Why childhood cancer survival in UK is way behind Europe

Early diagnosis for some types of the disease is three times more likely in Germany than in the UK.

The delays here mean recovery chances can be as low as 30 per cent, compared to 46 per cent in other countries.

The respected journal The Lancet Oncology accuses the NHS of continuing to set a low priority on children's services and says the disparity should be "urgently addressed".

Professor Alan Craft, co-author of a report for the journal, said cancer survival is just one measure by which the UK performs badly in comparison with its European neighbours.

Britain's perinatal mortality rate - the measure of children dying shortly before or after birth - puts us a poor 15th in Europe, he said.

There is also clear evidence that children with diabetes fare worse here.

"Waiting lists, A&E waiting times and access to GPs are political hot potatoes that keep hospital managers awake at night," he said. "Children's health doesn't. But the evidence suggests that children who fall ill are not doing as well as they might."

The report looked at cases picked up by chance during routine examinations. Trials carried out in Germany on Wilms' tumour - a common childhood cancer - showed that, between 1994 and 2001, 27.4 per cent of sufferers were first diagnosed during a visit to a health professional for an unrelated problem, or by routine surveillance.

By comparison, just 11 per cent of patients at the Royal Marsden Hospital in London and four per cent of those referred to the Newcastle Hospital or Royal Victoria Infirmary in Newcastle, were identified in this way.

Early diagnosis by routine or incidental examination was linked to the increased survival rate in Germany, said Professor Craft and co-author Kathy Pritchard-Jones.

Neuroblastoma, a childhood cancer of the nervous system, was also treated less successfully in the UK, they said.

Survival rates were 30 per cent compared with 46 per cent in countries such as Germany, Belgium, the Netherlands, Luxembourg and Switzerland.

The doctors believe there are a number of reasons for the imbalance. Children in the UK may be given a different treatment plan, while routine surveillance and opportunities for diagnosis also vary. Most German children see a paediatrician regularly for check-ups.

Dr Carole Easton, chief executive of the childhood cancer charity CLIC Sargent, said UK survival rates have increased over the past 30 years, with seven out of 10 now surviving their illness.

"There is a danger in comparing international data on this subject," she said. "Cancer registry data is collected differently throughout Europe and this can make comparisons unreliable."

The Department of Health said the number of children successfully treated for cancer had risen from 25 per cent in the 1960s to around 75 per cent, and it did not recognise the perinatal mortality rate quoted for the UK.

"Children are a high priority for the NHS," said a spokesman. "In 2004 we published the National Service Framework for Children, Young People and Maternity services. This was the first time that standards for children's health services were set.

"And in 2005, the National Institute for Health and Clinical Excellence produced guidance for the NHS specifically on childhood and adolescent cancers. And we recognise there is more to do."

Tumour dismissed as growing pains

When Ellis Fothergill first started feeling unwell doctors dismissed her sore back as growing pains and constipation.

In fact, she was suffering from Wilms' tumour, a rare kidney cancer. It was only after her father noticed a lump in her stomach that tests revealed the truth.

By this time, the cancer had grown to the size of a man's fist and doctors were forced to remove her kidney.

Last night her mother, Melanie Green, 37, said it was only through her family's persistence that the illness was identified.

"I'd taken her to the GP at least three times with a urinary infection before she was diagnosed," she said.

"The doctor said her aching back was just growing pains. Who knows what would have happened if we'd not taken her to hospital."

Ellis, six, from Eckington, near Sheffield, had a five-hour operation last year to remove her left kidney, followed by radiotherapy and chemotherapy. Her weight fell to little more than a stone. She is now in remission and due to return to school in September.

• For more information on Wilms' tumour contact the children's cancer charity CLIC Sargent at www.clicsargent.org..uk