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Iechyd Cyhoeddus Cymru Welsh Cancer Intelligence and Surveillance Unit, Health Intelligence Division, Public Health Wales Public Health Wales Am y fersiwn Gymraeg ewch i www.wcisu.wales.nhs.uk Cancer in Wales A summary report of population cancer incidence, mortality and survival – includes new 2012 data released as Official Statistics on 9 April 2014 www.wcisu.wales.nhs.uk How many people get cancer? People living longer increases the number of new cancer cases The trend in the number of new cancer cases each year is still going up (Figure 1). There were just over 18,000 new cases of cancer diagnosed in the residents of Wales in 2012. That’s around ten per cent more in 2012 - or almost 1,700 extra cases - compared to ten years before in 2003. Figure 1 Annual number of new cancer cases in Wales. All persons, all ages. 2003-2012 20000 Number of new cancer cases in Wales 18000 16000 14000 12000 10000 8000 6000 4000 2000 0 2003 2004 2005 2006 2007 2008 2009 2010 Year of diagnosis Source: Welsh Cancer Intelligence and Surveillance Unit’s Cancer Registry www.wcisu.wales.nhs.uk 2011 2012 Summary Our report highlights how the ageing population of Wales, along with socioeconomic inequalities and deprivation, are increasing the large burden of ill-health and mortality from cancer in society. The types of cancers that are common (such as bowel, lung, breast and melanoma) suggest that prevalent health-risk behaviours in Wales are also contributing to the population cancer burden. The main risk behaviours are smoking, alcohol drinking, physical inactivity, obesity and a poor diet, along with more sun and UV exposure with sunburns. They are all influenced by many factors in society, rather than just in the individual. Although air pollution is now known to be a risk for lung cancer, smoking remains the major problem. The large increase in cancer incidence in women appears to be mainly due to lung cancer. Despite recent improvements, such as for age-adjusted lung cancer incidence in men and age-adjusted breast cancer incidence in women, trends in these and other cancers may yet change depending on current and future risk factors. Population cancer surveillance will need to continue to inform public health and health service responses. Cancer survival is improving overall, but from a low level and with lower survival in deprived areas. Survival from lung cancer remains low and, in common with most UK countries, survival for most smoking-related cancers is far from the best in Europe. Better understanding of the causes of low survival in Wales will remain challenges alongside cancer prevention. Welsh Cancer Intelligence and Surveillance Unit Official Statistics 2012 data. Published 10 April 2014 1 Cancer in Wales Published 10 April 2014 Two-thirds of all new cancer cases in 2012 were in people aged 65 and over Cancer still more common in men, but rate is going up in women, down in men We examined the overall 2003-2012 trend more closely by looking at the trends in cancer numbers for different age groups (Figure 2). The number of cases in 2012 were higher than 2003 for all age groups from 60 years and older, except for the 80-84 years group, which was only marginally lower. The largest rise of 34 per cent was in the 65 to 69 age group. By 2012, two-thirds of all cancer cases were diagnosed in people aged 65 and over. In Wales, the rate of cancer in men is about 18 per cent more than in women – that’s around 70 extra cases for every 100,000 men compared to the rate in women. Although cancer is more common in men, the incidence is coming down slowly (Figure 4 and Table 1), but increasing in women. 3000 Annual number of cases 2500 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79 80-84 85+ 2000 1500 1000 500 450 400 EASR per 100,000 population Figure 2 Trends in annual numbers of cancers by age group. Wales, all persons. 