1
Welsh Cancer Intelligence and Surveillance Unit Official Statistics 2013 data
Published 4 February 2015
Welsh Cancer Intelligence and Surveillance Unit
Health Intelligence Division, Public Health Wales Uned Deallusrwydd a Gwyliadwriaeth Canser Cymru
Cyfadran Deallusrwydd Iechyd, Iechyd Cyhoeddus Cymru
Cancer in Wales A summary report of the population cancer incidence,
mortality and survival – includes new 2013 data
released as Official Statistics on 3 February 2015
www.wcisu.wales.nhs.uk
View the Official Statistics using the interactive dashboard to conduct your own analysis according to cancer type, health board or all Wales level, by incidence,
mortality or survival for the time period 2001-2013 at www.wcisu.wales.nhs.uk
2
Welsh Cancer Intelligence and Surveillance Unit Official Statistics 2013 data
Published 4 February 2015
Project team
Dr Ceri White, Rebecca Thomas, Tamsin Long, Ciarán Slyne, Julie Howe, Helen Crowther, Dr Dyfed Wyn Huws
Acknowledgements A special thanks to all the Welsh Cancer Intelligence and Surveillance Unit’s staff, especially the registration team without whom the data used within this report would not be produced.
Thanks to the following people for their help with this publication: Dr Clare Elliot, Gwenllian Evans, Dr Judith Greenacre, Dr Ciarán Humphreys, Isabel Puscas, Hannah Thomas and Janet Warlow
Publication Details Title: Cancer in Wales, A summary report of the population cancer incidence, mortality and survival – includes new
2013 data released as Official Statistics
Date: This commentary published 4 February 2015 based on Official Statistics released on 3 February 2015 ISBN: 978-1-910768-00-6
Contact:
Welsh Cancer Intelligence and Surveillance Unit, Public Health Wales 16 Cathedral Road
Cardiff CF11 9LJ Email: [email protected] Website: www.wcisu.wales.nhs.uk
© 2015 Public Health Wales NHS Trust
Material contained in this document may be reproduced without prior permission
provided it is done so accurately and is not used in a misleading context.
Acknowledgement to Public Health Wales NHS Trust to be stated.
Copyright in the typographical arrangement, design and layout belongs to Public Health Wales NHS Trust.
Definitions Age-standardised rates and EASR
Age-standardisation adjusts rates to take into account how many old or young people are in the population being looked at. When rates are age-standardised, you know that differences in the rates over time or between
geographical areas do not simply reflect variations or changes in the age structure of the populations. This is important when looking at cancer rates because cancer mainly affects older people. Throughout this report we use European Age Standardised Rates (EASR) using the 2013 European Standard Population (ESP) unless otherwise specified.
Statistical significance If a difference between rates or survival between populations is statistically significant, it means that that difference is unlikely to have occurred due to chance alone, and that we can be more confident that we are observing a ‘true’ difference. In this report we use the conventional arbitrary cut-off of less than a 5% chance to
mean statistically significant. Just because a difference is statistically significant doesn’t necessarily mean that it is large or important - that can depend on our judgment and other things. Relative survival
This is a way of comparing the survival of people who have a specific disease – in our case, cancer - with the survival experienced by the general population, over a certain period of time. It is calculated by dividing the
percentage of patients with the disease who are still alive at the end of the period of time (e.g. one or five years after diagnosis) by the percentage of people in the general population of the same sex and age who are alive at the end of the same time period. The relative survival rate shows whether the disease shortens life. We use relative survival in this report. All cancers
When we use the phrase “all cancers” in this report, by convention, we always mean all cancers excluding non-melanoma skin cancer.
3
Welsh Cancer Intelligence and Surveillance Unit Official Statistics 2013 data
Published 4 February 2015
Key findings
All cancers combined – number of new cases and incidence rates
The number of new cases of cancer in residents
of Wales continues to rise in men and women –
there were 19,026 new cases in 2013, up by
over 12 per cent compared to 2004
The largest increases in numbers in men and
women were in the 65-69 and 70-74 year-old
age groups
In general, cancer becomes more common with
increasing age, except for the 90+ age group in
women – the age specific cancer rate rises
more steeply in men than women with
increasing age, and for ages 70 years and over,
rates in men are over 50 per cent higher than
women
Age-specific all cancer incidence rates in older
age groups reduced dramatically in men from
2004 to 2013 whereas in women there was little
change.
