1. Main findings
Survival at 1 year and 5 years after diagnosis improved for 7 of the 8 cancers examined in this report among adults diagnosed in England between 2005 and 2009. There has been little change in survival for bladder cancer.
The wide geographic disparities in survival are persistent. Among the 25 geographic areas of the NHS (Area Teams) that cover the whole of England, the range in age-standardised 1-year survival was greater than 10% for cancers of the oesophagus and stomach (both men and women) and for women with cancer of the colon, cervix and bladder. For 5-year survival, the geographic range was wider than 10% for cancers of the colon and bladder (both men and women), for prostate cancer and for cancers of the stomach and cervix in women.
For men, 1-year survival for stomach cancer increased in 21 of the 25 Area Teams (ATs), with the average annual increase ranging from 0.1% to 4.0% per year. The average increase in 1-year survival was also 0.1% per year or more for cancers of the colon (20 ATs), lung (19 ATs) and oesophagus (16 ATs). 5-year survival from cancers of the colon and lung also increased at 0.1% per year or more in 22 ATs.
For women, 1-year survival for colon cancer rose in 21 of the 25 ATs, with the average annual increase ranging from 0.1% to 3.3% per year. 1-year survival also increased for cancers of the breast and lung in 20 ATs. 5-year survival also increased at 0.1% per year or more for cancers of the lung (22 ATs), breast (20 ATs) and cervix (20 ATs).
Nôl i'r tabl cynnwys2. Summary
Cancer survival has been examined for adults (15 to 99 years) diagnosed with 1 of 8 common cancers in England between 2005 and 2009. All the patients were followed up for their vital status for at least 5 years, to 31 December 2014. The cancers are those of the oesophagus, stomach, colon, lung, breast (women), cervix, prostate and bladder (Background notes 1 and 2). These cancers represent 61% of new cancers diagnosed in England in 2013,1 with a wide range of pathways for diagnosis and treatment, and different levels of survival. Estimates of 1-year and 5-year net survival (Background note 2) are presented for each sex and for both sexes combined.
Results are presented for England as a whole, and for 3 geographic levels of organisation of the NHS in England: 4 NHS Regions, 12 Clinical Senates (average population about 4.5 million) and 25 Area Teams (average population about 2.2 million) (Background note 5).
Age-standardised survival estimates are presented for adults who were diagnosed during 2007 to 2009 and followed up to 31 December 2014. Estimates are age-standardised to adjust for changes in the age profile of cancer patients over time and between geographical areas (Background note 3). To show trends over time, unstandardised survival estimates for each year of the period 2005 to 2009 are also presented, together with the average annual change (Background note 4).
Collaboration
The cancer registration data in this publication were collected by the National Cancer Registration and Analysis Service in Public Health England. This publication is produced in partnership with the Cancer Research UK Cancer Survival Group at the London School of Hygiene and Tropical Medicine.
London School of Hygine and Tropical Medicine
Download this image London School of Hygine and Tropical Medicine
.png (34.2 kB)3. Results
Figure 1: 1-year age-standardised net survival1 (per cent) for adults2 diagnosed during 2007 to 2009 and followed up to 2014: England, 8 common cancers, by sex
Source: Office for National Statistics, London School of Hygiene and Tropical Medicine
Notes:
- Survival estimates were age-standardised using a standard population of cancer patients (see Background note 3 of statistical bulletin).
- Adults ages 15 to 99 years.
- The symbol (:) means not available. Breast cancer in males is rare, and survival estimates are not available.
- The symbol (z) means not applicable.
Download this chart Figure 1: 1-year age-standardised net survival^1^ (per cent) for adults^2^ diagnosed during 2007 to 2009 and followed up to 2014: England, 8 common cancers, by sex
Image .csv .xls
Figure 2: 5-year age-standardised net survival1 (per cent) for adults2 diagnosed during 2007 to 2009 and followed up to 2014: England, 8 common cancers, by sex
Source: Office for National Statistics, London School of Hygiene and Tropical Medicine
Notes:
- Survival estimates were age-standardised using a standard population of cancer patients (see Background note 3 of statistical bulletin).
- Adults ages 15 to 99 years.
- The symbol (:) means not available. Breast cancer in males is rare, and survival estimates are not available.
- The symbol (z) means not applicable.
