Download Cancer Statistics: In Detail

BRIEFING PAPER
Number SN02677, 30 September 2015
Cancer Statistics: In
Detail
By Alex Bate, Carl Baker
Inside:
1. Incidence: All Cancers
2. Mortality: All Cancers
3. Survival Rates: All Cancers
4. Specific Cancer Sites
5. Performance and Waiting
Times
6. Screening
7. International Data
www.parliament.uk/commons-library | intranet.parliament.uk/commons-library | [email protected] | @commonslibrary
Number SN02677, 30 September 2015
Contents
Summary
Incidence
Mortality
Survival
Screening
3
3
3
3
3
1.
1.1
1.2
1.3
1.4
1.5
1.6
1.7
Incidence: All Cancers
Explaining Age-Standardised Rates
Trends over Time
Cancer Incidence by Age
Gender
England, Wales, Scotland, Northern Ireland
Regions
Deprivation
4
4
5
6
9
10
10
12
2.
2.1
2.2
2.3
2.4
Mortality: All Cancers
Trends over Time
Age
UK Countries and Local Authorities
Mortality-Incidence Ratio
14
14
14
15
17
3.
3.1
3.2
3.3
Survival Rates: All Cancers
Trends over Time in England and Wales
Scotland
Northern Ireland
18
18
19
20
4.
4.1
4.2
4.3
4.4
4.5
4.6
4.7
Specific Cancer Sites
Breast Cancer
Lung Cancer
Colorectal Cancer
Prostate Cancer
Skin Cancer
HPV-Related Cancers
Other Cancer Sites
21
21
22
24
26
28
29
30
5.
5.1
5.2
5.3
Performance and Waiting Times
14-Day Wait from Referral to Specialist Appointment
31-Day Wait from Diagnosis to Treatment
62-Day Wait from Urgent GP Referral to Treatment
31
31
31
31
6.
6.1
6.2
Screening
Breast
Cervix
32
32
33
7.
7.1
7.2
International Data
Incidence and Mortality
Survival
35
35
37
Cover page image copyright: Untitled by Penn State. Licensed under CC BY-NC 2.0 /
image cropped.
2
3
Cancer Statistics: In Detail
Summary
Incidence
•
•
•
•
•
Age-standardised cancer incidence has grown steadily since 1995.
The most common cancers are prostate (men), breast (women),
and lung and colorectal (both genders). These cancers account for
over half of all cancers in each gender.
Cancer incidence rates are substantially higher among older
people.
Between the ages of 20 and 59, women are more likely to
contract cancer than men. After this the balance shifts: from age
60 onwards, men become increasingly more likely to contract
cancer than women.
Scottish male cancer incidence rates are the lowest in the UK,
whilst female rates are the highest. Wales has the highest male
incidence rates, whilst Northern Ireland has the lowest female
rates.
Mortality
•
•
•
Cancer death rates have steadily fallen in the last twenty years.
Rates among men are approximately 38% higher than among
women.
Cancer accounts for more than 50% of deaths among women
between the ages of 50 and 69.
Cancer mortality rates are highest in Scotland, without much
difference between the rates of other UK countries.
Survival
•
•
•
Around half of adult cancer patients diagnosed in England in
Wales in 2010-11 are expected to survive for 10 years or more.
Survival rates vary vastly between specific types of cancer. 87% of
breast cancer patients survive for five years after diagnosis, but
around 10% of lung cancer patients survive this period.
Survival rates are much lower for patients diagnosed through
emergency presentation. Of major cancers, colorectal (25%) and
lung (38%) have particularly high rates of diagnosis through
emergency presentation.
Screening
•
•
76% of women aged 53-64 have undergone a breast screening
test in the past three years. 13% of eligible women – half a
million – have never had a screening.
78% of eligible women aged 25-64 have had a cervical screening
test in the past five years.
Number SN02677, 30 September 2015
1. Incidence: All Cancers 1
1.1 Explaining Age-Standardised Rates
Cancer incidence rates in this document are given as ‘age-standardised
incidence rates’. These summarise the incidence rate that a population
would have if it had a standard age structure. Age-standardised rates
differ from crude rates in that they take into account the age structure
of the population being examined. This is very important for cancer,
which is far more prevalent among the elderly than the young, meaning
that variation among crude rates over time and between geographical
areas would likely only reflect a higher or lower proportion of elderly
people in the population.
There is more than one ‘standard population’ used for calculating these
rates. The ONS cancer incidence statistics use the European AgeStandardised Population. Sections 1-6 of this document use European
Age-Standardised Rates. Section 7, however, involves comparison with
countries outside of Europe, so uses the World Age-Standardised
Population. As such, the rates reported in sections 1-6 are not
comparable with those in section 7.
A further complication is that the European Age-Standardised
Population was updated in 2013. However, not all cancer data has been
updated to reflect this change. This means some data reported before
2013 may not be directly comparable with data reported after this date.
The ONS Cancer Registration data release contains a detailed
description of how these rates are calculated.
1
Unless otherwise stated, all data in this section is sourced from the ONS Cancer
Statistics Registrations (Series MB1), No. 44, 2013.
http://www.ons.gov.uk/ons/rel/vsob1/cancer-statistics-registrations--england--seriesmb1-/no--44--2013/stb-cancer-registration-2013.html
4
5
Cancer Statistics: In Detail
1.2 Trends over Time
In 2013, 293,000 people were diagnosed with cancer in England 2. This
is 24% higher than the number diagnosed in 2003. Chart 1 shows
changes in directly
Chart 1: Age-standardised incidence
age-standardised rates
rate per 100,000 population,
per 100,000
England, 2013
population since 1995.
Male age-standardised
800
Male
cancer rates have
700
increased by 5% over
600
the period, while rates
500
Female
among women have
400
increased by 15%.
300
Table 1 and Chart 2
200
(below) show the most 100
common cancers
0
among men and
women respectively.
For both genders, the
three most common cancers account for over half of all cancers. Lung
and colorectal cancer make up over 10% of cancers in both genders,
while prostate and breast cancer comprise over a quarter of cancers in
men and women respectively.
Table 1: Most common cancers, England 2013
Men
Site
Registrations % of total registrations
Prostate
40,372
26.9%
Lung
19,830
13.2%
Colorectal
18,839
12.6%
Total
79,041
52.8%
Women
Site
Registrations % of total registrations
Breast
44,540
31.2%
Lung
16,823
11.8%
Colorectal
14,926
10.4%
Total
76,289
53.4%
2
Figures for ‘all cancers’ in this document refer to ICD-10 classification codes C00C97, excluding C44 (non-melanoma skin cancer) as is customary. Data on nonmelanoma skin cancer is not considered to be reliable. A useful explanation of why
is available here: http://www.ncri.ie/faqs/using-cancer-data/why-are-data-nonmelanoma-skin-cancer-sometimes-excluded
Number SN02677, 30 September 2015
Chart 2: Most common cancers as a proportion of all cancers,
England, 2013
Prostate
Breast
Other
Other
Lung
Lung
Colorectal
Colorectal
Men
Women
Among men, prostate cancer has increased its share of total male
cancers from 24.6% to 26.9% since 2005. Among women, breast
cancer as a proportion of all cancers has fallen, although the number
registrations of breast cancer has risen in absolute terms.
Table 2, below, shows how incidence rates of selected cancers have
changed from 1995-2013. Sites are listed by ICD-10 disease category.
Table 2: Cancer sites with large changes in incidence: % change 3
Rising Rates
Thyroid gland
Skin
Liver
Kidney
Lip, oral cavity & pharynx
Male Female
x
+162
+130
+73
+65
+175
+91
+122
+86
+65
Falling rates
Secondary (respiratory/ digestive)
Stomach
Bladder
Lung
Larynx
Male Female
-62
-48
-41
-28
-19
-49
-47
-36
-25
x
These figures compare directly age-standardised rates from 1995 with
those from 2013 and includes some minor and rare categories of
cancer. Liver cancer incidence has doubled over the time period and is
now the eighteenth most common cancer in England. Rates of stomach
and bladder cancer have fallen notably since 1995.
While skin cancer rates have risen markedly in both men and women,
the rise among men has been much higher. See section 4.5 for more
data on skin cancer.
1.3 Cancer Incidence by Age
Cancer rates are much higher among older people than among young
people. Chart 3, below, illustrates the scale of this difference.
