30-day mortality after systemic anti-cancer therapy (SACT)
Patients treated in 2024

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 NHSScotland 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 treatment intent.

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

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 NHSScotland, the cancer type with the highest SACT 30-day mortality was cancers of unknown primary at 11.8% (8 out of 68 patients died). The lowest SACT 30-day mortality was for germ cell cancer at 0% (none of 153 treated patients died).
• Among the most commonly treated cancers, those with more than 1,000 patients treated in 2024, the highest SACT 30-day mortality was recorded for lung and chest cancer at 5.8% (144 out of 2,496 patients died). SACT 30-day mortality was the lowest for breast cancer at 2.0% (95 out of 4,707 patients died).
• No health board or regional cancer network had significantly higher mortality than the Scotland-wide average for any cancer type in 2024. The two health boards which had significantly higher mortality in 2023 had mortality consistent with the Scotland-wide average in 2024.

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

SACT is the use of drugs that affect the whole body with the aim to destroy cancer cells. SACT also affects healthy cells which can cause harmful side-effects. A decision to treat the patient reflects the prescriber’s belief that the treatment is likely to benefit the patient and outweigh any harmful side-effects of SACT, including irreversible toxicity which can, in some cases, result in the patient dying.

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 and 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. The statistics in this release cover all adult patients who were prescribed SACT in secondary care in Scotland in 2024 and all deaths occurring within 30 days of starting the last treatment cycle. 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 2026.