Tuesday, April 24, 2012

There were 136,372 new cases of cancer registered for males and 132,386 for females in England during 2010 - ONS

Summary

This annual bulletin presents the number of newly diagnosed cases of cancer (incidence) and the age-standardised incidence rates for the three most common cancers for males and females in England, in 2010.

This is the first time that the Office for National Statistics (ONS) has published 2010 statistics on cancer incidence in England.

Table 1: Number of newly diagnosed cancers and age-standardised rates; by sex, 2010, England

Males     Females
Site Number Percentage Rate2       Site Number Percentage Rate
Prostate 34,892 25.6 106.4     Breast 41,259 31.2 125.7
Lung  18,738 13.7 55.9     Lung 15,041 11.4 37.9
Colorectal 18,590 13.6 56.5     Colorectal 14,628 11 36.1
                   
Sub-total 72,220 53.04 : 5     Sub-total 70,928 53.64 : 5
    .
All cancers3 136,372 100 422.6     All cancers2 132,386 100 369.6

Table notes:

  1. Prostate cancer is defined by the International Classification of Diseases, Tenth revision (ICD-10) code C61, lung cancer is defined as ICD-10 code C34, colorectal cancer is defined as ICD-10 codes C18-20 and breast cancer is defined as ICD-10 code C50.
  2. Directly age-standardised rate per 100,000 using the European Standard Population, see background note 1.
  3. Cancer incidence is defined using International Classification of Diseases, Tenth Revision (ICD-10) codes C00-C97 excluding code C44, non-melanoma skin cancer.
  4. Percentages may not sum to sub-total or total due to rounding.
  5. Denotes not applicable – rates are not calculated on this subtotal.
  6. Source: Office for National Statistics on behalf of the Cancer Registries

Incidence rates

The accompanying tables give detailed figures for the numbers of cases and rates by sex and age group.

There has been little change in the age-standardised incidence rate of cancer registrations (see background notes 1 and 2) in England in the last three years. Between 2009 and 2010, the age-standardised incidence rate for males decreased by 1.7 to 422.6 per 100,000 population while the female age-standardised rate increased by 2.7 to 369.6 females per 100,000 population.

Figure 1: Age-standardised rate of cancer registrations, 2001-2010 England

Age-standardised rate of cancer registrations, 2001-2010 England

Notes:

  1. Directly age-standardised rate per 100,000 using the European Standard Population, see background note 1.
  2. Cancer incidence is defined using International Classification of Diseases, Tenth Revision (ICD-10) codes C00-C97 excluding code C44, non-melanoma skin cancer.
  3. Figures for 2001–2009 are based on rates reported in the most recent Annual Reference Volume and represent registrations received at ONS by September 2010, figures for 2010 are based on registrations received at ONS by December 2011.
  4. Source: Office for National Statistics on behalf of the Cancer Registries
 

Most common cancers among males and females

Table 1 summarises figures for the three most common cancers in males and females, together they account for 53 per cent of all new cancer registrations. The three most common sites for new cancer registrations for men in 2010 are prostate, lung and colorectal. For females, the three most common sites are breast, lung and colorectal.

Number of new cases diagnosed by site

There were 136,372 new cases of cancer registered for males and 132,386 for females in England in 2010 (see background note 2).

For males, the overall number of registrations increased by 1,736 in 2010 compared with 2009. There were 299 more cases of prostate cancer in 2010 compared with 2009, while there were 363 more cases of colorectal cancer, and 246 more cases of lung cancer.

For females, the overall number of registrations increased by 2,343 cases in 2010 compared with 2009. There were 999 more cases of breast cancer, 419 more cases of lung cancer and 104 more cases of colorectal cancer in 2010, compared with 2009.

Breast cancer continued to account for around one-in-three newly diagnosed cases of cancer in females. Between 2001 and 2010, the age-standardised incidence rate for breast cancer increased by 6.3 per cent (Cancer statistics – registrations, England). The primary risk factors for breast cancer are considered to be age, late childbearing, lack of breastfeeding, higher hormone levels and family history (Cancer Research UK).

Figure 2: Directly age-standardised rates for the three most common sites: by sex, 2001-2010 England

Females:

Directly age-standardised rates for the three most common sites: by sex, 2001-2010 England

Enlarged to show detail for lung and colorectal cancer in females

Enlarged to show detail for lung and colorectal cancer in females

Notes:

  1. Directly age-standardised rate per 100,000 using the European Standard Population, see background note 1.
  2. Breast cancer is defined by the International Classification of Diseases, Tenth revision (ICD-10) code C50, lung cancer is defined as ICD-10 code C34 and colorectal cancer is defined as ICD-10 codes C18–C20.
  3. Figures for 2001–2009 are based on rates reported in the most recent Annual Reference Volume and represent registrations received at ONS by September 2010, figures for 2010 are based on registrations received at ONS by December 2011.
  4. Source: Office for National Statistics on behalf of the Cancer Registries

Prostate cancer accounts for just over one-in-four newly diagnosed cases of cancer in males. A sharp rise in the incidence of prostate cancer was observed in the early part of the 1990s after increased use of prostate-specific antigen (PSA) testing resulted in more cases being diagnosed (Quinn et al, 2001). Between 2001 and 2010 the age-standardised rate increased by around
10 per cent. The established risk factors of prostate cancer are age, family history and ethnicity: although many other factors including alcohol, smoking, diet, physical activity and medications have also been implicated in its development (Cancer Research UK). Prostate cancer is relatively uncommon in men under 45 but becomes more common with advancing age.