All cancers combined – number of cancer deaths and mortality rates
The increase in the number of cancer deaths
over the ten years up to and including 2013
was small, especially in women - there were
small changes in the majority of age groups,
but with a large increase in both sexes for those
aged 85 years and over
Cancer mortality rates increase with age,
similar for both sexes up to 55-59 years they
then diverge - in men aged 90 years and over
the age-specific cancer mortality rate was twice
that for women in 2013
The age-specific cancer mortality rates
decreased for the majority of age groups
between 2004 and 2013, and these decreases
were generally smaller in women than men
There were slight increases in mortality rate
amongst 85-89 year old women and 90 years
and over men, with little change for 90+
women
All cancers combined – survival Survival from all cancers combined steadily
improved – for the first time we saw over 70
per cent of people diagnosed with cancer
surviving at least one year
Women have better survival than men but the
gap is decreasing
All cancers combined – variations between geographic areas
The incidence rate for all cancers combined
varies greatly between health board and local
authority populations - the highest local
authority cancer incidence rate in Merthyr Tydfil
is almost 20 per cent higher than the lowest in
Ceredigion in 2009-2013
All cancer mortality rates are highest in some
local authorities in the south east Wales valleys
and north east Wales - the highest is in Blaenau
Gwent which is 12 per cent higher than Wales,
whereas the rate in Monmouthshire is 16 per
cent lower than Wales
One year survival from all cancers combined is
very similar in all health board populations
All cancers combined – inequalities by area deprivation The gap in all cancers incidence rate between
the least and most deprived areas of Wales
continues to increase
The gap in mortality rate between least and
most deprived areas has slightly increased
Survival from all cancers combined is lower in
more deprived areas, but the gap between most
and least deprived areas has decreased
Number of new cases for different cancer types In 2013 the most common cancers in Wales in
terms of numbers were female breast cancer,
prostate, lung and bowel cancer
Prostate, bowel, female breast, melanoma and
lung cancer had the largest increases in
numbers over 10 years
4
Welsh Cancer Intelligence and Surveillance Unit Official Statistics 2013 data
Published 4 February 2015
Almost all the increase in lung cancer numbers
occurred in women because the number of new
cases diagnosed in women increased by almost
a third, compared to only two per cent in men
Almost two thirds of the increase in bowel
cancer numbers was in men because bowel
cancer cases increased by a quarter in men and
by almost a fifth in women
Around two thirds of the increase in melanoma
was in men because the number of cases in
men nearly doubled, and in women increased
by nearly a half
Cervical (neck of the womb), oesophageal
(gullet) and stomach cancers showed decreases
in numbers
Liver cancer in men showed the largest
percentage increase in numbers, doubling over
10 years, and for women the percentage
increase in liver cancer numbers was as much
as 70 per cent
Uterine cancer (cancer of the womb), head and
neck cancer, and urinary tract excluding
bladder cancer in men also showed increases in
numbers of nearly a half
Mortality rates of different cancers
Lung cancer had the highest age-adjusted
mortality rate in Wales in 2013 followed by
prostate and female breast cancer
The liver cancer mortality rate in men increased
by over a half, and melanoma mortality rate in
men increased by nearly a third
Lung cancer had the largest absolute increase
in mortality rate in women, but liver cancer had
the largest percentage increase of nearly two
thirds
The gap in mortality rate between the least and
most deprived areas of Wales is very large for
lung cancer and it has widened, although the
modest gap in bowel cancer mortality rate
narrowed slightly
Survival from different cancer types There was some improvement in one-year
survival for the majority of cancer types, but
survival from pancreas, lung and liver cancer is
still very poor - testicular cancer has the
highest one year survival rate followed closely
by melanoma, prostate and female breast
cancers
One year survival for all cancers combined
varies little between health board populations,
but for some cancer types, such as oesophageal
cancer, there is wide variation
Lung cancer one year survival is lowest in the
most deprived areas, although the gap is much
less than for incidence rate, and unlike
incidence, the deprivation gap in survival has
decreased. Our recent report on lung cancer
survival is available at
http://www.wcisu.wales.nhs.uk/lung-cancer-
overview
Bowel cancer has a deprivation gap in incidence
and one year survival, worse in the most
deprived areas - the gap in incidence is much
smaller than lung cancer, but the deprivation
gap in one year survival is wider
5
Welsh Cancer Intelligence and Surveillance Unit Official Statistics 2013 data
Published 4 February 2015
1Incidence, mortality
and survival for all cancers combined
Number of new cancer cases continues to increase in Wales among both men and women
Over the ten years up to and including 2013 the
number of cancer cases slowly increased. In 2013 a
total of 2,105 - or over 12 per cent - more people
living in Wales were diagnosed with cancer
compared to 2004. The increase separately
happened in both men and women.
There were 19,026 new cases of cancer
diagnosed among residents of Wales in 2013
compared with 16,921 new cases in 2004.
9,808 (or 11.5 per cent more) new cases of
cancer were diagnosed in men and 9,218
(or 13.4 per cent more) new cases were
diagnosed in women in 2013 compared with
8,795 cases in men and 8,126 cases in
women in 2004.