2003-2012 Figure 4 Cancer incidence rates in Wales by sex, 2003-2012 350 300 Males Females Persons 250 200 150 100 50 0 500 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 Year of diagnosis 0 2003 2004 2005 2006 2007 2008 2009 2010 2011 Source: Welsh Cancer Intelligence and Surveillance Unit’s Cancer Registry www.wcisu.wales.nhs.uk 2012 Year of diagnosis Source: Welsh Cancer Intelligence and Surveillance Unit’s Cancer Registry www.wcisu.wales.nhs.uk But, during the same period, there was little change in most age-specific cancer rates per 100,000 with no clear trends (Figure 3). This suggests that the increase in number of cases we observed is partly explained by people living longer and the ageing of the population. However, it is not yet clear why the numbers and rates in the 85 and over group, and the 80 to 84 years group, dropped sharply in 2012 from their peaks in 2011. Figure 3 Age-specific cancer incidence rates in Wales. All persons, 2003-2012 Age specific incidence rate per 100,000 population 3500 The reasons for the differences include the historic patterns of male smoking and alcohol use being different to those in women. Naturally there are also many sex-specific cancers such as prostate, breast, and cervix, for example. We highlight the different trends in the most common cancer types in men and women later. Table 1 Difference in cancer incidence between men and women in Wales. All ages. 2012 Men 9417 443.0 433.8 452.4 Women 8612 374.2 365.7 382.8 2500 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79 80-84 85+ 2000 1500 1000 500 2003 2004 2005 2006 2007 2008 2009 2010 2011 Upper Confidence Limit Incidence rate per 100,000 EASR Source: Welsh Cancer Intelligence and Surveillance Unit’s Cancer Registry www.wcisu.wales.nhs.uk 3000 0 Lower Confidence Limit Total Cases 2012 Year of diagnosis Source: Welsh Cancer Intelligence and Surveillance Unit’s Cancer Registry www.wcisu.wales.nhs.uk 2 Welsh Cancer Intelligence and Surveillance Unit Official Statistics 2012 data. Published 10 April 2014 Definitions Age-standardised rates and EASR Age-standardisation adjusts rates to take into account how many old or young people are in the population being looked at. When rates are age-standardised, you know that differences in the rates over time or between geographical areas do not simply reflect variations or changes in the age structure of the populations. This is important when looking at cancer rates because cancer mainly affects older people. Throughout this report we use European Age Standardised Rates (EASR) unless otherwise specified. Statistical significance If a difference between rates or survival between populations is statistically significant, it means that that difference is unlikely to have occurred due to chance alone, and that we can be more confident that we are observing a ‘true’ difference. In this report we use the conventional arbitrary cut-off of less than a 5% chance to mean statistically significant. Just because a difference is statistically significant doesn’t necessarily mean that it is large or important - that can depend on our judgment and other things. Relative survival This is a way of comparing the survival of people who have a specific disease – in our case, cancer -with the survival experienced by the general population, over a certain period of time. It is calculated by dividing the percentage of patients with the disease who are still alive at the end of the period of time (e.g. one or five years after diagnosis) by the percentage of people in the general population of the same sex and age who are alive at the end of the same time period. The relative survival rate shows whether the disease shortens life. We use relative survival in this report. All cancers When we use the phrase ‘all cancers’ or ‘all malignancies’ in this report, by convention, we always mean all cancers excluding non-melanoma skin cancer. Lowest health board cancer incidence is 8% below the incidence for Wales Cancer gets more common the more deprived an area gets Many diseases or health conditions show a health gradient, becoming increasingly more common as socioeconomic deprivation increases. Overall, cancer is no exception. The incidence rate of cancer is 20 per cent higher in the most deprived areas of