Cancer cases rise, but more people survive

Cancer cases rise, but more people survive: New cancer statistics for the UK have hit the headlines, with most papers reporting that fewer people are dying from the disease, despite a rise in the numbers being diagnosed.

These 2008-2010 figures were produced by the Office for National Statistic (ONS) and show:

• the number of people diagnosed with cancer each year (incidence) was nearly 320,000
• the number of people dying from cancer each year (mortality rates) was about 156,000

The report found that Wales had the highest rate of cancer for men and Scotland had the highest cancer rates for women.

What were the main findings of the report?

Below are the key findings for the UK from 2008-2010:

• about 163,100 men and 159,800 women were newly diagnosed with cancer in each of those years, corresponding to an incidence rate of 431 per 100,000 men and 375 per 100,000 women
• about 81,800 men and 74,400 women died from cancer in each year, corresponding to mortality rates of 204 per 100,000 men and 149 per 100,000 women
• in Wales, the rate of cancer for men was 6% higher than in the UK as a whole
• Scotland had the highest cancer rate for women, around 10% higher than in the UK as a whole
• Scotland also had the highest cancer mortality rates, around 15% higher than the UK average for both men and women

How does this compare to previous years?

The data shows that while incidence rates have increased over previous years, the good news is that mortality rates have fallen.

• there were 403 new cases of cancer per 100,000 men in 2001-3, compared with 431 new cases per 100,000 in 2008-10
• there were 343 new cases per 100,000 women in 2001-3 compared with 375 per 100,000 in 2008-10
• mortality rates decreased over the same period – from 229 to 204 deaths per year per 100,000 men, and from 161 to 149 deaths per year per 100,000 women

The report does not compare incidence and mortality rates for individual cancers between the two time periods.

What are the most common cancers?

The four most common cancers in the UK are breast, prostate, lung and colorectal (bowel) cancer. In the period 2008-10:

• Breast cancer was the most common newly diagnosed cancer in women, with 48,988 cases diagnosed each year, an incidence of 126 new cases per 100,000 women.
• In the same period, 11,757 women died from breast cancer each year, a mortality rate of 25 deaths per 100,000 women.
• Prostate cancer was the most common newly diagnosed cancer in men, with an average of 40,460 new cases each year, an incidence of 105 new cases per 100,000 men.
• The number of men who died each year from the disease was 10,427, a mortality rate of 24 deaths per 100,000.
• Lung cancer was the second most common newly diagnosed cancer in both men and women. An average of 23,398 men and 18,766 women were newly diagnosed each year. On average, 19,668 and 15,374 women died of lung cancer each year, giving a rate of 50 deaths per 100,000 among men and 32 deaths per 100,000 among women.
• Colorectal cancer was the third most common newly diagnosed cancer, with 22,517 cases annually in men and 17,864 new cases in women. An average of 8,569 men and 7,207 women died of this disease each year, giving mortality rates of 21 deaths per 100,000 and 13 deaths per 100,000 respectively.

Are there variations in cancer rates / mortality within the UK?

Yes. Aside from the differences in overall cancer rates given above, there were also variations in the incidence and mortality rates for individual cancers between different countries in the UK.

• For breast cancer, Northern Ireland had the lowest incidence rates in the UK, although mortality rates were similar across the four countries.
• Scotland had the lowest incidence rate for prostate cancer, while Wales had the highest. Mortality rates were similar across the UK.
• Scotland had higher rates of lung cancer in both men and women as well as the highest mortality rates for this disease.
• Lung cancer rates among men were lowest in England, and lower among women in England and Northern Ireland than in Scotland or Wales.
• England had significantly lower lung cancer mortality rates among men than the three other countries.

How do the UK's cancer figures compare with other industrialised (or EU) nations?

The report compares data on UK cancer rates with those for nine other countries in Northern Europe (Denmark, Estonia, Finland, Iceland, Latvia, Lithuania, Norway, Republic of Ireland, Sweden).

• the UK had the third lowest incidence rate for men (the Republic of Ireland had the highest incidence and Sweden the lowest)
• the UK had the fifth highest incidence rate for women (Denmark had the highest incidence and Latvia the lowest)

Are there significant differences between men and women's cancer incidence and mortality rates?

Broadly, for common cancers affecting both sexes – such as lung and colorectal – both incidence and mortality rates among men are higher than those among women.
There was some speculation in the media that this could be due to the fact that men are (allegedly) less willing to see a GP about persistent symptoms or changes to their body that could be the initial signs of cancer. This means that their cancers may be diagnosed at a later stage, making them harder to treat. The ONS report itself makes no comment about the gender disparity.

What could explain the change in trends in cancer incidence and mortality?

The recent increase in cancer incidence is thought to be mainly the result of the UK's ageing population, since the risk of developing most cancers increases with age. 
Other factors such as earlier diagnosis may also play a part. For example, national screening programmes for breast cancer may affect annual figures, as could the NHS Bowel Cancer Screening Programme in England which started in July 2006.
The report points out that variations in the incidence of prostate cancer across the UK may be due to differences in the use of prostate specific antigen (PSA) testing, a blood test that is far from 100% accurate which some countries use to screen for prostate cancer.
These may also actually be differences in levels of diagnosis rather than differences in the actual number of cases (note that PSA testing as a universal screening test for prostate cancer is not performed in the UK).
Scotland's comparatively high rates of lung cancer could be explained by higher smoking and drinking rates. The overall decrease in cancer deaths since 2003 is likely to be explained by earlier diagnosis of many cancers and better treatments.
Analysis by Bazian. Edited by NHS Choices. Follow Behind the Headlines on Twitter.

Links To The Headlines

Cancer death rates fall by nearly 10% thanks to earlier diagnosis, better treatment and decline in smoking. Daily Mail, December 6 2012
More people 'are surviving cancer'. BBC News, December 6 2012
Cancer patients are living longer than ever before. The Daily Telegraph, December 6 2012
Cancer cases on the rise but fewer patients are dying. Daily Express, December 7 2012