A man aged 80-84 is approximately 27 times more at risk from cancer
than a man aged 40-44. On the other hand, a woman aged 80-84 is
eight times more at risk from cancer than a woman aged 40-44.
3
‘x’ indicates an incidence rate that has fallen from or risen to less than 5
6
7
Cancer Statistics: In Detail
Chart 3: Cancer incidence by age group: rates per 100,000
population, newly diagnosed cases England 2013
4,000
Men
3,500
Women
3,000
2,500
2,000
1,500
1,000
500
0
To further illustrate the extent to which cancer registration is higher
among older people, Chart 4 (below) shows the cumulative percentage
of cancer registrations among all age groups. Among men, over 81% of
cancers are among those aged over 60. Among women, the equivalent
figure is 70%.
Chart 4: Cumulative percentage of all cancer registrations by age, England 2013
Women
Age 0-59
Men
Age 0-59
0%
10%
60-64
60-64
20%
65-69
30%
40%
65-69
70-74
70-74
50%
75-79
80-84
75-79
60%
70%
80-84
80%
Cancers common amongst older people
Chart 5 (below) highlights the cancers most common among older
people aged 80 and above: Unsurprisingly, given that cancer in general
is most common in the elderly, the most common cancers below are the
same as those listed in Table 1 (above).
85-89 90+
85-89 90+
90%
100%
Number SN02677, 30 September 2015
Chart 5: Rates per 100,000 population for specific cancer sites
among those aged 80+, England 2013
Age
Female
Oesophagus
80-84
85-89
90+
47.9
61.8
62.8
80-84
85-89
90+
Stomach
80-84
85-89
90+
47.7
52.9
48.0
463.1
503.6
494.0
80-84
85-89
90+
Colorectal
80-84
85-89
90+
311.8
340.2
306.7
520.1
575.9
523.1
80-84
85-89
90+
Lung
80-84
85-89
90+
323.5
322.7
248.2
105.3
115.4
128.8
80-84
85-89
90+
Skin
80-84
85-89
90+
61.1
65.6
61.6
6.7
6.2
3.9
80-84
85-89
90+
Breast
80-84
85-89
90+
432.1
458.9
459.9
738.6
775.9
932.3
80-84
85-89
90+
Prostate
80-84
85-89
90+
195.0
236.4
272.6
80-84
85-89
90+
Bladder
80-84
85-89
90+
51.9
69.4
78.3
123.3
129.5
116.2
80-84 Non-Hodgkin's 80-84
85-89
Lymphoma
85-89
90+
90+
82.1
82.9
67.2
57.4
89.4
138.2
80-84
85-89
90+
Unspecified
site
55.0
81.7
117.9
Male
Age
112.0
116.8
116.2
80-84
85-89
90+
117.6
136.7
114.7
80-84
85-89
90+
Most common cancers amongst adolescents and young people
Chart 6 (below) highlights the cancers most common among young
people aged 15-29. Although cancer is very rare in the young, the
distribution of specific sites is notably different than in older people. For
instance, testicular cancer is one of the most common sites in young
men, and Hodgkin’s disease is one of the most common cancers in the
young of both genders. Cervical cancer among women aged 25-29 has
increased notably over the past decade, as discussed by the National
Cancer Intelligence Network in their document on Cervical Cancer. 4
It is important to remember the difference in scale between Chart 5
(above) and Chart 6 (below). Above, male breast cancers are so low as
to be almost invisible on the scale. But the rate of male breast cancers
4
NCIN, Cervical Cancer Incidence and Screening Coverage, February 2011
8
9
Cancer Statistics: In Detail
among those aged 80-89 is higher than all male cancer sites except
testicular cancer among ages 20-29.
Chart 6: Rates per 100,000 population for specific cancer sites
among those aged 15-29, England 2013
Male
Age
Age
Female
1
1.6
3.3
15-19
20-24
25-29
Colorectal
15-19
20-24
25-29
2.5
2.3
3.1
0.7
2
4.6
15-19
20-24
25-29
Skin
15-19
20-24
25-29
1.6
4.7
10.3
15-19
20-24
25-29
Breast
15-19
20-24
25-29
1.5
9.6
15-19
20-24
25-29
Cervix
15-19
20-24
25-29
0.2
3.7
21.4
15-19
20-24
25-29
Ovary
15-19
20-24
25-29
2.1
3.8
5.5
3
9.7
17.2
15-19
20-24
25-29
Testis
15-19
20-24
25-29
0.4
0.9
2.2
15-19
20-24
25-29
Thyroid gland
15-19
20-24
25-29
1.7
1
2
3
4.2
4.3
15-19
20-24
25-29
Hodgkin's
Disease
15-19
20-24
25-29
3.8
4.6
3.7
2.2
2.4
2.8
15-19
20-24
25-29
Non-Hodgkin's
Lymphoma
15-19
20-24
25-29
1.3
2.3
2.2
3.3
2.5
2.7
15-19
20-24
25-29
Leukaemia
15-19
20-24
25-29
1.7
1.7
1.7
1.4
2.2
3.2
15-19
20-24
25-29
Brain
15-19
20-24
25-29
1.7
1
2
1.4 Gender
The age-standardised rate of cancer incidence is higher in men than in
women. However, this gender gap has fallen over the past two decades.
In 1995 male rates were 38% higher than female rates, but by 2013
this had fallen to 26%.
Chart 7 (below) shows the gender distribution of cancer rates in
different age groups. This chart does not represent the magnitude of
rates at different ages – this is given above in Chart 3 – but instead the
gender balance of rates for each age group. A 50% value represents
equal rates among men and women for that age group, and a 75%
value represents rates being three times as high for men as for women
(i.e. male rates totalling 75% of the summed rates).
Number SN02677, 30 September 2015 10
Rates are fairly even between genders until age 25, when there is a
large jump in female rates which is not matched in male rates. In the
40-44 and 45-49 age groups, female rates are more than double male
rates. The gender balance changes gradually in higher age groups,
plateauing from age 70 onwards.
Chart 7: Gender distribution of cancer rates per age
group, 2013
75%
FEMALE
100%
25%
MALE
50%
90+
85-89
80-84
75-79
70-74
65-69
60-64
55-59
50-54
45-49
40-44
35-39
30-34
25-29
20-24
15-19
10-14
5-9
1-4
Under 1
0%
1.5 England, Wales, Scotland, Northern
Ireland
Table 3 (below) details the rates in the various constituent countries of
the UK. Since 2003, all rates have risen except male rates in Scotland
and Wales, which have fallen by 8% and 3% respectively.
Table 3: Age-standardised incidence rates per 100,000 in UK
countries, 2013
Male
Female
Scotland N. Ireland
England Wales
679
694
683
708
581
539
542
563
Source: ONS, WCISU, ISD Scotland, Northern Ireland Cancer Registry
In Scotland, the gender gap has narrowed over the past two decades. In
1997 rates among Scottish men were 34% higher than among women,
but this has reduced to a 17% gap in the 2013 data. This is lower than
the English and Welsh gender gaps (both 26%). The largest gender gap
is in Northern Ireland, where male cancer rates are 29% higher than
female cancer rates.
1.6 Regions
Chart 8 (below) shows variance in cancer incidence rates across English
regions. Rates tend to be higher in the North and lower in the South,
especially in the South East. These differences vary between specific
cancer sites – for instance, skin cancer incidence is highest in the south.
11 Cancer Statistics: In Detail
Further instances of this regional variation will be explored in section 4,
where data on specific cancer sites is discussed.
The highest male cancer rates are found in the North West -- 10%
above the rates of men in London, where the lowest rates are
registered. Among women, the highest rates are in the North East, 14%
higher than in London.
Chart 8: Cancer rates per 100,000 population in English
regions, 2013
North West
Male
Female
North East
Yorks & Humber
West Midlands
South West
ENGLAND
South East
East Midlands
East
London
0
100
200
300
400
500
600
700
Wales
Incidences rates between 2009 and 2013 were lower than average in
Ceredigion and Powys, and higher than average in Merthyr Tydfil,
Torfaen and Newport. The highest local authority cancer incidence rate
in Merthyr Tydfil was almost 20 per cent higher than the lowest in
Ceredigion. Other local authorities did not vary notably from the Welsh
average. 5
Scotland
Scottish rates by NHS health board are shown in Chart 9 (below). Areas
such as Shetland, Western Isles and Orkney have low populations and
therefore low numbers of cancer registrations, which gives them very
large 95% confidence intervals. 6 As a result, their positions at the top or
bottom of the rankings should take this into consideration.