Wales, compared to the least deprived – that’s around 80 extra cancer cases for every 100,000 people living in the most deprived areas (Figure 5). But not all cancers follow this pattern, notably breast cancer, which is more common amongst more affluent women. Cancer incidence for six of the seven local health boards is similar to that for Wales (Figure 6) – the differences are within a range we might expect from chance alone. But the incidence for the Powys population is nearly eight per cent lower than the Wales incidence, and is lower than would be expected from chance alone. Figure 6 Cancer incidence rate (EASR) per 100,000 people by local health board of residence. Wales, persons, all ages. 2010-2012 Figure 5 Cancer incidence rate (EASR) for areas with increasing deprivation (fifths) in Wales. All persons, all ages. 2008-2012 500 384.7 – 393.3 393.3 – 401.9 450 401.9 – 410.4 EASR per 100,000 population 400 410.4 – 419.0 419.0 – 427.6 350 300 250 200 150 100 50 0 1 (Least deprived) 2 3 4 5 (Most deprived) Deprivation fifth Source: Welsh Cancer Intelligence and Surveillance Unit’s Cancer Registry www.wcisu.wales.nhs.uk Source: Welsh Cancer Intelligence and Surveillance Unit’s Cancer Registry www.wcisu.wales.nhs.uk ©Crown Copyright and database right 2014. Ordnance Survey 100044810 Welsh Cancer Intelligence and Surveillance Unit Official Statistics 2012 data. Published 10 April 2014 3 Cancer in Wales Published 10 April 2014 Highest local authority cancer incidence Which are the most common cancers? is 17% more than lowest Over 18,000 cases of cancer in residents of Wales were Ceredigion’s cancer incidence is the lowest of the 22 local authority areas (Figure 7). It’s about eight per cent below the Wales incidence. Torfaen’s rate is nearly eight per cent higher than Wales’. It is the highest in Wales. That means that, on average, there’s a difference of 67 new cases of cancer per 100,000 people each year between Ceredigion and Torfaen. The differences between local authority areas are in part due to variation in deprivation. diagnosed during 2012. The relative number of the different types are shown in Figure 8. Figure 8 Number and proportion of the five most common types of cancer diagnosed in Wales. All persons, all ages. 2012 Bowel, 2444, 14% Figure 7 Annual cancer incidence by local authority populations. Wales, persons, all ages. 2008-2012 Other, 7741, 43% Prostate, 2419, 13% 500 EASR per 100,000 population 450 400 350 Lung, 2370, 13% 300 250 200 150 Melanoma, 693, 4% Female Breast, 2362, 13% 100 Source: Welsh Cancer Intelligence and Surveillance Unit’s Cancer Registry www.wcisu.wales.nhs.uk Local authority of residence Wales Not statistically significant Statistically significant Source: Welsh Cancer Intelligence and Surveillance Unit’s Cancer Registry www.wcisu.wales.nhs.uk Torfaen Flintshire Denbighshire Blaenau Gwent Caerphilly Merthyr Tydfil Rhondda Cynon Taff Newport Wrexham Cardiff Vale of Glamorgan Conwy WALES Pembrokeshire Neath Port Talbot Bridgend Gwynedd Swansea Carmarthenshire Isle of Anglesey Powys Monmouthshire 0 Ceredigion 50 Bowel cancer is the most common cancer in Wales for first time There were 474 more cases of bowel cancer in 2012 than in 2003, making bowel cancer the most common cancer in Wales in 2012. This is the first time this has happened since our records began. The ageing of the population during this time played a part (Figure 9). Increased awareness and the introduction of bowel screening may also be responsible, but we’re not yet clear about this. Figure 9 Bowel cancer incidence (EASR) in Wales by sex, all ages. 2003-2012 70 EASR per 100,000 population 60 50 40 Males Females Persons 30 20 10 0 2003 2004 2005 2006 2007 2008 2009 2010 2011 Year of diagnosis Source: Welsh Cancer Intelligence and Surveillance Unit’s Cancer Registry www.wcisu.wales.nhs.uk 4 Welsh Cancer Intelligence and Surveillance Unit Official Statistics 2012 data. Published 10 April 2014 2012 Number of lung cancer cases increases by more than a third over 10 years in women, but hardly changes in men There have been major changes in lung cancer