Incidence (numbers or rates of new cancer
cases) varies between cancer type and
gender over time (see section 4).
The increase in the number of cancer deaths is small, especially in women and despite the rise in the number of new cases
Over the last ten years the number of cancer
deaths registered in Wales shows small fluctuations
year on year. In 2013 the number of cancer
deaths showed a small increase compared to 2012.
There were 8,688 cancer deaths registered
among residents of Wales in 2013 compared
with 8,484 cancer deaths in 2004 – a rise of
2.4 per cent.
4,579 cancer deaths were registered in men
with 4,109 cancer deaths registered in
women in 2013 compared with 4,462 cancer
deaths in men and 4,022 cancer deaths in
women in 2004.
Cancer mortality (numbers or rates of
cancer deaths) varies between cancer type
and gender over time.
Cancer survival is steadily improving in Wales
One year survival from all cancers combined is
continuing to increase, although the increase in
more recent years is slower than earlier years
(figure 1). For the first time, over 70% of people
diagnosed with cancer within the latest time period
of 2008-2012 in Wales are now surviving for at
least one year. However, there are wide variations
between different types of cancer and inequalities
in survival across population groups and
geographies in Wales (section 2).
Five year survival (for patients diagnosed 2004-
2008) is also increasing but more slowly than in
previous years. This increase is still encouraging,
as over half of people diagnosed with cancer can
expect to survive for at least five years. To allow
for all patients to be followed up for five years,
survival calculations are only available for
diagnoses made up to 2008 at present.
There are numerous factors that may affect
survival, including type of cancer, early diagnosis
and stage at diagnosis, general health, patient age,
improvements in effective treatments and fair
access to effective treatment, through to
participation in effective population screening
programmes for some cancers such as breast,
bowel and cervical cancers.
Risk factors for many cancers are known but
vary by cancer type. More than 40% of all cancers in the UK are linked to risk factors
such as tobacco, alcohol, being overweight, diet, physical inactivity, infection, radiation, occupation and post-menopausal hormones.
Smoking causes nearly a fifth of all cancers in the UK including over 80% of lung
cancers.
6
Welsh Cancer Intelligence and Surveillance Unit Official Statistics 2013 data
Published 4 February 2015
Figure 1: Gradual increase in one and five year relative survival (%) for all cancers in Wales over time
Source: Welsh Cancer Intelligence and Surveillance Unit’s Cancer Registry www.wcisu.wales.nhs.uk
Cancer incidence by age and sex
The number of people registered with a new
diagnosis of cancer in Wales in 2013 remains low
up to age 40 years in women and 45 years in men.
From then on the annual number of cases starts
increasing steeply with age for both men and
women (figure 2). At younger ages the numbers
are similar for each gender.
More women than men are diagnosed with cancers
between the ages of 30 to 54, and at 90 years and
over. The increase starts earlier in women due to
women specific cancers such as breast and cervical
cancer. For older age groups there are increasingly
more women than men alive. More men than
women were diagnosed with cancer between age
bands 60-64 years and 80-84 years.
The largest increase in numbers has occurred in
65-69 age groups in both men and women, as well
as the 70-74 groups. The 50-54 and 90+ age
groups also show notable increases in women.
These shifts have resulted in the most common age
at diagnosis for both men and women in 2013
occurring between 65 and 69 years (1,688 men,
1,362 women). This is about 10 years younger
than it was a decade previously. Demographics
explain most of these changes in the number of
people diagnosed with cancer in specific age groups
in men and women.
Figure 2: The most common age at diagnosis has fallen from 75-79 years in 2004 to 65-69 years in 2013 for both men and women
Source: Welsh Cancer Intelligence and Surveillance Unit’s Cancer Registry www.wcisu.wales.nhs.uk
Cancer incidence rates
The rate takes into account the differing sizes of
the population in each age group.
Age-specific cancer incidence rates are very low for
those aged under 40 years in 2013. After this age
the rates start rising slowly in men and slightly
more steeply in women. The increase continues
steadily with age in women. Women however, show
a decrease in the rate for those aged 90 years and
over. In men after 50 the rates rise steeply with no
decrease at very old age. However, the rate of
increase does become less steep from age 75
onwards. Women have higher rates than men up to
the age of 59 years. From age 60 years onwards,
the incidence rates are higher in men compared to
women and the gap continues to increase for all
remaining ages. For ages 70 years and over, rates
in men are over 50% higher than women (figure
3).
In men there has been a dramatic reduction in age-
specific rates in the older age groups in 2013
compared with 2004 which is probably due to lung
cancer (see section 4). In women there has been
little change over time although there has been a
small increase in some age groups. For example,
age-specific incidence rates have markedly
decreased in men for all age groups 75 and older,
whereas in women there have been small to
modest increases in rates in the 50-54, 65-69, 80-
84 and 85-89 age groups.