5
6
Welsh Cancer Intelligence and Surveillance Unit, Cancer in Wales, 3 February 2015
That is, we can be 95% sure that the true incidence rate lies within the given
interval
Number SN02677, 30 September 2015 12
Chart 9: Age-standardised incidence rates by NHS Health Areas, Scotland 2013
Shetland
Western Isles
Greater Glasgow & Clyde
Lothian
Ayrshire & Arran
Lanarkshire
SCOTLAND
Male
Female
Fife
Highland & Argyll
Borders
Tayside
Grampian
Forth Valley
Dumfries & Galloway
Orkney
0
200
400
600
Source: ISD Scotland, Detailed Cancer Data 7
The rates for Greater Glasgow & Clyde, Lanarkshire, Ayrshire & Arran,
Lothian and Shetland are higher than Scottish rates as a whole among
both sexes. Male and female rates are both lower than the Scottish
rates as a whole in Orkney, Dumfries & Galloway, Grampian, Tayside,
Borders, Highland & Argyll and Fife.
Northern Ireland
When analysed by Health and Social Care Trust area, Belfast has a
higher rate of cancer incidence than the Northern Ireland average,
whereas the South Eastern trust area has a lower than average
incidence. 8
1.7 Deprivation
Chart 10 presents data from the National Cancer Intelligence Network’s
Cancer by Deprivation in England, 1996-2011 9, showing that – when
accounting for age – those who are more deprived are more likely to
develop cancer.
7
8
9
ISD Scotland, Cancer Statistics, last accessed 30 September 2015
Queen’s University Belfast, Northern Ireland Cancer Registry, last accessed 24
September 2015
NCIN, Cancer by Deprivation in England, May 2014
800
1000
13 Cancer Statistics: In Detail
Chart 10: Age-standardised incidence rates by
deprivation quintile, England 2006-10
Most deprived
4th quintile
3rd quintile
2nd quintile
Male
Female
Least deprived
0
100
200
300
400
500
These figures are calculated by breaking down using the income domain
scores of the Indices of Multiple Deprivation 10. The document linked
above contains deprivation breakdowns for specific cancer sites.
10
DCLG, English Indices of Deprivation, last accessed 30 September 2015
Number SN02677, 30 September 2015 14
2. Mortality: All Cancers
2.1 Trends over Time
Despite the rise in incidence rates described above, mortality rates from
cancer in England and Wales have fallen in recent years. As Chart 11
shows, male mortality rates from cancer fell by 30% between 1994 and
2013. Female mortality rates also fell by 22%. Although male mortality
rates remain higher than rates among women, the ratio between the
two fell from 1.67 in 1994 to 1.49 in 2013.
Chart 11: Mortality rates for men and women, England
and Wales 1994-2013
Age-standardised death rates per million
3,500
3,000
2,500
Male
2,000
1,500
Female
1,000
500
0
1994 1996 1998 2000 2002 2004 2006 2008 2010 2012
Source: ONS Mortality Statistics 11
According to the ONS, the figure for Standardised Years of Life Lost
(SYLL) to cancer has not fallen as quickly as mortality rates. 12 Between
2001 and 2013, SYLL fell by around 8% in both men and women. Over
the same period, mortality rates fell by 12% among women and 18%
among men.
2.2 Age
Chart 12 shows the mortality rate from cancer broken down by age
group. Between ages 25 and 54, mortality rates are higher among
women than men; among all other age groups, rates are higher for
men.
11
12
ONS, Mortality Statistics: Deaths Registered in England and Wales, 2013
ONS, Avoidable mortality in England and Wales, 2013
15 Cancer Statistics: In Detail
38,673
Chart 12: Cancer mortality rates per million population,
2013
45,000
25,000
15,000
5,000
0
11
10,000
<1
30
22
23
21
33
32
82
101
236
339
894
981
3,221
2,662
8,026
5,817
20,000
1-4
17,372
11,284
30,000
19,734
Female
16,841
Male
35,000
29,780
40,000
5-14 15-24 25-34 35-44 45-54 55-64 65-74 75-84 85-89 90+
Source: ONS Mortality Statistics
Chart 13 (below) shows mortality from cancer as a proportion of all
deaths for each age group, broken down by gender. While cancer
deaths are about 25-35% of all deaths for ages 5-14, this drops for
ages 15-24. After this, the proportion steadily rises, peaking at over
50% for women among 50-69 year olds. At age 75, the proportion of
cancer deaths for men rises above that of women for the first time.
Chart 13: Deaths from cancer as a percentage of all deaths,
per age group
60%
50%
40%
Male
Female
30%
20%
10%
0%
Source: ONS Mortality Statistics
2.3 UK Countries and Local Authorities
Cancer mortality rates are highest in Scotland, as Chart 14 shows. Male
rates are 13% above the UK-wide rate, and female rates are 18%
above the UK rate. The male and female rates for England, Wales and
Northern Ireland are all less than 5% above or below the UK-wide rate.
Number SN02677, 30 September 2015 16
Chart 14: Age-Standardised Cancer Mortality
Rates in UK Countries, 2012
250
Male
200
150
100
50
199
147
196
225
143
174
198
152
206
147
0
UK
England
Scotland
Wales
Northern
Ireland
Source: Cancer Research UK 13
Table 4 and Figure 1 display a breakdown of local authorities in terms
of premature deaths to cancer. Many of the lower-ranked authorities
are in the north of England. Northern areas perform worse than
Southern areas in general, even when controlling for deprivation. The
London Boroughs of Newham, Brent, Waltham Forest and Haringey all
rank in the upper half (lower rates) of the premature deaths table
despite also being in the highest rank for deprivation. York is the only
least deprived area in the lower half (higher rates) of the premature
deaths table.
The highest premature death rates in less-deprived areas were found in
Thurrock, Milton Keynes, Northamptonshire and Warrington. The
lowest premature death rates in more-deprived areas were found in
Enfield, Camden, Torbay and Bolton. The full ranking of local authorities
can be found on the Longer Lives PHE website. 14
Table 4: Highest & lowest rates of premature deaths to cancer by
local authority
1 Harrow
2 Kensington & Chelsea
3 Barnet
4 Rutland
5 Buckinghamshire
6 Wokingham
7 Herefordshire
8 Windsor and Maidenhead
9 Surrey
10 Kingston upon Thames
11 Dorset
12 Westminster
13 Redbridge
14 Richmond upon Thames
15 Bath and North East Somerset
16 South Gloucestershire
17 Bromley
18 Cheshire East
19 Hampshire
20 Brent
13
14
104.0
116.3
118.0
119.3
120.0
120.3
120.7
121.1
121.1
122.1
122.2
122.4
123.2
123.5
124.8
125.2
126.0
127.0
127.8
128.4
Premature deaths per 100,000
150 Manchester
198.9
149 Liverpool
195.2
148 Middlesbrough
194.4
147 Kingston upon Hull
192.2
146 South Tyneside
192.0
145 Salford
190.3
144 Knowsley
190.3
143 Halton
188.0
142 Stoke-on-Trent
183.9
141 Blackpool
182.8
140 Barking and Dagenham
179.7
139 Doncaster
179.0
138 Nottingham
177.2
137 Redcar and Cleveland
176.0
136 Hartlepool
175.9
135 Oldham
174.9
134 Newcastle upon Tyne
173.6
133 Tameside
173.3
132 North Tyneside
172.8
131 Gateshead
172.8
Cancer Research UK, Cancer mortality for all cancers combined
Public Health England, Mortality rankings, last accessed 30 September 2015
17 Cancer Statistics: In Detail
Figure 1: Locations of highest and lowest rates of premature
deaths to cancer by local authority
Source: LongerLives
2.4 Mortality-Incidence Ratio
The mortality-incidence ratio (MIR) compares mortality rates with
incidence rates. This ratio is obtained by dividing the number of deaths
by the number of incidences. In England in 2013, the MIR was 0.47 for
men and 0.44 for women. 15 The MIR was highest in the North East
(0.52 for men, 0.47 for women) and lowest in London (0.44 for men,
0.40 for women).