Download this chart Figure 2: 5-year age-standardised net survival^1^ (per cent) for adults^2^ diagnosed during 2007 to 2009 and followed up to 2014: England, 8 common cancers, by sex
Image .csv .xlsIn England as a whole, 1-year survival was above 70% and 5-year survival above 45% for cancers of the colon, breast (women), cervix and prostate, and for bladder cancer in men (Figures 1 and 2).
For bladder cancer in women, 1-year survival was just below 70% (67%) and just above 45% (47.3%) at 5 years. Changes in the coding and classification of bladder cancer since 2000 have contributed to a reduction in the survival estimates in England and to some of the observed regional variation (Background note 6).
For cancers of the oesophagus, stomach and lung, survival remains very low, with 1-year survival below 45% and 5-year survival below 20%.
Survival is generally higher in men at 1 year, except for lung cancer, while 5-year survival is generally higher in women, except for bladder cancer. For bladder cancer, both 1-year and 5-year survival are about 10% higher in men than in women.
Trends in cancer survival are shown in the reference tables as the annual change in net survival over the 5-year period 2005 to 2009. This is presented as the average difference from one year to the next (Background note 4). In England as a whole and for both sexes combined, 1-year and 5-year survival improved between 2005 and 2009 for 7 of the 8 cancers examined in this report, while survival of bladder cancer was stable.
The largest annual improvement in 1-year survival in England in men was for cancer of the stomach (average increase 1.0% per year) and in women, for cancer of the oesophagus (1.2%). The largest annual improvements in 5-year survival were for colon cancer (average increase 1.5% per year for men and 1.2% for women) and for cervix cancer (also 1.2% per year). For all other cancers at national level, 1-year and 5-year survival continued to increase, slowly, between 2005 and 2009 (average increase less than 1% per year). Bladder cancer in women was an exception: survival fell slightly between 2005 and 2009 (-0.2% per year for 1-year survival and -1.1% per year for 5-year survival).
Among the 12 Clinical Senates, the largest annual improvement in 1-year survival was for oesophageal cancer, both for men (Yorkshire and The Humber, average increase 2.8% per year) and for women (Thames Valley, 4.0% per year). For 5-year survival, the largest annual increase from 2005 to 2009 for men was for colon cancer in East Midlands (2.8% per year) and for women, for cervical cancer in East of England (2.9% per year).
Area Teams are smaller than Clinical Senates and more variation can be expected. Nevertheless, wide and persistent differences in survival between the 25 Area Teams in England were seen for each of the 8 cancers examined here that were diagnosed during the 3-year period 2007 to 2009 (see Tables 1 and 2). For women, the range in 1-year survival estimates between Area Teams was more than 10% for cancers of the oesophagus, stomach, colon, cervix or bladder and wide differences persisted at 5 years. Five-year survival from bladder cancer, in women, differed even more widely between Area Teams (range about 27% – but see Background note 6).
For men, the range in survival between Area Teams was more than 12% for 1-year survival from cancers of the oesophagus and stomach, and for 5-year survival from cancers of the prostate and bladder. It should be noted that some of the geographic variation in bladder cancer survival can be attributed to differences between the regions of England in the speed of adoption of changes in pathological coding and classification during this period (Background note 6).