Different cancer types have reduced or increased in
age-specific rates by different amounts in men and
women.
... in general cancer becomes more
common with increasing age.
However, there are exceptions for
certain cancer types like childhood
cancers and those predominantly
affecting younger adults....”
7
Welsh Cancer Intelligence and Surveillance Unit Official Statistics 2013 data
Published 4 February 2015
Figure 3: The age-specific cancer rate rises more steeply for men than for women with increasing age
Source: Welsh Cancer Intelligence and Surveillance Unit’s Cancer Registry www.wcisu.wales.nhs.uk
Cancer deaths by age and sex
The number of cancer deaths registered amongst
Wales’ residents in 2013 remained low up to age 45
years. Numbers then increased substantially with
increasing age for both men and women (figure 4).
The peak for men was at 75-79 years whereas the
peak for women was 80-84 years.
Comparing the numbers of deaths in 2013 over the
previous ten years, there have been small changes
in the majority of age groups, but a large increase
was seen in both sexes for those aged 85 years
and over (figure 4). This is largely due to an
increase in the number of people in these older age
groups due to demographic changes, in part
leading to an increase in the number of new cancer
cases in men and women (see previously). This has
occurred despite the corresponding fall in incidence
rate in the oldest men and the incidence rate
remaining static in the oldest women.
Figure 4: The number of registered cancer deaths by age group shows small fluctuations over time in both men and women
Source: Welsh Cancer Intelligence and Surveillance Unit’s Cancer Registry www.wcisu.wales.nhs.uk
Taking into account the demographic changes in
the number of men and women in each age group
between 2004 and 2013 there are different
patterns for trends in mortality rate compared to
the change in the number of deaths.
For men and women cancer mortality rates
increase with age (figure 5). Rates are similar for
both sexes up to 55-59 years but then diverge with
men having much higher rates compared to women
thereafter. The rate in men for those aged 90
years and over in 2013 is twice that for women.
The age-specific cancer mortality rate for men
decreased for the majority of age groups between
2004 and 2013, although there was a slight
increase in the rate for men aged 90 years and
over. The decreases in rate that occurred for most
age groups for women were much smaller than
those seen in most age groups in men. There was
also a slight increase in the mortality rate amongst
85-89 year old women and little change for the
90+ year old women.
8
Welsh Cancer Intelligence and Surveillance Unit Official Statistics 2013 data
Published 4 February 2015
Figure 5: The age specific cancer mortality rates show little change over time in men and women
Source: Welsh Cancer Intelligence and Surveillance Unit’s Cancer Registry www.wcisu.wales.nhs.uk
Women have better survival than men but the gap is decreasing
One year and five year relative cancer survival for
all cancer combined is increasing in both sexes.
Survival in women is higher than in men, partly
reflecting the mortality figures seen earlier in this
report (table 1). This is most likely due to the high
survival rates for female breast cancer patients.
The gap between both sexes has decreased over
time, possibly due to the improving survival for
prostate cancer in recent years. Relative survival
in men has increased by nearly seven percentage
points for one year and nearly five percentage
points for five years. Five year survival has shown
a relative improvement of 10.4% for men and
4.7% for women over time.
Table 1: Increases for one and five year relative survival from cancer for men and women over time, with the increases greater in men
One year relative survival (%)
Five year relative survival (%)
2000-2004
2008-2012
2000- 2004
2004-2008
Men 62.3 69.1 46.1 50.9
Women 67.3 71.8 53.1 55.6
Source: Welsh Cancer Intelligence and Surveillance Unit’s Cancer Registry www.wcisu.wales.nhs.uk
9
Welsh Cancer Intelligence and Surveillance Unit Official Statistics 2013 data
Published 4 February 2015
2 Cancer geography in
Wales
Cancer incidence by geography
The main determinants of the number of new
cancer cases in a defined population each year is
the size of the population and its age structure –
cancer incidence in general increases with age. The
change in the number of cases between 2004 and
2013 in each local authority or health board
population are largely explained by changes in
these two factors (figure 6).
Cancer incidence rates show great
variation between health boards and local authorities in Wales
Once we take account of the differences in
population size and age structure between
geographic areas of Wales, we see that there is
considerable variation in the age-adjusted cancer
incidence rates per 100,000 population (figure 7).
The incidence for Powys Teaching health board is 8
per cent lower than the incidence for Wales, and is
lower than would be expected by chance alone.
Similarly, the rate in Cwm Taf University health
board is 4 per cent higher than the incidence for
Wales, and is higher than would be expected by
chance alone. This accounts for a difference of
around 74 new cancer cases per 100,000
population between the highest and lowest
incidence rate health boards in Wales for the period
2009-2013.