Some variation in this ratio is evident between specific cancer sites:
•
•
•
•
•
15
The MIR for colorectal cancer is higher among women than in
men in every region (except the South West, where it is equal). It
is also higher or equal for stomach cancer in 5 of 9 English
regions.
The skin cancer MIR is lowest for men and women in Yorkshire
and the Humber. In the East Midlands, the male MIR (0.24) is
more than 1.5 times as high as the female ratio (0.15).
The breast and lung cancer MIRs do not vary much between
regions.
The prostate cancer MIR is highest in the North East and East
Midlands (0.26) and lowest in London (0.20).
The Leukaemia MIR is 13% higher in women than in men, whilst
the MIR for bladder cancer is 29% higher in women. In the South
East, the bladder cancer MIR (0.69) is 53% higher than the male
rate (0.45)
ONS, Cancer Statistics Registrations, England, 2013
Number SN02677, 30 September 2015 18
3. Survival Rates: All Cancers
According to Cancer Research UK, around 50% of adult cancer patients
diagnosed in England and Wales in 2010-2011 are expected to survive
for 10 years or more. Specifically, the figure is 46% for men and 54%
for women.
Chart 15: Survival rates for all cancers, England and Wales
80%
Male
70%
Female
60%
50%
40%
30%
66.7%
74.1%
49.3%
20%
59.2%
45.8%
53.7%
10%
0%
1-Year Survival
5-Year Survival
10-Year Survival
Source: Cancer Research UK 16
There is, however, large variation between different types of cancer,
with 78% of breast cancer patients surviving for 10 years or more but
only 4% of male and 7% of female lung cancer patients surviving this
period. Survival rates for specific cancer sites are explored in Section 4.
One key issue concerning cancer survival is the contribution of routes to
diagnosis to cancer survival prospects. The National Cancer Intelligence
Network’s publication Routes to Diagnosis 17 shows that those who are
diagnosed through presentation at emergency departments are
significantly less likely to survive their cancer – an effect which is visible
in all cancer sites and all groups. The issue is explored in more detail in
the Commons Library briefing paper, Cancer: Waiting Times for
Diagnosis and Treatment.
3.1 Trends over Time in England and Wales
Male five-year survival rates have almost doubled over the past 40 years,
as Chart 16 (below) shows. Female rates have remained higher than
male rates, with almost 60% now surviving for at least five years after
diagnosis.
16
17
Cancer Research UK, Cancer mortality for all cancers combined
NCIN, Routes to Diagnosis: Exploring Emergency Presentations, 2013
19 Cancer Statistics: In Detail
Chart 16: Five-year net cancer survival rates, England and
Wales
70%
Men
Women
60%
50%
40%
30%
20%
10%
34.3%
25.1%
40.9%
29.6%
47.1%
34.8%
52.7%
42.0%
55.9%
45.8%
59.2%
49.3%
2000-2001
2005-2006
2010-2011
0%
1971-1972
1980-1981
1990-1991
Source: Cancer Research UK
The ONS Cancer Survival Index for Clinical Commissioning Groups
(CCGs) found that one-year net survival improved from 59.7% for
patients diagnosed in 1997 to 69.3% for patients diagnosed in 2012.
Between 1997 and 2012, one-year survival rates have improved most in
Greater Manchester, Lancashire, and South Yorkshire & Bassetlaw. 18
Information on cancer survival rates for specific sites by NHS area team
can be found in the relevant ONS document. 19
3.2 Scotland
Of those diagnosed between 2007 and 2011, 66% of men and 70% of
women survived one year from diagnosis. The corresponding five-year
survival rates were 48% for men and 54% for women. These rates are
below those of England and Wales in Chart 16 (above), although the
gap is greater for women than for men.
Chart 17: Cancer survival rates, Scotland,
diagnosis 2007-2011
80%
Male
Female
70%
60%
50%
40%
30%
66.2%
69.5%
48.1%
20%
53.9%
10%
0%
1-Year Survival
5-Year Survival
Source: ISD Scotland
18
19
ONS, Index of cancer survival for Clinical Commissioning Groups in England, Adults
diagnosed 1997-2012 and followed up to 2013, 2014
ONS, Cancer survival by NHS England Area Team: Adults diagnosed 1997-2012,
followed up to 2013, 2014
Number SN02677, 30 September 2015 20
3.3 Northern Ireland
Of those diagnosed between 2004 and 2008, 68% of men and 70% of
women survived at least one year from diagnosis. The corresponding
five-year survival rates were 52% for men and 55% for women. The
male rates are broadly in line with the rates from England and Wales as
presented above, whilst the female rates are lower than the English and
Welsh equivalents. However, data for the equivalent time period for
Northern Ireland (up to 2011) is not available, so direct comparison is
not possible.
Chart 18: Cancer survival rates, Northern Ireland, diagnosis
2004-2008
80%
Male
70%
Female
60%
50%
40%
30%
67.5%
70.3%
51.5%
20%
55.1%
10%
0%
1-Year Survival
Source: Northern Ireland Cancer Registry
5-Year Survival
21 Cancer Statistics: In Detail
4. Specific Cancer Sites
4.1 Breast Cancer
44,540 cases of breast cancer were registered among women in the UK
in 2013. 20 20% of cases were among women aged under 50.
Incidence of breast cancer among women rose by 23% between 1995
and 2003.
Age-standardised incidence rate per
100,000 population
Chart 19: Incidence of Breast Cancer among women,
England 1995-2013
180
160
140
120
100
80
60
40
20
0
1995
1997
1999
2001
2003
2005
2007
2009
2011
2013
Chart 20: Cumulative percentage of breast cancer registrations by age group
Age 0-59
0%
10%
20%
60-64
30%
40%
50%
65-69
60%
70-74
70%
Source: ONS Cancer Registration 2013
In 2011, rates of breast cancer were around 5% lower in Northern
Ireland than in the UK as a whole. The Welsh rate was just below the
UK rate, whilst the incidence rate for Scotland was around 4% higher
than those for the UK. 21
Rates of breast cancer are highest in the South West and South East,
which are 4% and 5% respectively above rates for England as a whole.
20
21
Men can contract breast cancer, but it is very rare. 291 cases were registered in the
UK in 2013 and 86 men are recorded as dying from breast cancer. Cancer Research
UK has more information here: http://www.cancerresearchuk.org/cancerhelp/type/breast-cancer/about/types/breast-cancer-in-men
Cancer Research UK, Statistics by Cancer Type, last accessed 30 September 2015
75-79
80%
80-84 85-8990+
90%
100%
Number SN02677, 30 September 2015 22
Rates are lowest in London and the North East, which 6% and 5%
below the English rate. However, compared to other cancer sites, breast
cancer does not display much regional disparity.
Mortality
10,144 women died from breast cancer in 2013. 22 10% of these deaths
were among women aged under 50, whereas 36% were among
women aged 80 or over. The age-standardised female death rate from
breast cancer was 353 per million population. For those aged 90 and
over, the rate was 3,494 per million.
Survival
Breast cancer survival rates are high relative to other cancer sites. For
women diagnosed between 2010 and 2011 the one-year survival rate
was 96% while the five-year survival rate was 87%.
Chart 21: Breast cancer survival rates by year of diagnosis,
England and Wales
2000-2001
One-year
2005-2006
2010-2011
2000-2001
Five-year
2005-2006
2010-2011
70%
75%
80%
85%
90%
95%
100%
Source: Cancer Research UK
4.2 Lung Cancer
36,653 cases of lung cancer were registered in the UK in 2013. 54% of
cases were in men, and 77% were in people aged 65 or over. Only
2.5% of cases were in people aged under 50.
Incidence of lung cancer among males fell by 28% between 1995 and
2013. By contrast, female rates rose by 26% over the same time period.
Male rates of lung cancer remained 43% higher among men than
women in 2013, but this is a notable change from 1995 when male
incidence was 2.5 times that of women.
Lung cancer incidence is below that of breast cancer. For women, the
risk of breast cancer is over 2.5 times as high.
22
ONS Mortality Statistics.