numbers in men and women. The number of cases in men remained similar between 2003 and 2012, but the number in women increased by over a third. The number of cases in women is now approaching that in men. This means that cancer incidence per 100,000 men has dropped in that time, once age is considered, but the incidence rate has increased in women (Figure 10). The combined rate for men and women has stopped coming down, and is now flat-lining. Different historic smoking patterns in men and women account for most of these changes, but we also now know that some forms of air pollution are increasingly recognised as risk factors for lung cancer. Figure 10 Lung cancer incidence (EASR) in Wales by sex, all ages. 2003-2012 The five most common cancers in men during 2012 were ● prostate (2,419 cases) ● bowel (1,405) ● lung (1,249) ● head and neck (427) ● bladder (391) 70 60 EASR per 100,000 population Prostate cancer incidence rate changes little, but actual numbers go up 50 40 Males Females Persons 30 20 10 The number of cases of prostate cancer diagnosed in 2012 was 376 more than in 2003. The ageing population probably explains most of this modest rise because the rate standardised for age has remained almost constant over the ten year period. 0 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 Year of diagnosis Source: Welsh Cancer Intelligence and Surveillance Unit’s Cancer Registry www.wcisu.wales.nhs.uk During 2014-2015 we will be analysing information on lung cancer in more detail. Breast cancer incidence steadily coming down since 2010 The five most common cancers in women in 2012 were ● breast (2,362 cases) ● lung (1,121) ● bowel (1,039) ● ovary (452) ● uterus (449) In 2012 the number of cases of breast cancer was marginally lower than in 2003. Once the effect of population age is considered, the rate was over eight per cent lower in 2012 than ten years previously, after peaking in 2010. Welsh Cancer Intelligence and Surveillance Unit Official Statistics 2012 data. Published 10 April 2014 5 Cancer in Wales Published 10 April 2014 How many die from cancer? The overall cancer mortality rate has decreased in ten years... … but, the number of cancer deaths increased by almost one third in people aged 85 and over The general trend in cancer mortality rate is coming down, once changes in population age structure are taken into account. By 2012, mortality was around 174 per 100,000 people - that’s 11 per cent less than ten years before (Figure 11). Figure 11 Cancer mortality (EASR) rate in Wales. All persons, all ages. 2003-2012 200 Even though the age-adjusted mortality rate is going down, the trend in the annual number of deaths from cancer is still increasing due to population changes. There were 8,654 deaths in 2012 compared to 8,370 in 2003. But this general three per cent increase is small in comparison to the 31 per cent increase in deaths in the 85 years and older age group, where most cancer deaths occur (Figure 12). Figure 12 Annual number of cancer deaths by age group. Wales, all persons. 2003-2012 180 1800 140 120 1600 100 1400 80 60 40 20 0 2003 2004 2005 2006 2007 2008 2009 2010 Registered year of death Source: Welsh Cancer Intelligence and Surveillance Unit’s Cancer Registry www.wcisu.wales.nhs.uk 2011 2012 Annual number of cancer deaths EASR per 100,000 population 160 1200 50-54 55-59 60-64 65-69 70-74 75-79 80-84 85+ 1000 800 600 400 200 0 2003 2004 2005 2006 2007 2008 2009 2010 2011 Registered year of death Source: Welsh Cancer Intelligence and Surveillance Unit’s Cancer Registry www.wcisu.wales.nhs.uk 6 Welsh Cancer Intelligence and Surveillance Unit Official Statistics 2012 data. Published 10 April 2014 2012 Cancer mortality rate is one third higher in men than women We know that cancer is more common in men, but men have a higher death rate from cancer too. Cancer incidence is around 16% higher in men than women, but mortality is over a third higher. This is consistent with lower cancer survival in men (Figure 13). Figure 13 Cancer mortality (EASR) in men and women. Wales, all ages. 2010-2012 EASR per 100,000 population 