Figure 6: Change in the number of new cancer cases diagnosed in Wales at local authority and health board level over time
Source: Welsh Cancer Intelligence and Surveillance Unit’s Cancer Registry www.wcisu.wales.nhs.uk ©Crown Copyright and database right 2015. Ordnance Survey 100044810
2004 2013
10
Welsh Cancer Intelligence and Surveillance Unit Official Statistics 2013 data
Published 4 February 2015
Figure 7: The cancer incidence rate (EASR) per 100,000 populations is statistically significantly higher than Wales for two health boards in 2009-
2013
Source: Welsh Cancer Intelligence and Surveillance Unit’s Cancer Registry www.wcisu.wales.nhs.uk
Figure 8: The highest local authority cancer
incidence rate in Merthyr Tydfil is almost 20 per cent higher than the lowest in Ceredigion in 2009-2013
Source: Welsh Cancer Intelligence and Surveillance Unit’s Cancer Registry www.wcisu.wales.nhs.uk ©Crown Copyright and
database right 2015. Ordnance Survey 100044810
Cancer incidence at small geographic area shows
greater variation (figures 8 and 9). The highest
rates are in the Merthyr Tydfil, Newport and
Torfaen local authority areas whereas the lowest
rates are in Powys and Ceredigion. Although not
the highest, there are also areas of high incidence
rates in the north east and south east of Wales.
Smaller areas with the highest rates are found
across much of the south Wales valleys, deprived
inner city areas and across many parts of north
east Wales. There are also several areas of
moderate or high incidence across parts of
Anglesey and Gwynedd and other areas of north
Wales as well as Carmarthenshire and
Pembrokeshire. There are also pockets of high
incidence rates in many rural towns.
Areas of lower incidence exist in some more
affluent urban areas of south Wales, but are few in
number across most rural areas apart from a small
number of affluent rural areas, and across the less
affluent rural areas of Ceredigion. Chance plays a
role in the large variations in cancer incidence at all
geographic levels, as well as past and present
socioeconomic inequalities. Areas of deprivation
and former industrialisation, in addition to many
associated health risk behaviours such as smoking,
obesity, diet and nutrition, alcohol and physical
activity account for a considerable amount of the
cancer incidence rates and their variation.
Figure 9: The cancer incidence rate at Middle Super Output Area (MSOA) shows considerable variation across Wales
Source: Welsh Cancer Intelligence and Surveillance Unit’s
Cancer Registry www.wcisu.wales.nhs.uk ©Crown Copyright and database right 2015. Ordnance Survey 100044810
582.6
613.6
619.0
630.9
633.9
635.7
650.5
656.8
Powys Teaching
Abertawe Bro Morgannwg University
Hywel Dda University
Wales
Betsi Cadwaladr University
Cardiff & Vale University
Aneurin Bevan University
Cwm Taf University
Statistically significantly different to Wales Not statistically significantly different to Wales Wales
569.3 – 591.6591.7 – 614.0614.1 – 636.3636.4 – 658.7658.8 – 681.0
Wales = 630.9
EASR per 100,000 population
72.076001 - 72.830000
71.322001 - 72.076000
70.568001 - 71.322000
69.814001 - 70.568000
69.060000 - 69.814000
457.2 – 552.1552.2 – 647.0647.1 – 741.9742.0 – 836.8836.9 – 931.7
Wales = 630.9
EASR per 100,000
population
72.076001 - 72.830000
71.322001 - 72.076000
70.568001 - 71.322000
69.814001 - 70.568000
69.060000 - 69.814000
11
Welsh Cancer Intelligence and Surveillance Unit Official Statistics 2013 data
Published 4 February 2015
Cancer deaths by geography
Cancer mortality varies considerably between
health board populations (figure 10). Powys
Teaching health board has a mortality rate 10 per
cent lower than Wales as a whole, and this is lower
than would be expected by chance alone. Cwm Taf
University health board has a mortality rate which
is nearly 8 per cent higher relative to Wales and is
higher than would be expected by chance alone.
The difference between these two health boards is
54 deaths per 100,000 population, making the rate
in Cwm Taf University health board 20 per cent
higher than that in Powys Teaching health board
Betsi Cadwaladr University health board had the
largest number of cancer deaths in 2004 and 2013
due to this health board having the largest
population of all health boards in Wales and a large
proportion of older people, amongst other factors,
contributing to a higher recent and past cancer
incidence (figure 11). The local authority of Cardiff
has the largest number of cancer deaths in Wales
with Merthyr Tydfil having the lowest number of
deaths mainly due to their respective population
sizes.