23 Cancer Statistics: In Detail
Age-standardised incidence rate per
100,000 population
Chart 22: Incidence of Lung Cancer, England 1995-2013
140
120
100
80
60
40
Male
20
Female
0
1995 1997 1999 2001 2003 2005 2007 2009 2011 2013
Chart 23: Cumulative percentage of lung cancer registrations by age group
Female
Age 0-59
Male
Age 0-59
0%
60-64
60-64
10%
20%
65-69
70-74
65-69
30%
70-74
40%
50%
75-79
80-84
75-79
60%
80-84
70%
80%
Source: ONS Cancer Registration 2013
UK Countries
In 2012 rates of male lung cancer were 26% higher in Scotland than in
the UK as a whole. For Scottish women, the rate is 38% above the UKwide rate, and indeed are almost as high as the male rate for the UK as
a whole. The lowest rates are found among Northern Irish women, at
64.4 per 100,000. 23
English Regions
Rates of lung cancer are highest in the North East and North West. Male
rates for both regions are 26% higher than rates for England as a
whole, whilst for women rates are 59% and 33% respectively above
the English rates. The lowest rates are found in the South East and
South West.
23
Cancer Research UK.
85-89 90+
85-89 90+
90%
100%
Number SN02677, 30 September 2015 24
Mortality
30,437 people died of lung cancer in 2013, of which 55% were men. 24
2% of deaths were among people under age 50, while 80% were of
people aged 65 or over. The age-standardised death rate from lung
cancer was 746 per million for men and 485 per million for women.
Among those aged 90 and over, age-standardised male rates are more
than double the equivalent female rate.
Survival
Survival rates from lung cancer are low relative to other cancer sites.
Age-standardised one-year survival rates for 2010-11 are 30% in men
and 35% in women, up from 24% and 25% respectively among those
diagnosed in 2000-2001. Five year rates for 2010-11 are 8% for men
and 12% for women.
Chart 24: Lung cancer survival rates by year of diagnosis,
England and Wales
2000-2001
2005-2006
2010-2011
2000-2001
2005-2006
2010-2011
2000-2001
2005-2006
2010-2011
2000-2001
2005-2006
2010-2011
0%
10%
20%
30%
40%
Source: Cancer Research UK
4.3 Colorectal Cancer
33,765 cases of colorectal cancer were registered in 2013. 56% of
cases were among men. This gender difference is particularly evident in
rectal cancer (64% male) and cancer of the rectosigmoid junction (60%
male). 72% of colorectal cancers were in people aged 65 or over, while
6% were in people younger than 50.
Unlike breast and lung cancers, rates of colorectal cancer have risen only
slightly since 1995, with a rise of 3% for men and 2% for women. In
both men and women, rates of colorectal cancer are similar to those of
lung cancer.
24
ONS Mortality Statistics.
25 Cancer Statistics: In Detail
Age-standardised incidence rate per
100,000 population
Chart 25: Incidence of Colorectal Cancer, England
1995-2013
100
90
80
70
60
50
40
Male
30
Female
20
10
0
1995 1997 1999 2001 2003 2005 2007 2009 2011 2013
Chart 26: Cumulative percentage of colerectal cancer registrations by age group
Female
Age 0-59
Male
Age 0-59
0%
10%
60-64
65-69
60-64
20%
70-74
65-69
30%
40%
75-79
70-74
50%
80-84
75-79
60%
70%
Source: ONS Cancer Registration 2013
UK Countries
In 2011, male rates of colorectal cancer were around 15% higher in
Scotland and Northern Ireland than in the UK as a whole. Among
women, Northern Irish, Scottish and Welsh rates were above the UKwide rate (14%, 11% and 8% respectively). 25
English Regions
Among English regions, patterns of colorectal cancer differ between
genders. Male rates in the East are the lowest in England, whilst female
rates are the second highest behind the South West. The highest male
rates are in the North East, 12% above the rates for England as a
whole. The lowest female rates are in London, where the second lowest
male rates are also found.
Mortality
5,839 people died of colorectal cancer in 2013, of which 58% were
men. 26 5% of deaths were in those aged under 50, while 78% were
among those aged over 65.
25
26
Cancer Research UK.
ONS Mortality Statistics.
85-89
80-84
80%
90+
85-89 90+
90%
100%
Number SN02677, 30 September 2015 26
Survival
Colorectal cancer one-year survival rates for 2010-11 are 77% for men
and 74% for women, rising from 71% and 68% in those diagnosed in
2000-2001. Five-year survival rates for 2010-11 are 58% for women
and 59% for men.
Chart 27: Colorectal cancer survival rates by year of
diagnosis, England & Wales
2000-2001
2005-2006
2010-2011
2000-2001
2005-2006
2010-2011
2000-2001
2005-2006
2010-2011
2000-2001
2005-2006
2010-2011
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
Source: Cancer Research UK
4.4 Prostate Cancer
40,372 cases of prostate cancer were registered in 2013. Only 1% of
these cases were in men aged under 50, whereas 76% were in men
aged 65 or over.
Rates of prostate cancer among men were 43% higher in 2013 than in
1995. A major rise occurred between 1998 and 2001.
Prostate cancer in men is slightly more common than breast cancer in
women, and has markedly higher incidence than either colorectal or
lung cancer among men. Rates of prostate cancer are just over twice as
high as those of lung cancer in men.
Age-standardised incidence rate per
100,000 population
Chart 28: Incidence of Prostate Cancer, England 1995-2013
200
180
160
140
120
100
80
60
40
20
0
1995
1997
1999
2001
2003
2005
2007
2009
2011
2013
27 Cancer Statistics: In Detail
Chart 29: Cumulative percentage of prostate cancer registrations by age group
Age 0-59
0%
10%
60-64
20%
65-69
30%
70-74
40%
50%
75-79
60%
70%
80-84
80%
Source: ONS Cancer Registration 2013
Prostate cancer rates were lowest in Scotland in 2011, at 20% lower
than the UK as a whole. Northern Ireland also has incidence below the
UK-wide rate, with Welsh rates higher than the UK as a whole. 27
In the English regions, rates of prostate cancer are markedly lower in the
North East than any other region, 17% lower than the England average.
The three regions with the highest incidence are, in descending order,
the South West, the East, and the West Midlands.
Mortality
9,726 people died of prostate cancer in 2013. 28 Less than 0.5% of
these deaths were among men under 50. 94% of deaths were among
men aged 65 or over. The age-standardised death rates were 479 per
million among men.
Survival
Prostate cancer survival rates are high relative to other cancer sites. 94%
of patients diagnosed between 2010 and 2011 survived for one year,
and 85% survived for five years. This is an improvement from 2000-01,
where rates were 89% for one-year survival and 73% for five-year
survival.
Chart 30: Prostate cancer survival rates by year of
diagnosis, England and Wales
2000-2001
One-year
2005-2006
2010-2011
2000-2001
Five-year
2005-2006
2010-2011
0%
20%
Source: Cancer Research UK
27
28
Cancer Research UK.
ONS Mortality Statistics.
40%
60%
80%
100%
85-8990+
90%
100%
Number SN02677, 30 September 2015 28
4.5 Skin Cancer
12,246 cases of skin cancer were registered in 2013, with an almost
even gender distribution. 24% of these cases were among people aged
under 50 – much higher than most cancers. Among women, 29% of
cases were in those aged under 50 and 14% were in those aged under
40. Overall, 50% of cases were among people aged 65 or over.
Rates of skin cancer among men are more than 2.5 times higher than in
1995. Incidence among women has also risen, albeit at a slower rate,
having risen by 91% since 1995. Male incidence became larger than
female incidence in 2005.
Skin cancer is rarer than lung, prostate or colorectal cancer. Men are
just under seven times more likely to contract prostate cancer than skin
cancer, and women are over seven times more likely to contract breast
cancer than skin cancer. As for lung cancer, male rates are
approximately 3.5 times that of skin cancer, whereas female rates are
almost three times as high for lung cancer.
Age-standardised incidence rate
per 100,000 population
Chart 31: Incidence of Skin Cancer, England 1995-2013
30
25
20
15
10
Male
Female
5
0
1995 1997 1999 2001 2003 2005 2007 2009 2011 2013
Chart 32: Cumulative percentage of skin cancer registrations by age group
Female
Age 0-59
Male
60-64
Age 0-59
0%
10%
20%
60-64
30%
40%
65-69
50%
65-69
70-74
70-74
60%
75-79
75-79
70%
Source: ONS Cancer Registration 2013
UK Countries
In 2011 incidence rates for Welsh and Scottish men were 5% higher
than the UK rate, whilst the rate for Northern Irish men is 26% below
the UK rate. The rates for Scottish and Welsh women are similar to their
80%
80-84 85-8990+
80-84
85-8990+
90%
100%
29 Cancer Statistics: In Detail
male equivalents, whilst the rates for Northern Irish women is 8% below
that of the UK. 29
English Regions
Incidence rates of skin cancer are highest in the South West, at 41%
(men) and 27% (women) above the English rate. The South East also
has high incidence. London’s rates are markedly below those of any
other region for men and women – male rates there are less than half
of those in the South West. The gender gap also differs between
regions. In London, male rates are only 1% higher than female rates,
whereas in the East Midlands the gap is 24%.
