Cancer care in Wales

How does cancer care in Wales measure up? Shane Doheny looks at the statistics.

With population ageing one in every two of us can expect to be diagnosed with cancer at some point in our lives. Caring for people with cancer is as important as ever. So how does cancer care in Wales compare with the rest of the UK?

Cancer incidence and mortality

According to a report by the Office for National Statistics (ONS), there is a higher incidence of cancer (excluding non-melanoma skin cancer) in Wales and Scotland than in the UK as a whole. Compared with the UK as a whole, between 2008 and 2010, 6% more men in both Wales and Scotland were registered as suffering from cancer. In Scotland 10% more women were registered compared with 3.5% more in Wales.

But looking at mortality rates (adjusted for the age profiles of the different populations), the ONS shows that mortality was highest in Scotland where 15% more men and 16% more women died from cancer, than in the rest of the UK. In Wales, mortality rates were 2% higher for men and 3% higher for women. So while relatively large proportions of the population are diagnosed with cancer in Wales, deaths caused by cancer is not so high.

Cancer screening

Diagnosing cancer early is among the most effectives ways of dealing with cancer. Following the advice of the UK National Screening Committee and the Welsh Screening Committee, NHS Wales operates three cancer screening programmes – cervical screening, breast cancer screening and bowel cancer screening. Comparing screening coverage across the UK, none of the four countries has been achieving their targets. The NHS in England achieves the highest rates of coverage for both bowel and breast cancer screening, the NHS in Wales achieved the highest rate in cervical screening.

Cancer screening uptake/coverage rates in the UK




Northern Ireland

Bowel Screening Uptake (aged 60-74, tested within 2 years) Target: 60%

52.6% (2013-14)

58.5% (2012-13)

56.1% (2011-2013)


Breast Screening Uptake (aged 50-70, tested within 3 years) Minimum Standard 70% Target 80%

72.1% (2013-14)

76.4% (March 2013)

73.5% (2010-13)

72.3% (Sept 2012)

Cervical Screening coverage (aged 25-64, tested within 5 years) Target 80%

78.4% (2014)

78.3% (March 2013)

70.7%1 (March 2014)

78.0% (2011-12)

1 In Scotland, cervical screening is offered to eligible women aged 20-60 every three years. This figure shows the proportion of eligible women screened in the previous 3.5 years.

2 In Northern Ireland, the Ministerial target for Bowel Cancer screening coverage is 55%

Recent work by the NHS in Wales has aimed to increase the rate at which cancers are diagnosed quickly.

Waiting for cancer care

A key question for cancer patients is how long they must wait to be treated by the NHS. All four countries use a 62 day and a 31 day target. The 62 day target is aimed at GP referrals of patients with suspected cancer. The 31 day target is for the time between receiving a confirmed diagnosis of cancer and the start of cancer treatment for all patients.

Comparing the performance of health services in the UK on these targets, it is clear that the NHS in Scotland and England are close to, or exceed, their 62 and 31 day targets. The NHS in Wales is doing better than the health service in Northern Ireland but it falls well short of its 62 day target. The NHS in Wales is actually outperforming NHS England on the 62 day target, but as NHS Wales sets a higher target, its performance looks worse.

62 day target

31 day target


83.9% (quarter ending March 2015 – target 95%)

96.1% (quarter ending March 2015 – target 98%)


83.4% (2014/15 – target 85%)

97.7% (2014/15 – target 96%)


94.2% (quarter ending December 2014 – target 95%)

97.5% (quarter ending December 2014 – target 95%)

Northern Ireland

62.5% (September 2014 – target 95%)

95.1% (September 2014 – target 98%)

The Cancer Drugs Fund

There have been calls to introduce a Cancer Drugs Fund in Wales since the Conservative Liberal Democrat Coalition Government introduced one in England in 2010. The Cancer Drugs Fund is expected to provide £340m to the NHS in England in 2015/16. This is to enable access to drugs not currently funded by the NHS. These are drugs that have not yet been appraised by the National Institute for Health and Care Excellence (NICE), or that NICE have concluded are not cost effective for use in the NHS.

In Wales the focus has been on making it easier to get funding for medicines for rare diseases and end of life care. The All Wales Medicines Strategy Group (AWMSG) has developed a Patient Access Scheme to provide Welsh patients access to drugs that have not been approved by NICE by improving the cost-effectiveness of the medicine. The AWMSG is also piloting a process which provides patients with medicines for rare diseases.

Still, the main way cancer patients in Wales access high cost drugs is by making an Individual Patient Funding Request. Each Health Board operates its own process. The Welsh Government rejected a recommendation from the National Assembly’s Health and Social Care Committee to establish a national panel to consider such funding requests. This means that access to some drugs will continue to depend on where people live.

Overall, the numbers suggest that NHS Wales is managing care for cancer patients quite well. Surveys of cancer patients add to this positive picture. But there is room for improvement.

Let’s talk cancer, which launched on Monday, is an online project where cancer patients and their loved ones are being asked to post their experiences and their ideas for making care better in Wales. The project aims to get patients and their loved ones to suggest the areas where there is room for improvement and how to make it happen. To take part visit

Dr Shane Doheny is a Research Associate at the Institute for Medical Genetics at Cardiff University.

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