Figure 10: The cancer mortality rate (EASR) per 100,000 population is statistically significantly
higher than Wales in Cwm Taf university health board for 2009-2013
Source: Welsh Cancer Intelligence and Surveillance Unit’s Cancer Registry www.wcisu.wales.nhs.uk
Figure 11: Variation seen in the number of cancer deaths registered in Wales at local authority and health board level over time
Source: Welsh Cancer Intelligence and Surveillance Unit’s Cancer Registry www.wcisu.wales.nhs.uk ©Crown Copyright and database right 2015. Ordnance Survey 100044810
2004 2013
12
Welsh Cancer Intelligence and Surveillance Unit Official Statistics 2013 data
Published 4 February 2015
Cancer mortality rates are highest in some local
authorities in the south east Wales valleys and
north east Wales. The highest mortality rate is in
Blaenau Gwent which is 12 per cent higher than
Wales, whereas the rate in Monmouthshire (figure
12) is 16 per cent lower than Wales.
Figure 12: The highest local authority mortality rate in Blaenau Gwent is over a third higher than the lowest in Monmouthshire in 2009-2013
Source: Welsh Cancer Intelligence and Surveillance Unit’s Cancer Registry www.wcisu.wales.nhs.uk ©Crown Copyright and
database right 2015. Ordnance Survey 100044810
Cancer mortality shows great variation between
neighbouring areas at small area level in part due
to small numbers and small populations (figure
13). Mortality shows a similar pattern to incidence
with the south Wales valleys tending to show
higher rates along with the deprived inner city
areas.
Figure 13: The cancer mortality rate at Middle Super Output Area shows pockets of high and low mortality in Wales with great variation between
some neighbouring areas
Source: Welsh Cancer Intelligence and Surveillance Unit’s Cancer Registry www.wcisu.wales.nhs.uk ©Crown Copyright and database right 2015. Ordnance Survey 100044810
One year survival from cancer is very similar in all health boards
Over 70 per cent of Welsh residents can now
expect to survive at least one year after being
diagnosed with cancer. The one year relative
survival is similar across the seven health board
populations (figure 14).
Powys Teaching health board has the best relative
survival which is over 3 per cent higher (2.4
percentage points) than the rate for Wales. The
health board with the worst survival rate is Cwm
Taf University health board which is nearly 2 per
cent lower (or 1.3 percentage points) than the rate
for Wales. Cardiff and Vale University health board
along with Powys Teaching health board have one
year survival rates higher than Wales as a whole,
and higher than can be expected by chance alone.
251.4 – 268.4268.5 – 285.3285.4 – 302.2302.3 – 319.1319.2 – 336.1
Wales = 299.8
EASR per 100,000
population
72.076001 - 72.830000
71.322001 - 72.076000
70.568001 - 71.322000
69.814001 - 70.568000
69.060000 - 69.814000
191.9 – 257.2257.3 – 322.6322.7 – 387.9388.0 – 453.3453.4 – 518.6
Wales = 299.8
EASR per 100,000
population
72.076001 - 72.830000
71.322001 - 72.076000
70.568001 - 71.322000
69.814001 - 70.568000
69.060000 - 69.814000
13
Welsh Cancer Intelligence and Surveillance Unit Official Statistics 2013 data
Published 4 February 2015
Figure 14: One year relative survival is similar across the seven health boards of Wales in 2008-2012
Source: Welsh Cancer Intelligence and Surveillance Unit’s Cancer Registry www.wcisu.wales.nhs.uk ©Crown Copyright and database right 2015. Ordnance Survey 100044810
Variation between health boards is larger for five year relative survival
Over a half of all Welsh residents diagnosed with
cancer survive for at least five years. There is
more variation for five year relative survival
compared with one year relative survival. Cwm Taf
University health board shows a higher proportion
of deaths between one and five years post
diagnosis compared to other health board, nearly 8
per cent lower compared to the five-year survival
rate for Wales (figure 15). Four of the health
boards have a better survival rate than Wales with
Powys Teaching health board having the best
survival (5 per cent higher than the rate for
Wales). Cwm Taf University health board and
Abertawe Bro Morgannwg University health board
have rates lower than can be expected by chance
alone, whereas Cardiff and Vale University health
board and Powys Teaching health board have rates
higher than can be expected by chance alone.