Mortality
2,641 people died of skin cancer in 2013, of which 57% were men.
14% of deaths were among those aged under 50. 72% of deaths were
among those aged 65 or over. The age-standardised death rates were
51 per million among men and 32 per million among women. 30
Survival
Skin cancer survival rates are high relative to other cancer sites. 97% of
men and 98% of women diagnosed between 2010 and 2011 survive
one year, and 92% of women survive for five years. For men, the fiveyear survival rate is 88%.
Chart 33: Skin cancer survival rates by year of diagnosis,
England and Wales
2000-2001
2005-2006
2010-2011
2000-2001
2005-2006
2010-2011
2000-2001
2005-2006
2010-2011
2000-2001
2005-2006
2010-2011
0%
20%
40%
60%
80%
100%
Source: Cancer Research UK
4.6 HPV-Related Cancers
Some incidences of human papillomaviruses (HPVs), known as high-risk
or oncogenic HPVs, can cause cancer. The most well-known HPV-related
cancer is cervical cancer, but HPV can also lead to cancers of the vulva,
vagina, anus, penis and the lining of the mouth and throat.
29
30
Cancer Research UK.
ONS Mortality Statistics.
Number SN02677, 30 September 2015 30
Table 5: Incidence, mortality and survival data for HPV-related
cancers
Site
Gender
Cases
Cervix
F
Lip, mouth and pharynx M
F
M
Anus
F
Vulva
F
Vagina
F
Penis
M
Survival
1-year
5-year
67.4%
28
82.8%
62
27
-
Incidence Mortality
2,639
4,958
2,326
369
646
1,061
179
486
9.8
19.6
8.9
1.6
2.5
4.0
0.7
2.2
Inci dence: a ge-s ta nda rdi s ed ra te per 100,000 popul a ti on
Morta l i ty: a ge-s ta nda rdi s ed ra te per mi l l i on popul a ti on
Entri es ma rked wi th a da s h a re una va i l a bl e
Source: ONS Ca ncer Regi s tra ti on, ONS Morta l i ty Sta ti s ti cs , a nd Ca ncer Res ea rch UK.
More information on HPV-related cancer can be found on Macmillan
Cancer Support’s website.
4.7 Other Cancer Sites
Data on other cancer sites can be obtained from the ONS and Cancer
Research UK publications sourced above. Alternatively, please contact
the relevant specialists at the House of Commons Library who will be
happy to provide data relating to any other cancer site.
31 Cancer Statistics: In Detail
5. Performance and Waiting
Times
The NHS monitors performance for cancer treatment on a number of
key standards. 31 These include:
•
•
•
14-day wait from urgent GP referral to first specialist appointment
31-day wait from diagnosis to first definitive treatment
62-day wait from urgent GP referral to first definitive treatment
5.1 14-Day Wait from Referral to Specialist
Appointment
In April-June 2015, 93.6% of patients received their first specialist
appointment within two weeks of referral. This was down slightly from
the high of 95.5% for the same quarter in 2013-14. The operational
standard (target) for this measure is 93%.
The performance rate varies between cancers. For gastrointestinal
cancers the rate is below 93%. However, for haematological
malignancies (excluding acute leukaemia) and testicular cancer the rates
are above 96%.
5.2 31-Day Wait from Diagnosis to Treatment
Of admitted patients, 97.5% received their first treatment within 31
days of diagnosis in April-June 2015. This was down slightly from the
high of 98.4% for the same quarter in 2012-13. The operational
standard for this measure is 96%.
Breast and lung cancer patients fared best on this measure, with over
98% receiving treatment within 31 days. For urological cancer patients
the rate was 94.1%.
5.3 62-Day Wait from Urgent GP Referral to
Treatment
Overall, 82% of admitted cancer patients receive treatment within 62
days of urgent GP referral in April-June 2015. This was down from the
high of 87.5% for the same quarter in 2012-13. The operational
standard for this measure is 85%.
The figure is over 95% for breast and skin cancer. Of lung cancer
patients, only 70.9% were treated within 62 days of referral. Urological
and lower gastrointestinal cancer patient treatment rates within this
measure are also below 75%.
31
All data in this section is taken from the relevant NHS England statistical work areas:
http://www.england.nhs.uk/statistics/statistical-work-areas/cancer-waiting-times/
Number SN02677, 30 September 2015 32
6. Screening
6.1 Breast
The NHS Breast Screening Programme offers free breast screening every
three years for all women aged 50 to 70. In 2013-14, 76% of women
aged 53-64 had undergone a breast screening test in the past three
years. Coverage has fluctuated between 75% and 77% since 2004.
13% of eligible women aged 53-64 – about half a million – had never
had a screening test. 32
The highest rate of women never screened was in London, at 18%,
while the lowest was in the East Midlands, at 10%. Correspondingly,
these two areas had the lowest and highest rates (respectively) of
women screened within the past three years.
At the English local authority level, most of the authorities with lower
coverage were London boroughs. The exceptions in the lowest twenty
authorities were Manchester, Blackburn with Darwen, Oldham,
Liverpool, Slough and Southend-on-Sea.
Table 6: Breast screening coverage, highest and lowest local
authorities, 2013-14
1 Leicestershire
2 Rutland
3 Shropshire
4 Cumbria
5 Nottinghamshire
6 Wokingham
7 Derbyshire
8 West Berkshire
9 Northumberland
10 Barnsley
11 York
12 South Gloucestershire
13 Dorset
14 Gloucestershire
15 Cornwall & Isles of Scilly
16 North Yorkshire
17 Poole
18 Isle of Wight
19 Wiltshire
20 Northamptonshire
32
83.6%
82.5%
81.9%
81.7%
81.6%
81.5%
81.5%
81.4%
81.2%
80.6%
80.5%
80.5%
80.4%
80.3%
80.3%
80.2%
80.2%
80.1%
80.0%
80.0%
% in last 3 years, age 53-64
150 Islington
58.2%
149 Kensington and Chelsea
59.3%
148 Manchester
60.5%
147 Hammersmith and Fulham
61.0%
146 Camden
61.0%
145 Westminster
61.3%
144 Hackney & City of London
61.9%
143 Tower Hamlets
62.8%
142 Lambeth
63.3%
141 Wandsworth
64.3%
140 Kingston upon Thames
64.4%
139 Southwark
64.6%
138 Blackburn with Darwen
65.2%
137 Lewisham
65.7%
136 Merton
66.3%
135 Croydon
66.5%
134 Oldham
67.0%
133 Liverpool
67.8%
132 Slough
67.8%
131 Southend-on-Sea
67.8%
Health & Social Care Information Centre, Breast Screening Programme, England
2013-14, 2015
33 Cancer Statistics: In Detail
Chart 34: Breast screening coverage by age (% in last 3 years),
England 2013-14
100%
80%
60%
40%
20%
0%
45-49
50-52
53-54
55-59
60-64
65-69
70
71-74
75+
6.2 Cervix
All women between the ages of 25 and 64 are eligible for a free cervical
screening test every three to five years. 78% of eligible women have
been screened at least once in the last five years. This is a slight fall from
2004, when the figure was 81%. 33 Table 7, Figure 1 and Chart 35
(below) show breakdowns by both local authority and age group.
At a local level, London once again has low coverage rates, with half of
the bottom 20 local authorities – although coverage for the lowest
areas is higher than for the areas with the lowest breast cancer
screening coverage. The coverage for the highest areas is broadly similar
to that of the best performing authorities for breast cancer screening.