250.0 200.0 150.0 100.0 50.0 0.0 Women Sex Men Source: Welsh Cancer Intelligence and Surveillance Unit’s Cancer Registry www.wcisu.wales.nhs.uk Cancer mortality rate is over 50% higher in most deprived areas of Wales compared to the least deprived Cancer mortality is higher in more deprived areas. Whereas cancer incidence is 20 per cent higher in the most deprived areas compared to the least deprived, mortality is 50 per cent higher, which reflects the gradient in survival (Figure 14). Figure 14 The gradient of cancer mortality rate (EASR) for areas with increasing deprivation (fifths). Wales, persons, all ages. 2007-2011 250 EASR per 100,000 population 200 150 100 50 0 1 (Least deprived) 2 3 4 5 (Most deprived) Deprivation fifth Source: Welsh Cancer Intelligence and Surveillance Unit’s Cancer Registry www.wcisu.wales.nhs.uk Welsh Cancer Intelligence and Surveillance Unit Official Statistics 2012 data. Published 10 April 2014 7 Cancer in Wales Published 10 April 2014 Highest health board cancer mortality is 6% more than for Wales The cancer mortality rate between the populations of the seven health boards varies (Figure 15). The mortality rates of the populations of the Hywel Dda and Powys areas are lower than the Wales mortality, and Cwm Taf and Aneurin Bevan populations are higher. These differences are greater than might be expected from chance alone. The Cwm Taf population has a cancer mortality rate six per cent higher than the Wales mortality. Figure 15 Cancer mortality rate (EASR) by local health board populations. Persons, all ages, 2008-2012 Difference between local authority area with highest and lowest mortality is over 47 deaths per 100,000 people There is wider variation between the cancer mortality rates of local authority populations (Figure 16). The lowest is in Ceredigion which is 13 per cent below the Wales mortality, and Blaenau Gwent has the highest mortality by the same percentage. The variation between local authority areas is partly explained by deprivation, and broadly follows the same pattern as cancer incidence. Figure 16 Cancer mortality rate (EASR) by local authority populations. Persons, all ages, 2008-2012 240 200 200 Wales Not statistically significant Statistically significant Source: Welsh Cancer Intelligence and Surveillance Unit’s Cancer Registry www.wcisu.wales.nhs.uk Not statistically significant Statistically significant Source: Welsh Cancer Intelligence and Surveillance Unit’s Cancer Registry www.wcisu.wales.nhs.uk 8 Welsh Cancer Intelligence and Surveillance Unit Official Statistics 2012 data. Published 10 April 2014 Blaenau Gwent Torfaen Merthyr Tydfil Neath Port Talbot Newport Rhondda Cynon Taff Local authority of residence Wales Flintshire Caerphilly Denbighshire Cardiff Isle of Anglesey WALES Gwynedd 0 Bridgend 40 Conwy Cwm Taf University Aneurin Bevan University Health board of residence Betsi Cadwaladr University Wales Abertawe Bro Morgannwg University Cardiff & Vale University Hywel Dda University Powys Teaching 0 Wrexham 20 80 Swansea 40 Pembrokeshire 60 120 Carmarthenshire 80 Powys 100 160 Vale of Glamorgan 120 Ceredigion 140 Monmouthshire 160 EASR per 100,000 population EASR per 100,000 population 180 Deaths from lung cancer more than bowel and breast cancers combined Lung cancer accounted for almost 22 per cent of all cancer deaths in 2012 (Figure 17). At 1,894 deaths, it accounts for most cancer deaths, ahead of other common cancers such as bowel, breast and prostate, and more than bowel and breast combined. These cancers also have the highest mortality rates (Figure 18). Figure 17 Number of deaths from different types of cancer, 2012 Bowel 912 Lung Breast 1894 594 All cancer deaths 8654 Prostate Pancreas 556 440 Other cancers 4258 Figure 18 Mortality rate (EASR) for different cancer types. Wales, persons, all ages 2010-2012 40 35 30 25 20 15 10 Testis Hodgkins Thyroid & Endocrine Cervix Larynx Uterus Melanoma Liver Head & Neck Leukaemia Non-Hodgkins Lymphoma Bladder Brain & CNS Stomach Urinary Tract exc Bladder Oesophagus Ovary Pancreas Prostate Colorectal 0 Lung 5 Female Breast Source: Welsh