Figure 15: Cwm Taf University health board has the lowest five year relative survival of all health boards in Wales in 2004-2008
Source: Welsh Cancer Intelligence and Surveillance Unit’s Cancer Registry www.wcisu.wales.nhs.uk ©Crown Copyright and database right 2015. Ordnance Survey 100044810
69.1 – 69.869.9 – 70.670.7 – 71.371.4 – 72.172.2 – 72.8
Wales = 70.4%
72.076001 - 72.830000
71.322001 - 72.076000
70.568001 - 71.322000
69.814001 - 70.568000
69.060000 - 69.814000
71.4
72.8
70.0
69.569.1
69.4
71.8
49.1 – 50.550.6 – 51.851.9 – 53.253.3 – 54.554.6 – 55.9
Wales = 53.2%
72.076001 - 72.830000
71.322001 - 72.076000
70.568001 - 71.322000
69.814001 - 70.568000
69.060000 - 69.814000
54.0
55.9
54.1
51.849.1
52.9
55.2
14
Welsh Cancer Intelligence and Surveillance Unit Official Statistics 2013 data
Published 4 February 2015
3 Incidence, mortality
and survival by area deprivation
The gap in incidence rate between least and most deprived areas continues to increase
The incidence rate for all cancer combined
decreased in the least deprived fifth in Wales from
2002-2006 to 2009-2013, while the incidence rate
increased in the most deprived fifth. This resulted
in the gap between the least and most deprived
fifths widening (figure 16).
The gap increased from 97 new cancer cases per
100,000 population per year in 2002-2006 to 131
new cancer cases per 100,000 population in 2009-
2013 - an increase of over a third. Put another
way, the incidence rate in the most deprived areas
was 16.3 per cent higher than in the least deprived
areas for 2002-2006 and increased to 22.5 per cent
higher in 2009-2013.
Figure 16: The difference between the cancer incidence rate (EASR) per 100,000 population in the least deprived fifth compared to the most
deprived fifth has increased over time
Source: Welsh Cancer Intelligence and Surveillance Unit’s Cancer Registry www.wcisu.wales.nhs.uk
The gap in mortality rate between least and most deprived has slightly increased
The all cancers combined mortality rate decreased
in all deprivation fifths during the same interval.
The decrease in the least deprived fifth was larger
than the decrease in the most deprived fifth (figure
17). Thus the gap between the least and most
deprived fifths increased slightly from 113.3 per
100,000 population in 2002-2006 to 119.9 per
100,000 population in 2009-2013, or nearly a 6 per
cent increase. So the mortality rate in the most
deprived areas was 40.8 per cent higher than in
the least deprived areas for 2002-2006 which
increased to 48.0 per cent higher in 2009-2013. Figure 17: The difference between the cancer mortality rate (EASR) per 100,000 population in
the least deprived fifth compared to the most deprived fifth has slightly increased over time
Source: Welsh Cancer Intelligence and Surveillance Unit’s Cancer Registry www.wcisu.wales.nhs.uk
Cancer survival is lower in deprived areas but the gap is larger for some cancers
One year relative survival for all cancers combined
has improved in all deprivation fifths over time
(figure 18). However, the increase is greater in the
most deprived fifth than in the least deprived fifth
in Wales. This has narrowed the gap between the
least and most deprived fifth from 13.5 percentage
points in 1999-2003 to 12.1 percentage points in
2008-2012, or by approximately 10 per cent.
The most recent one year relative survival in the
most deprived fifth remains on a par with that of
the middle deprived fifth a decade before, and
seven percentage points below what the least
deprived fifth experienced a decade before.
Five year relative survival has improved in all
deprivation fifths over time (figure 19). However,
the increase is greater in the least deprived fifth
than the most deprived fifth giving a widening gap.
The deprivation gap increased from 16.2
percentage points in 1999-2003 to 17.1 percentage
points in 2004-2008, or by approximately 6 per
cent.
15
Welsh Cancer Intelligence and Surveillance Unit Official Statistics 2013 data
Published 4 February 2015
The most recent five year relative survival in the
most deprived fifth is now on a par with the next
most deprived fifth experienced a decade before
and 12 percentage points below what was
experienced a decade before in the least deprived
fifth. In the latest time period a 17 percentage
point difference is seen between the least and most
deprived fifth.
Figure 18: One year relative survival (%) for all cancers combined has improved in all deprivation fifths over time but the increase is greater in the most deprived fifth than the least deprived fifth thus narrowing the gap
Source: Welsh Cancer Intelligence and Surveillance Unit’s Cancer Registry www.wcisu.wales.nhs.uk
Figure 19: A greater increase in five year survival (%) is seen in the least deprived fifth compared to the most deprived fifth over time, widening the gap
Source: Welsh Cancer Intelligence and Surveillance Unit’s Cancer Registry www.wcisu.wales.nhs.uk
16
Welsh Cancer Intelligence and Surveillance Unit Official Statistics 2013 data
Published 4 February 2015
4 Incidence, mortality
and survival of different cancer types
Incidence by cancer type
In 2013 the most common cancers in Wales in
terms of numbers were female breast cancer,
prostate, lung and bowel cancer (figure 20).