Table 7: Cervical screening coverage, highest and lowest local
authorities, 2013-14
1 Nottinghamshire
2 Derbyshire
3 North East Lincolnshire
4 East Riding of Yorkshire
5 South Gloucestershire
6 Rutland
7 Bexley
8 Bromley
9 Wokingham
10 Northumberland
11 Dorset
12 Leicestershire
13 Havering
14 Bracknell Forest
15 West Berkshire
16 Barnsley
17 Central Bedfordshire
18 Poole
19 North Yorkshire
20 Calderdale
33
82.6%
82.6%
82.4%
82.0%
81.9%
81.8%
81.8%
81.7%
81.7%
81.3%
81.3%
81.3%
81.3%
81.3%
81.2%
81.1%
81.1%
81.0%
81.0%
81.0%
% in last 5 years, age 25-64
150 Kensington and Chelsea
67.8%
149 Hammersmith and Fulham
68.6%
148 Westminster
69.5%
147 Camden
69.9%
146 Manchester
71.1%
145 Harrow
71.2%
144 Ealing
72.0%
143 Liverpool
72.1%
142 Blackburn with Darwen
72.2%
141 Birmingham
72.2%
140 Hounslow
72.4%
139 Leicester
72.6%
138 Middlesbrough
73.2%
137 Blackpool
73.4%
136 Wandsworth
73.4%
135 Brent
73.5%
134 Slough
73.5%
133 Luton
73.5%
132 Hillingdon
73.6%
131 Portsmouth
73.8%
HSCIC, Cervical Screening Programme, England 2013-14, 2015
Number SN02677, 30 September 2015 34
Figure 2: Locations of highest and lowest rates of cervical
screening coverage by local authority
Chart 35: Cervical screening coverage by age (% in last 5
years), England 2013-14
100%
90%
80%
70%
60%
50%
40%
30%
20%
10%
0%
20-2425-2930-3435-3940-4445-4950-6450-5455-5960-6465-6970-74 75+
Coverage increases sharply from age 20 to 30, when it stays at around
75-80% until women stop being eligible for free screenings at age 65.
35 Cancer Statistics: In Detail
7. International Data
Figure 3: Incidence, age-standardised rates per 100,000
population
Figure 4: Mortality, age-standardised rates per 100,000
population
Source: GLOBOCAN 2012
7.1 Incidence and Mortality
International comparisons in this section are taken from the GLOBOCAN
2012 34 report, which estimates incidence and mortality for major cancer
34
World Health Organization, Globocan 2012: Estimated Cancer Incidence, Mortality
and Prevalence Worldwide in 2012, last accessed 30 September 2015
Number SN02677, 30 September 2015 36
types across the world. The incidence rates reported below are
calculated using the World Age-Standardised Population rather than the
European Age-Standardised Population, so are not comparable or
consistent with those discussed in previous sections.
Chart 36 (below) shows incidence and mortality in selected countries.
Recorded cancer incidence varies greatly across countries, from 91 per
100,000 in Saudi Arabia to 338 per 100,000 in Denmark. The UK’s
incidence rate of 273 is relatively high. However, mortality rates are
much more uniform between countries, as the upper section of the
chart shows. One should be cautious about interpreting these wide
variations in registered incidence as indicators of the scale of variation in
cancer prevalence, since in some cases low incidence rates may reflect
low quality cancer registration data (and vice versa for high rates).
Chart 36: Cancer incidence and mortality rates (age-standardised) per 100,000,
selected countries
500
450
400
Incidence
Mortality
350
300
250
200
150
100
50
Saudi Arabia
India
Nigeria
Pakistan
Mexico
Iran
Indonesia
Philippines
Iraq
Egypt
Greece
China
South Africa
Ukraine
Brazil
Japan
Russia
Turkey
Finland
Portugal
Spain
Romania
Bulgaria
Austria
Poland
Sweden
Switzerland
Italy
UK
Germany
New Zealand
Canada
South Korea
France
Ireland
Australia
USA
Denmark
0
Source: GLOBOCAN 2012
Because of the mortality-incidence anomaly, it is useful to look at the
ratio between mortality rates and incidence rates in each country.
Assuming equivalent data quality, a high mortality-incidence ratio
suggests either that few cancers beyond those which are terminal are
detected, or that the quality of medical care is such that few of those
with cancer survive. A low ratio suggests either that many non-fatal
cancers are detected, or that the quality of medical care is such that
many detected cancers can be treated.
Chart 37 (below) compares mortality-incidence ratio with the raw
incidence data found above. There is a negative relationship (r2=0.674)
between the two variables, suggesting that countries with high
incidence rates are likely to have low mortality-incidence ratios, while
countries with low incidence rates are likely to have high incidencemortality ratios. As such, even though countries like India have very low
incidence rates, their mortality rates are high, at around 70% of
37 Cancer Statistics: In Detail
incidence. By contrast, the figure for the UK is closer to 40%, despite
the UK’s incidence being around three times that of India.
Chart 37: Correlation between incidence and mortality-incidence ratio
Mortality rate as a proportion of incidence rate
1
0.9
Niger
0.8
Haiti
0.7
India
South Africa
0.6
Russia
Chile
0.5
Lebanon
0.4
UK
USA
New Zealand
0.3
Denmark
South Korea
0.2
R² = 0.674
0.1
0
0
50
100
150
200
250
300
Age-standardised incidence rate
Source: GLOBOCAN 2012
7.2 Survival
Detailed data on survival rates is given in EUROCARE-5 35, an
epidemiological study of patients diagnosed between 2000 and 2007.
The table on the following page shows in detail the performance of
European nations for key cancers, with colour coding denoting
performance relative to other European countries for that particular
cancer, gender and survival measure.
The data in Table 8 (below) suggests that the UK and Ireland perform
slightly below the European average for many cancers. This discrepancy
is particularly evident in cancers of the pancreas and lung. On the other
hand, the performance of Ireland, Northern Ireland and Scotland on skin
cancer survival is above the European average.
Similar findings were published in The Lancet in 2011, finding that
between 1995 and 2007 relative cancer survival was lower in the UK
and Denmark than in Norway, Canada, Australia and Sweden. 36
35
36
European Cancer Registry, EUROCARE-5, last accessed 30 September 2015
The Lancet, ‘Cancer survival in Australia, Canada, Denmark, Norway, Sweden, and
the UK, 1995—2007 (the International Cancer Benchmarking Partnership): an analysis
of population-based cancer registry data’, 377:9760, January 2011
350
400
Number SN02677, 30 September 2015 38
Table 8: Cancer survival rate (%), Europe 2007
Breast
Cervix
F1 F5 F1 F5
European average 94.8 81.8 84.1 62.4
Central
Austria
93.6 82.1 83.9 66.1