Cancer Intelligence and Surveillance Unit’s Cancer Registry www.wcisu.wales.nhs.uk EASR per 100,000 population 45 Cancer type Source: Welsh Cancer Intelligence and Surveillance Unit’s Cancer Registry www.wcisu.wales.nhs.uk Welsh Cancer Intelligence and Surveillance Unit Official Statistics 2012 data. Published 10 April 2014 9 Cancer in Wales Published 10 April 2014 What are the chances of survival? Survival from cancer is steadily improving, but remains low compared to the best in Europe On average, almost 70 per cent of Welsh residents diagnosed with cancer can expect to survive at least one year. It’s improving, but progress is slow. The latest available figures for 2007-11 are only four per cent higher than the figures for the period 2003-2007 (Table 2). Table 2 One year relative survival from cancer in Wales. Persons, all ages. Period of diagnosis One year relative survival % 2007-2011 69.9 2006-2010 69.2 2005-2009 68.6 2004-2008 67.9 2003-2007 67.2 Source: Welsh Cancer Intelligence and Surveillance Unit’s Cancer Registry www.wcisu.wales.nhs.uk It takes longer before we can report on five year survival because we have to wait to see what happens to people diagnosed with cancer. But we know that for the latest available period, five year survival increased by nearly eight per cent compared to the period 1999-2003 (Table 3). Table 3 Five year relative survival from cancer in Wales. Persons, all ages. Women have higher cancer survival rates than men Even though cancer is much more common in men, one year survival is four per cent higher in women than men. Five year survival has a wider gap, being ten per cent higher in women than men (Table 4). Table 4 Relative cancer survival in men and women in Wales. Persons, all ages. Five year survival (2003-2007) One year survival (2007-2011) Men 50.0% 68.5% Women 55.0% 71.5% Source: Welsh Cancer Intelligence and Surveillance Unit’s Cancer Registry www.wcisu.wales.nhs.uk Cancer survival is lower in more deprived areas In more deprived areas the chance of survival gets worse for both one year and five year relative survival. In Wales, one year survival in the most deprived areas is 17 per cent less than in least deprived areas - there is a steep gradient. For five year survival the difference is wider – the chance of survival is 28 per cent less in the most deprived areas compared to the least deprived (Figure 19). Period of diagnosis Five year relative survival % 2003-2007 52.5 2002-2006 51.5 2001-2005 50.5 100 2000-2004 49.6 90 1999-2003 48.7 80 Increasing survival can be due to a combination of changing pattern of cancer types in the population; better treatments available and accessed by all who need them; earlier diagnosis and screening; age at diagnosis; as well as an improvement of health generally across the population, so that if people are diagnosed with cancer, they will have fewer other illnesses that may affect their treatment. It is not yet clear to what extent these different factors have combined to influence survival. The improving survival in Wales needs to be considered in the context of better survival in many European countries, especially for smoking-related cancers (Eurocare 5 study). Relative Survival (%) Source: Welsh Cancer Intelligence and Surveillance Unit’s Cancer Registry www.wcisu.wales.nhs.uk Figure 19 Five year cancer survival gradient for areas with increasing deprivation (fifths). Wales, persons, all ages. 2003-2007 70 60 50 40 30 20 10 0 1 (Least deprived) 2 3 4 Deprivation fifth Source: Welsh Cancer Intelligence and Surveillance Unit’s Cancer Registry www.wcisu.wales.nhs.uk 10 Welsh Cancer Intelligence and Surveillance Unit Official Statistics 2012 data. Published 10 April 2014 5 (Most deprived) Variation in cancer survival between health board populations is small On average, almost 70 per cent of Welsh residents diagnosed with cancer can expect to survive at least one year. The variation in one year survival between health board for 20072011 is small, but the Betsi Cadwaldr and the Powys health board populations both have one year survival around two percentage