30-day mortality after systemic anti-cancer therapy (SACT)
Patients treated in 2025

About this release

This annual 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, by NHS health board of treatment or by treatment intent.

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 with patients.

• For NHS Scotland, the cancer type with the highest SACT 30-day mortality was cancers of unknown primary at 9.2% (6 out 65 patients died). The lowest SACT 30-day mortality was for germ cell cancer (1 out of 161 patients died).
• Among the most commonly treated cancers, those with more than 1,000 patients treated in 2025, the highest SACT 30-day mortality was recorded for lung and chest cancer at 7.9% (164 out of 2,064 patients died). SACT 30-day mortality was the lowest for breast cancer at 2.5% (126 out of 5,105 patients died).
• No regional cancer network had significantly higher mortality than the Scotland-wide average for any cancer type in 2025. One health board reported higher SACT 30-day mortality rates than the Scotland average. NHS Fife had a higher rate for upper gastrointestinal cancer in 2025.

Graph showing SACT 30-day mortality by treatment intent by cancer type. Cancer of unknown primary has the highest and germ cell cancer has the lowest.

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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 health 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 2025. 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, co-morbidities or any other unrelated cause.

Further information

The next release of this publication will be summer 2027.