Belgium
95.7 82.7 86.3 66.5
France
96.6 86.1 85.6 61.4
Germany
95.3 83.6 84.3 63.5
Netherlands
96.5 84.5 84.6 65.8
Switzerland
96.8 84.6 85.1 63.9
Eastern
Bulgaria
91.4 71.7 77.4 51.0
Czech Republic 92.0 78.0 83.6 63.0
Estonia
91.3 72.1 84.6 64.2
88.3 69.3 74.6 51.0
Latvia
Lithuania
87.2 66.7 77.4 56.0
Poland
90.9 71.6 79.9 53.6
Slovakia
91.5 73.9 81.4 60.4
Northern
Denmark
94.9 81.5 82.8 64.6
96.3 85.7 87.2 67.3
Finland
Iceland
96.7 87.2 90.6 69.6
Norway
96.4 84.7 87.8 71.0
Sweden
97.3 86.0 87.1 66.8
Southern
Croatia
89.8 76.3 81.8 65.1
Italy
96.7 85.5 88.3 67.5
Malta
95.7 80.8 74.8
Portugal
95.3 83.3 85.8 61.3
Slovenia
93.9 78.7 84.9 68.2
Spain
95.1 82.8 85.9 63.9
UK & Ireland
England
93.5 79.3 79.9 59.6
Ireland
93.7 79.0 81.9 58.9
Northern Ireland 94.4 81.9 83.2 61.1
Scotland
93.8 78.5 80.8 57.9
Wales
91.9 78.2 77.9 58.1
Cancer
Wors e
Non-Hodgkin's
Uterus
Colorectal
Lung
Lymphoma
Pancreas
Prostate
Skin
F1 F5 M1 M5 F1 F5 F1 F5 M1 M5 F1 F5 M1 M5 F1 F5 M1 M5 M1 M5 F1 F5 M1 M5
79.1 57.7 78.7 55.8 90.5 76.2 42.8 15.9 37.6 12.0 78.8 61.9 77.4 57.2 27.9 7.9 24.7 6.3 94.6 83.4 96.1 86.6 93.9 79.2
81.4
84.9
83.4
82.9
80.0
84.5
62.3
63.4
60.7
62.9
59.3
62.3
80.8
83.9
81.7
82.2
79.6
84.7
60.8
61.3
57.8
61.0
58.2
61.9
90.3
92.3
90.2
93.0
91.1
92.6
77.9
78.6
73.0
81.3
78.5
78.5
46.7
48.5
48.3
46.6
40.5
48.8
20.4
18.7
16.5
18.5
13.9
17.5
41.4
43.6
42.1
41.3
39.5
42.5
14.9
14.3
13.1
14.5
13.0
14.2
78.1
82.8
84.6
81.8
79.2
83.4
62.6
67.0
68.4
66.0
61.7
69.1
76.6
81.9
83.3
81.1
77.5
82.9
59.7
63.7
63.9
61.3
57.3
63.2
30.3
36.8
36.1
33.8
19.4
33.2
67.8
73.9
72.1
66.2
67.7
70.1
73.1
43.2
52.0
52.0
39.9
45.3
46.5
49.4
65.7
73.5
72.5
66.6
66.3
71.4
72.5
41.6
50.2
48.2
40.2
45.4
44.9
48.1
86.4
89.7
84.4
86.1
87.0
88.4
88.0
69.6
76.9
70.0
69.8
73.4
70.8
71.0
27.7
38.1
37.0
36.6
32.0
43.4
40.4
10.0
14.4
15.6
19.3
13.1
18.6
13.8
22.6
33.0
33.1
31.0
28.2
36.8
34.3
5.5
10.5
10.4
10.5
8.0
12.9
9.4
64.9
76.2
76.6
68.1
73.0
70.9
72.3
43.7
59.2
56.2
50.6
53.8
48.8
52.4
60.9
76.3
74.6
68.3
69.3
67.5
69.9
32.8
55.9
47.2
43.7
44.9
39.8
44.7
76.9
81.9
83.8
81.8
83.8
55.7
62.7
65.9
62.6
63.3
75.7
80.3
81.7
80.5
83.4
52.7
58.7
65.6
58.7
59.3
90.5
92.6
90.3
93.0
94.6
78.3
83.2
80.8
82.9
85.5
36.5
44.1
41.9
39.8
44.7
11.3
15.6
14.4
14.5
17.0
32.6
36.8
40.8
35.6
39.2
9.4
9.7
13.2
12.0
12.6
81.2
77.7
86.8
82.8
83.0
64.9
62.7
78.9
66.0
66.5
80.2
75.8
85.7
79.8
83.2
69.5
81.8
76.7
79.9
76.3
78.9
50.5
60.5
54.2
58.6
53.0
57.6
68.1
81.8
78.4
79.4
74.1
78.7
48.0
59.5
58.9
56.6
51.9
56.4
86.3
91.4
90.4
88.2
91.0
89.0
75.5
76.1
80.2
72.1
78.6
74.4
37.9
46.2
34.4
45.2
41.3
42.1
17.1
17.3
18.0
17.5
12.8
14.7
34.2
41.0
28.0
35.4
34.9
37.0
14.4
13.2
8.4
9.6
10.1
10.1
69.2
79.3
73.0
73.3
78.2
78.6
51.2
62.9
56.6
55.7
58.7
63.3
74.1
75.8
76.2
75.8
73.1
53.2
56.4
55.6
54.9
52.3
74.5
76.6
76.7
76.3
73.8
51.3
52.5
52.6
53.1
50.0
89.1
89.2
87.1
89.9
87.9
75.7
74.2
73.6
76.9
73.7
32.1
36.4
32.3
33.3
31.3
9.9
14.5
12.0
9.5
9.5
29.0
28.3
29.8
29.1
26.7
8.0
10.0
10.5
8.0
7.9
76.1
79.0
77.0
78.1
76.7
59.1
65.1
63.6
62.4
59.8
94.7
97.1
97.5
96.4
96.5
97.2
90.2
89.5
88.8
89.3
83.3
86.6
93.4
97.0
98.1
97.7
98.7
99.0
86.0
86.2
89.3
91.5
91.5
91.4
90.1
95.1
97.6
96.4
97.2
97.6
80.4
79.1
84.4
86.9
84.4
89.2
14.6
19.7
20.1
17.0
24.4
24.4
19.5
4.9 13.9 5.4 79.3
6.4 17.1 5.0 92.0
6.2 20.1 4.6 90.5
15.4 6.3 85.3
6.4 19.9 5.5 91.3
8.3 20.0 7.8 87.8
6.5 17.8 5.4 86.7
50.5
78.1
72.8
65.6
82.8
66.6
65.3
83.6
96.4
94.1
88.8
90.2
87.6
94.2
58.8
85.3
77.3
68.2
73.5
66.8
80.3
74.7
95.0
92.8
83.2
86.1
81.7
89.8
40.7
81.2
60.6
59.9
61.7
55.4
67.6
62.5
56.9
68.8
61.8
62.9
19.6
27.8
25.0
22.2
25.6
4.5 18.0 4.0
5.9 22.2 3.8
24.1 4.4
4.8 21.2 5.4
5.2 23.6 5.8
92.9
97.8
96.6
96.5
98.0
69.2
90.1
82.4
83.4
87.5
97.6
97.6
98.8
98.1
98.7
91.6
89.3
84.7
90.6
92.3
96.2
94.3
94.6
96.1
97.9
82.9
81.4
83.5
81.5
86.2
66.0
79.1
63.5
72.3
76.7
76.2
44.0
60.9
41.2
52.8
51.5
58.2
21.1
30.7
22.7
28.7
20.8
24.6
10.8 21.2 10.6
8.6 26.7 6.2
18.1
11.3 24.9 6.9
6.2 19.2 4.7
7.0 22.7 5.2
86.3
96.4
93.9
95.5
91.8
95.0
71.2
88.4
85.0
89.2
74.3
84.6
87.7
97.1
98.0
95.3
96.4
97.4
76.0
88.9
87.5
84.3
83.9
88.9
82.0
95.7
99.5
91.1
94.8
94.4
65.0
81.9
88.5
74.3
77.0
79.1
74.5
78.0
74.6
77.5
74.5
54.8
61.6
54.6
58.3
53.9
20.5 5.1 18.8 4.3 93.9 80.3
24.1 9.8 17.9 4.8 95.2 85.5
15.3
15.5 1.5 94.8 83.3
18.2
16.4 3.6 93.4 78.8
20.4 6.9 17.6 4.3 91.3 78.0
97.1
98.3
98.7
97.8
95.0
89.1
90.3
94.6
92.1
84.6
95.0
95.2
96.0
96.0
92.3
80.7
80.7
85.6
84.5
74.1
Better
(Rel a ti ve to Europea n a vera ge)
M1 = male one-year survival rate, %
survival rate, %
F1 = female one-year
M5 = female five-year survival rate, %
survival rate, %
F5 = female five-year
Source: Eurocare 5
9.0
11.7
9.2
9.5
4.0
8.0
26.7
32.8
30.3
30.6
18.8
30.7
7.3
9.3
6.4
8.4
4.1
5.4
The House of Commons Library research service provides MPs and their staff
with the impartial briefing and evidence base they need to do their work in
scrutinising Government, proposing legislation, and supporting constituents.
As well as providing MPs with a confidential service we publish open briefing
papers, which are available on the Parliament website.
Every effort is made to ensure that the information contained in these publically
available research briefings is correct at the time of publication. Readers should
be aware however that briefings are not necessarily updated or otherwise
amended to reflect subsequent changes.
If you have any comments on our briefings please email [email protected].
Authors are available to discuss the content of this briefing only with Members
and their staff.
If you have any general questions about the work of the House of Commons
you can email [email protected].
Disclaimer - This information is provided to Members of Parliament in support
of their parliamentary duties. It is a general briefing only and should not be
relied on as a substitute for specific advice. The House of Commons or the
author(s) shall not be liable for any errors or omissions, or for any loss or
damage of any kind arising from its use, and may remove, vary or amend any
information at any time without prior notice.
BRIEFING PAPER
Number SN02677, 30
September 2015
The House of Commons accepts no responsibility for any references or links to,
or the content of, information maintained by third parties. This information is
provided subject to the conditions of the Open Parliament Licence.