points above that for Wales, and Cwm Taf by about the same below it. These differences are more than can be expected by chance alone (Figure 20). Other factors, such as deprivation or the prevalence of other illnesses, that can affect survival may explain part of these differences. Figure 20 One year relative cancer survival by health board. Wales, 2007-2011 Figure 21 Five year relative cancer survival by health board. Wales, 2003-2007 67.6 – 68.5 48.3 – 49.9 68.5 – 69.4 49.9 – 51.5 69.4 – 70.3 51.5 – 53.2 70.3 – 71.2 53.2 – 54.8 71.2 – 72.1 54.8 – 56.4 Source: Welsh Cancer Intelligence and Surveillance Unit’s Cancer Registry www.wcisu.wales.nhs.uk ©Crown Copyright and database right 2014. Ordnance Survey 100044810 Source: Welsh Cancer Intelligence and Surveillance Unit’s Cancer Registry www.wcisu.wales.nhs.uk ©Crown Copyright and database right 2014. Ordnance Survey 100044810 On average, almost 53 per cent of Welsh residents diagnosed with cancer can expect to survive at least five years. The variation in five year survival for 2003-2007 is again small, although the difference between the Wales figure and three of the health boards are more than can be expected by chance – Cwm Taf is over four percentage points below, with Powys and Cardiff and Vale above the Wales survival by about four and 2.5 percentage points, respectively (Figure 21). Welsh Cancer Intelligence and Surveillance Unit Official Statistics 2012 data. Published 10 April 2014 11 Cancer in Wales Published 10 April 2014 Cancers of the liver, lung and pancreas have the lowest survival According to 2007-2011 survival data, the three cancers with the lowest one year survival in Wales are liver and lung with survival rates of well under 30 per cent - and, lowest of all, cancer of the pancreas with only an 18 per cent survival (Figure 22). Cancers of the testis (testicles), breast, melanoma and prostate have the highest one year survival, at over 95 per cent. But, bowel cancer one year survival is around 75 per cent. Figure 22 One year relative survival from different types of cancer in Wales. 2007-2011 Figure 23 Five year relative survival from different types of cancer in Wales. 2003-2007 Relative Survival (%) 10 20 30 40 50 60 Relative Survival (%) 70 80 90 100 Testis Breast (Female only) Melanoma Prostate Uterus Thyroid & Endocrine Hodgkins Cervix Larynx Rectum Head & Neck Non-Hodgkins Lymphoma Colorectal Bladder Colon Urinary Tract exc Bladder Ovary Leukaemia Oesophagus Stomach Brain & CNS Liver Lung Pancreas 0 Cancer type Cancer type 0 Source: Welsh Cancer Intelligence and Surveillance Unit’s Cancer Registry www.wcisu.wales.nhs.uk 10 20 30 40 50 60 70 80 90 100 Testis Breast (Female only) Melanoma Prostate Uterus Thyroid & Endocrine Hodgkins Cervix Larynx Rectum Head & Neck Non-Hodgkins Lymphoma Colorectal Bladder Colon Urinary Tract exc Bladder Ovary Leukaemia Oesophagus Stomach Brain & CNS Liver Lung Pancreas Source: Welsh Cancer Intelligence and Surveillance Unit’s Cancer Registry www.wcisu.wales.nhs.uk Liver, lung and pancreas also have the lowest five year survival for the latest available figures 2003-2007. Survival is less than four per cent for pancreas, and below seven per cent for lung cancer and liver cancer (Figure 23). Cancers with the highest five year survival are testis (96%), prostate (86%), breast (85%) and melanoma (84%). We will look at survival from lung cancer in much more detail in our reports during 2014-15. ISBN 978-0-9928835-1-5 © 2014 Public Health Wales NHS Trust All tables, charts and maps were produced by the Welsh Cancer Intelligence and Surveillance Unit. Data sources are shown under each graphic. Material contained in this document may be reproduced without prior permission provided it is done so accurately and is not used in a misleading context. Acknowledgement to Public Health Wales NHS Trust to be stated. Copyright in the typographical arrangement, design and layout belongs to Public Health Wales NHS Trust. Images reproduced with permission 12 Welsh Cancer Intelligence and Surveillance Unit Official Statistics 2012 data. Published 10 April 2014