🇬🇧 Global trends in cancer survival: insights from the CONCORD programme and implications for cancer control

Abstract

The CONCORD programme, co-ordinated by the Cancer Survival Group in London, is the world’s largest ongoing surveillance initiative for monitoring cancer survival. It deploys anonymised individual data provided by over 380 population-based cancer registries in more than 70 countries, covering tens of millions of patients diagnosed with cancer during 1990-2022. By tracking survival trends over time and across national and regional boundaries, CONCORD provides the epidemiological evidence base needed to evaluate cancer control performance, identify where outcomes are improving, and expose where inequalities persist.

This presentation will outline the objectives, methodology and core findings of CONCORD. The findings reveal wide variations in age-standardised net survival between world regions, which differ substantially even for cancers where effective treatments exist. For breast, colorectal and cervical cancers, for instance, five-year net survival in high-income countries can exceed the levels recorded in low- and middle-income settings by 20 to 40 percent. These disparities reflect differences in early detection, in equitable access to treatment, and in organisation of the health system, rather than cancer biology alone.

Temporal trends from successive CONCORD analyses indicate that survival has improved in many countries over the past 30 years, yet the pace of improvement remains uneven. While high-income settings have recorded consistent gains in survival for most types of cancer, progress in several low- and middle-income countries has stagnated or reversed, raising concerns about widening global inequalities in cancer outcomes.

The presentation will also address methodological considerations that are central to interpreting international comparisons, including variability in registry coverage and completeness, differences in diagnostic classification, and the analytical approaches used to standardise survival estimates for quantitative comparison between heterogeneous populations and health systems.

Population-based cancer registries are examined as the irreplaceable infrastructure underpinning this work. Their role in generating the evidence needed for rational, equity-focused cancer control planning will be discussed. The presentation concludes by considering how CONCORD findings can directly inform national cancer strategies, support the prioritisation of resource allocation, and contribute to reducing the survival gap between the world’s highest- and lowest-performing health systems.