British public confidence up to the next general election policy makers will also need to restore progress in cancer research, prevention and medical and social care improvement, despite the economic impacts of Brexit and Covid 19.’
Key policy opportunities revealed by the new UCL British public attitudes research include:
- Bringing forward funded plans for investing in well-equipped and staffed Community Diagnostic Hubs (CDHs). Located outside hospitals, CDHs are urgently needed to achieve or surpass the target of diagnosing 75% of all cancers at stages 1 and 2 by 2028 and improve disease identification in other fields. Earlier cancer detection allows more curative treatment. Additional investment in services such as targeted screening for lung cancer (which still accounts for 20% of all cancer deaths across the UK) is also needed.
- Identifying ways of further reducing tobacco smoking, with the goal of eliminating the habit by the start of the 2030s. British public support for stronger action on smoking prevention is deeper and more consistent than support for public health programmes on obesity, even though over one cancer in every 20 in the UK is caused by being overweight. In England a new tobacco strategy should be published in late 2021.
- Strengthening NHS users’ rights to personally optimised cancer treatment. As more varied and complex cancer treatments become available maintaining public confidence will require enhanced ways of recording when NHS clinicians have been prevented from optimising individuals’ cancer treatments because of inadequate resources or other restraints.
GPs currently refer NHS patients for urgent tests only when there is a 3% or greater chance of their symptoms being indicative of cancer. The new UCL report argues this threshold should be cut to 2% and eventually to 1%. It also recommends that while Britain brings Covid 19 under better control a critical review of the value of health economics in NHS decision-making ought to be undertaken, together with an evaluation of the successes and failures of cancer service planning in the UK since the 1990s.
This could open the way to the publication of revised cancer strategies for England and the other UK nations for 2025-35. (A new Northern Irish strategy is currently out for consultation.) Co-author and cancer clinician Professor Mark Emberton concluded: ‘I strongly support the efforts being made to re-awaken public awareness of the value of early cancer diagnosis and to encourage people to report unusual symptoms to their doctors, even if they seem minor. But there is only so much this can achieve without more investment in better diagnostic services and optimal access to effective new treatments for all stages of cancer. Our research should remind politicians that the UK public wants the NHS to be a global leader in cancer care.’
1 British Public Attitudes towards Cancer Research and Treatment in 2021. Available at https://www.ucl.ac.uk/pharmacy/british-public-attitudes-cancer-treatment...
NotesThe quantitative survey reported here was undertaken at the end of May 2021. Qualitative research continued through to August. This was the second UCL Cancer Policy Project survey of British public attitudes towards cancer research and treatment, following the initial survey undertaken in April 2019. The UCL Cancer Policy Project has been funded via grants to Professors Taylor and Emberton made through UCL by Merck and Co in the US and MSD in the UK. The company has not influenced the research undertaken or the writing of this report.
David Taylor is Emeritus Professor of Pharmaceutical and Public Health Policy at UCL. Mark Emberton OBE is
Professor of Interventional Oncology at UCL and Dean of the UCL Faculty of Medical Sciences. He is also an Honorary Consultant Urologist at University College Hospitals NHS Foundation Trust and a Founding Pioneer of Prostate Cancer UK.
For further information please contact David Taylor on 07970 139892 or at David.G.Taylor@ucl.ac.uk
British Public Attitudes towards Cancer Research and Treatment
Additional Report Findings Summary
NHS community health care and Local Authority social care are becoming increasingly important for people with cancer as the number of older long-term cancer survivors increases. Action to improve health and social care funding in England via a new National Insurance linked levy was announced on September 8th, although until 2025 this will have limited impact on social care resourcing. At present there is significant public discontent with the way residential and community social care services are financed and with their quality. On average 70% of UK adults say they are satisfied with NHS services, rising to 75% in people aged 65 years and over. But for LA social care the average satisfaction level is only 27%, falling to 22% in those aged 65 and over.
Support for the principles of the NHS remains strong. Over 80% of the UK electorate want a universally available tax funded health service. There is only limited backing for increased use of private care amongst minorities like those who say that Brexit will make it easier to fund the NHS.
Two thirds (63%) of UK adults believe that there will either be cures for most cancers or treatments that can hold them in check indefinitely by 2050. Amongst people in social grades A and B 70% now think this, as compared with 59% in less advantaged grades D and E.
Tobacco smoking is a major cause of cancers, ranging from many in the lung and the oesophagus to cancers of the pancreas and the bladder. Over 60% of UK adults support stronger action to stop smoking by the start of the 2030s, with only 14% actively opposing such an approach. Voters for all parties favour more effective action to stop smoking, although it is significantly less favoured by people in social grade E (who are most likely to be smokers) as opposed to those in grades A and B.
Most people say that when single blood tests for multiple forms of cancer become available they will want to be regularly tested. But a quarter of British adults are hesitant about accepting cancer testing. They tend to be relatively young and members of ethnic minorities. Such individuals are also more likely than others to say they are hesitant about accepting NHS recommended vaccines and to say that climate change is not a threat to human survival. If public interests in science-based health and social policies are to be protected the drivers of misleading beliefs should be understood and sympathetically countered.
Only 16% of adults currently say they think the cost of anti-cancer drugs is bankrupting the NHS, as compared to 23% in 2019. Yet most people are uncertain about the effectiveness of NHS pharmaceutical cost controls and whether better treatments can be afforded in Britain to the extent possible in nations like Germany. Anticancer medicines account for about 2% of NHS costs (0.1-0.2% of UK GDP) while total pharmaceutical spending on medicines and allied products net of discounts has been relatively stable for several decades as a percentage of health spending. It represents little more that 10% of NHS costs. Such figures are moderate by international standards.
Support for patent protection as a mechanism for funding pharmaceutical research and investment rose from 43% in April 2019 to 51% in May 2021. Opposition stands at just over 30%. Seven in every ten British adults now agree with the statement ‘taking everything I know into account I think research based pharmaceutical companies make an important positive contribution to society’ compared with six in ten in 2019. Such trends are linked to the successful use of vaccines and medicines to control the Covid 19 pandemic.
A majority (60%) of Britons accept that stopping the suffering caused by cancer is one of the most important things that humanity can hope to achieve by the 2050s. Yet there is more limited support for providing cancer treatments to poor nations via aid or at prices much lower than those the NHS pays. The UK can, if voters and political leaders choose, radically reduce its cancer related death rates by 2050. But global control of cancer is unlikely to be achievable this century without international collaborative efforts involving governments and agencies such as Universities and world-wide research based pharmaceutical companies. END