30-day mortality after systemic anti-cancer therapy (SACT)
Patients treated in 2023

About this release

This publication by Public Health Scotland (PHS) reports on the number and percentage of patients who died within 30 days of starting their last cycle of systemic anti-cancer therapy (SACT). The data are reported for NHS Scotland and the three regional cancer networks for 15 tumour groups. The data can be broken down by cancer sub-group or, for the first time in this year’s release, by NHS Health Board of treatment or treatment intent.

The data have been visualised in a dashboard available in the dashboard section below. The content of this report will be reviewed and developed over time following feedback from stakeholders and in agreement with the SACT Programme Board.

Main points

There are currently no targets for SACT 30-day mortality. Results for the regional cancer networks and NHS Health Boards have been compared with the results for Scotland overall to identify any variation across the country. Mortality may vary between types of cancer due to the behaviour of the disease, the treatments available and the decisions taken by oncologists together with their patients.

• For NHS Scotland, the cancer type with the highest SACT 30-day mortality was cancers of unknown primary at 11.8% (6 out of 51 patients died). The lowest SACT 30-day mortality was for germ cell cancer at 1.1% (2 out of 176 patients died).
• Among the most commonly treated cancers, those with more than 1,000 patients treated in 2023, the highest SACT 30-day mortality was recorded for lung and chest cancer at 6.0% (146 out of 2,444 patients died). The lowest SACT 30-day mortality was for breast cancer at 2.6% (117 out of 4,542 patients died).
• No regional cancer networks have significantly higher mortality than the Scotland-wide results. Two NHS Health Boards report higher SACT 30-day mortality rates than the Scotland average. NHS Ayrshire and Arran has a higher rate for lower gastrointestinal cancer and NHS Tayside has a higher rate for upper gastrointestinal cancer.

A graph showing SACT 30-day mortality by cancer type and treatment intent. Cancers of unknown primary have the highest 30-day mortality and germ cell cancer has the lowest. Non-curable treatment has higher mortality than curable treatment for all cancer types except haematological cancer.

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30-day mortality by cancer type for NHS Scotland

Background

Guidance for the safe delivery of systemic anti-cancer therapy (DL (2023) 15) first published in 2012 and revised in 2023, sets the framework for the safe delivery of SACT. The guidance includes clinical trials. It recognises the need to report and review all deaths occurring within 30 days of SACT administration as part of NHS Board clinical governance arrangements.

SACT drugs include cytotoxic chemotherapy, targeted therapies and immunotherapy. Hormone therapy is not included in this report. This publication includes all adult patients who were prescribed SACT in secondary care in Scotland in 2023. All deaths occurring within 30 days of starting the last treatment cycle are included in this report. These deaths may be directly due to the treatment received, but deaths unrelated to treatment are also included. These could be due to disease progression, due to co-morbidities or due to any other unrelated cause.

Further information

The next release of this publication will be summer 2025.