Figure 3: Directly age-standardised rates for the three most common sites: by sex, 2001-2010 England

Males:

Directly age-standardised rates for the three most common sites: by sex, 2001-2010 England

Notes:

  1. Directly age-standardised rate per 100,000 using the European Standard Population, see background note 1.
  2. Prostate cancer is defined by the International Classification of Diseases, Tenth revision (ICD-10) code C61, lung cancer is defined as ICD-10 code C34 and colorectal cancer is defined as ICD-10 codes C18–C20.
  3. Figures for 2001–2009 are based on rates reported in the most recent Annual Reference Volume and represent registrations received at ONS by September 2010, figures for 2010 are based on registrations received at ONS by December 2011.

The age-standardised incidence rate of lung cancer in males was 55.9 per 100,000 population in 2010. Since 2001 the age-standardised incidence rate has decreased by 15 per cent (from 66.1 males per 100,000 population). In contrast, the lung cancer incidence rate for females increased by 1.1 per cent to 37.9 per 100,000 population between 2009 and 2010, and by 10.8 per cent since 2001 (from 34.2 per females 100,000 population). The majority of lung cancer cases occur as a result of tobacco smoking. Historically, males started smoking earlier than females and it wasn’t until after the Second World War that females started to smoke in greater numbers. Smoking cessation has helped reduce the number of lung cancer cases in males but for females the lung cancer rate is still increasing (Cancer Research UK). This increase is in part due to females being more susceptible than males to developing lung cancer and could also be due to other non-smoking factors like genetics and the female hormone oestrogen (NHS Choices).

Colorectal cancer was the third most common cancer in both males and females. The age-standardised incidence rate for colorectal cancer has remained fairly constant for both sexes over the past 10 years.

Between 2009 and 2010 there was a 19.3 per cent decrease of carcinoma in situ of cervix uteri (see background note 4). Carcinoma in situ is not a malignant cancer but in some women it will develop into a malignant cancer if left untreated. In 2010 there were 22,132 newly diagnosed cases of carcinoma in situ of cervix uteri. The age-standardised incidence rate was 88 females per 100,000 population, compared with 27,438 cases and an incidence rate of 110.3 females per 100,000 population in 2009. This is likely to be due to the larger than usual increase in the 2009 cancer registrations of carcinoma in situ of cervix uteri. The death of a young celebrity from cervical cancer in 2009 led to a sudden increase in the awareness of the condition and improved levels of screening among young females, resulting in more cases being diagnosed during this period. The 2010 cancer registrations for carcinoma in situ of cervix uteri illustrate that registrations of this non-malignant cancer have now returned to levels comparable with previous years.

Policy context

In ‘Improving Outcomes: A Strategy for Cancer’ (January 2011), the Department of Health states that although improvements have been made in the quality of cancer services in England, a significant gap remains in survival compared with the European average (see background note 5). Survival rates for cervical, colorectal and breast cancer are some of the lowest among member states of the Organisation for Economic Co-operation and Development (OECD). The Outcomes Strategy sets out how the Department of Health aims to improve outcomes for all cancer patients and improve cancer survival rates, with the aim of saving an additional 5,000 lives every year by 2014/15.

Outcomes strategies set out how the NHS, public health and social care services will contribute to the ambitions for progress agreed with the Secretary of State in each of the high-level outcomes frameworks. The indicator set for the National Health Service (NHS) Outcomes Framework includes one- and five-year relative survival from colorectal, breast and lung cancers.

Acknowledgements

The National Cancer Registry at the Office for National Statistics wish to acknowledge the work of the regional cancer registries in England, which provide the raw data for these analyses.

Further information

Further cancer statistics are available on the ONS website:

Cancer statistics registrations (series MB1) will provide more detailed tables on cancer registrations including regional information. This will be published in June/July 2012. 
Cancer survival by cancer network in England
 Cancer incidence and mortality in the United Kingdom
 Cancer survival in England
 Geographic patterns of cancer survival in England
 Cancer survival in the ‘Spearhead’ Primary Care Trusts of England
Combined cancer survival by Primary Care Trusts

Further cancer statistics for the United Kingdom:

Statistics on cancer in Scotland are available from the Information Services Division (ISD), Scotland.

Statistics on cancer in Wales are available from the Welsh Cancer Intelligence Surveillance Unit.

Statistics on cancer in Northern Ireland are available from the Northern Ireland Cancer Registry.

Further information about statistics on cancer registrations published by the Office for National Statistics (ONS) can be found in the Summary Quality Report for cancer registrations.

Summary quality reports are overview notes which pull together key qualitative information on the various dimensions of the quality of statistics as well as providing a summary of the methods used to compile the output. Information about key users of these statistics are also provided.

References

1. Office for National Statistics (2011) Cancer statistics – registrations, England, 2009. Series MB1 no.40  www.ons.gov.uk/ons/publications/all-releases.html?definition=tcm%3A77-27454

2. Cancer Research UK. Breast cancer ‑ risk factors info.cancerresearchuk.org/cancerstats/types/breast/riskfactors/

3. Quinn M J, Babb P J, Brock A, Kirby E A & Jones J (2001) Cancer trends in England and Wales, 1950–1999. Studies on Medical and Population Subjects No.66, London: The Stationery Office.  www.ons.gov.uk/ons/rel/cancer-unit/cancer-trends-in-england-and-wales/smps-no--66/index.html

4. Cancer Research UK, Prostate cancer ‑ risk factors info.cancerresearchuk.org/cancerstats/types/prostate/riskfactors/

5. Cancer Research UK, Smoking – statistics info.cancerresearchuk.org/cancerstats/types/lung/smoking/ 

6. NHS Choices, Lung cancer in women www.nhs.uk/Livewell/Lungcancer/Pages/Womenandlungcancer.aspx

7. Department of Health (2011) Improving Outcomes: A Strategy for Cancer www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_123371
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