The use of techniques of economic analysis in improving the efficiency of cancer services is both complex and poorly understood. Like many other areas of health care, there are large variations in treatment patterns, a reluctance to invest in prevention, inadequate data about effectiveness, and a reluctance to invest in cost-effectiveness analysis to inform purchasers' choices. Without the deployment of such techniques and the basing of treatment choices on a balancing of costs and effects, resources will continue to be used inefficiently and to the detriment of patients' welfare.