Table 1: Range in age-standardised 1-year net survival (per cent) among Area Teams in England: adults diagnosed during 2007 to 2009 and followed up to 2014, 8 common cancers, by sex
ICD-10 code2 | Site description | Men | Women | Persons | ||||||||
Min | Max | Range | Min | Max | Range | Min | Max | Range | ||||
C15 | Oesophagus | 34.5 | 46.7 | 12.2 | 32.9 | 46.9 | 14.0 | 34.5 | 45.2 | 10.8 | ||
C16 | Stomach | 34.0 | 48.7 | 14.7 | 34.9 | 48.8 | 13.8 | 35.3 | 48.4 | 13.1 | ||
C18 | Colon | 69.0 | 75.7 | 6.7 | 63.9 | 75.5 | 11.6 | 68.2 | 75.0 | 6.7 | ||
C33-34 | Lung | 24.8 | 32.7 | 7.9 | 28.8 | 36.2 | 7.4 | 26.6 | 33.5 | 6.9 | ||
C50 | Breast | : | : | : | 94.5 | 96.6 | 2.1 | : | : | : | ||
C53 | Cervix | z | z | z | 75.9 | 86.3 | 10.4 | z | z | z | ||
C61 | Prostate | 89.4 | 95.3 | 5.9 | z | z | z | z | z | z | ||
C67 | Bladder | 73.0 | 81.5 | 8.5 | 57.8 | 77.3 | 19.4 | 69.1 | 80.2 | 11.2 | ||
Source: Office for National Statistics | ||||||||||||
Notes: | ||||||||||||
1. Adults aged 15 to 99 years. | ||||||||||||
2. International Classification of Diseases, tenth edition. | ||||||||||||
3. The symbol (:) means not available. Breast cancer in males is rare, and survival estimates are not available. | ||||||||||||
4. The symbol (z) means not applicable. |
Download this table Table 1: Range in age-standardised 1-year net survival (per cent) among Area Teams in England: adults diagnosed during 2007 to 2009 and followed up to 2014, 8 common cancers, by sex
.xls (28.7 kB)
Table 2: Range in age-standardised 5-year net survival (per cent among Area Teams in England: adults diagnosed during 2007 to 2009 and followed up to 2014, 8 common cancers, by sex
ICD-10 code2 | Site description | Men | Women | Persons | ||||||||
Min | Max | Range | Min | Max | Range | Min | Max | Range | ||||
C15 | Oesophagus | 8.8 | 17.8 | 9.0 | 9.2 | 17.2 | 8.1 | 9.5 | 17.7 | 8.2 | ||
C16 | Stomach | 12.0 | 21.5 | 9.5 | 12.8 | 25.3 | 12.5 | 13.5 | 22.9 | 9.4 | ||
C18 | Colon | 51.1 | 61.8 | 10.8 | 46.1 | 60.8 | 14.7 | 49.9 | 58.4 | 8.6 | ||
C33-34 | Lung | 6.4 | 10.9 | 4.5 | 8.1 | 12.3 | 4.2 | 8.0 | 11.4 | 3.3 | ||
C50 | Breast | : | : | : | 82.4 | 86.6 | 4.3 | : | : | : | ||
C53 | Cervix | z | z | z | 59.8 | 72.5 | 12.7 | z | z | z | ||
C61 | Prostate | 73.4 | 86.2 | 12.8 | z | z | z | z | z | z | ||
C67 | Bladder | 49.8 | 65.2 | 15.3 | 35.4 | 62.0 | 26.6 | 46.2 | 61.5 | 15.3 | ||
Source: Office for National Statistics | ||||||||||||
Notes: | ||||||||||||
1. Adults aged 15 to 99 years. | ||||||||||||
2. International Classification of Diseases, tenth edition. | ||||||||||||
3. The symbol (:) means not available. Breast cancer in males is rare, and survival estimates are not available. | ||||||||||||
4. The symbol (z) means not applicable. |
Download this table Table 2: Range in age-standardised 5-year net survival (per cent among Area Teams in England: adults diagnosed during 2007 to 2009 and followed up to 2014, 8 common cancers, by sex
.xls (28.7 kB)Additional information
Further information about our cancer survival estimates can be found in the Cancer Survival Quality and Methodology Information report. These are overview notes containing important qualitative information on the quality of statistics and a summary of the methods used to compile the output.
Statistics on cancer are produced:
in Scotland by the Scottish Cancer Registry
in Wales by the Welsh Cancer Intelligence and Surveillance Unit
in Northern Ireland by the Northern Ireland Cancer Registry
4. Policy context
Health policy-makers use population-based cancer survival statistics to plan services aimed at cancer prevention and treatment. Cancer survival estimates feed in to national cancer plans, such as: ‘Achieving world-class cancer outcomes: A Strategy for England 2015 to 2020’. The report recommends 6 strategic priorities to help improve cancer survival in England by 2020.
Cancer survival estimates also feed into outcomes strategies that set out how the NHS, public health and social care services will contribute to the progress agreed with the Secretary of State, in each of the high-level outcomes frameworks. The indicators set for the National Health Service (NHS) Outcomes Framework include 1- and 5- year survival from colorectal, breast and lung cancers.
Nôl i'r tabl cynnwys6. Acknowledgements
The National Cancer Registry at the Office for National Statistics and the London School of Hygiene and Tropical Medicine wish to acknowledge the work of the National Cancer Registration and Analysis Service in Public Health England, which provides the raw data for these analyses.
Nôl i'r tabl cynnwys