Figure 20: The most common cancers in men and women in Wales in 2013
Source: Welsh Cancer Intelligence and Surveillance Unit’s Cancer Registry www.wcisu.wales.nhs.uk
Prostate cancer accounted for over a quarter of all
new cancers diagnosed in men (figure 21). Bowel
and lung cancer each accounted for one in seven
cancers for men.
Figure 21: Over a quarter of all cancers in men was
prostate cancer in 2013
Source: Welsh Cancer Intelligence and Surveillance Unit’s Cancer Registry www.wcisu.wales.nhs.uk
Breast cancer accounted for nearly a third of all
cancers in women (figure 22). Lung cancer was the
second most common, approaching 12 per cent of
cases. One in ten new cancers in women was bowel
cancer.
Figure 22: Nearly a third of all cancers in women were breast cancer in 2013
Source: Welsh Cancer Intelligence and Surveillance Unit’s Cancer Registrywww.wcisu.wales.nhs.uk
The majority of the most common cancers in Wales
had an absolute increase in numbers between
2001-2003 and 2011-2013 (figure 23). Prostate,
bowel, female breast, melanoma and lung cancer
had the largest increases in numbers. Almost two
thirds of the increase in bowel cancer numbers was
in men. A similar proportion of the increase in
melanoma cases was also in men. Almost all the
increase in lung cancer numbers occurred in
women. Cervical, oesophageal and stomach
cancers showed decreases in numbers.
Although prostate cancer had the largest absolute
increase in numbers, liver cancer in men showed
the largest percentage increase(figure 24),
doubling over the time periods. For women the
percentage increase in liver cancer numbers was as
much as 70 per cent. Melanoma showed the second
largest percentage increase, with the number of
cases in men nearly doubling, and in women
increasing by nearly a half over the periods
examined. Uterine cancer (cancer of the womb)
also increased by nearly a half. Head and neck
cancer and urinary tract excluding bladder cancer
in men also showed increases of nearly a half.
The four most common cancers also showed at
least modest percentage increases. There was a
very large difference between men and women for
lung cancer. The number of new cases diagnosed in
women increased by almost a third, compared to
only 2 per cent in men. Prostate cancer numbers
increased by almost a third. Bowel cancer cases
increased by a quarter in men and by almost a fifth
in women. Apart from lung cancer in men, the
17
Welsh Cancer Intelligence and Surveillance Unit Official Statistics 2013 data
Published 4 February 2015
commonest cancer with the smallest percentage
increase in numbers, of 15 per cent, was breast .
cancer
Figure 23: Average change in the number of new cancer cases by cancer type in Wales shows large variation in 2011-2013 compared with 2001-2003
*Bladder cancer not shown due to a coding change in 2007 Source: Welsh Cancer Intelligence and Surveillance Unit’s Cancer Registry www.wcisu.wales.nhs.uk
A large percentage increase occurred in the
number of thyroid and endocrine cancer cases in
men, with women also showing a slight increase.
Caution is advised in the interpretation since
small numbers are involved in this large
percentage increase.
Taking account of changing population size and
age structure, the cancers with the highest age-
adjusted incidence rates in 2013 were prostate
cancer and female breast cancer, with rates over
twice as high compared to lung and bowel
cancers (figure 25). The first two cancers are of
course gender-specific so the denominator figure
is different to lung and bowel cancers that could
affect the whole population.
18
Welsh Cancer Intelligence and Surveillance Unit Official Statistics 2013 data
Published 4 February 2015
Figure 24: The percentage change of new cancer cases varies by cancer type in Wales, 2011-2013 compared with 2001-2003
*Bladder cancer not shown due to a coding change in 2007 Source: Welsh Cancer Intelligence and Surveillance Unit’s Cancer Registry. www.wcisu.wales.nhs.uk
Figure 25: Age adjusted incidence rates of cancer types in Wales, 2013 compared with 2004
* Bladder cancer not shown due to a coding change in 2007. Source: Welsh Cancer Intelligence and Surveillance Unit’s Cancer
Registry www.wcisu.wales.nhs.uk
19
Welsh Cancer Intelligence and Surveillance Unit Official Statistics 2013 data
Published 4 February 2015
The largest increases in age-adjusted incidence
rates in men from 2001-2003 to 2011-2013
occurred for melanoma, head and neck, urinary
tract excluding bladder, liver, prostate and bowel
cancer (figure 26). The more than 70 per cent
increase in melanoma incidence rate was the
largest percentage increase in men. Liver cancer
increased by two-thirds. There were also large
percentage increases in thyroid and endocrine (but
based on small numbers), urinary tract excluding
bladder and head and neck cancer. There were
large percentage decreases in stomach,
oesophageal and lung cancer (figure 27). Figure 26: The average change in the incidence rate (EASR) per 100,000 population shows a large
increase in melanoma and a large decrease in lung
cancer in men in Wales, 2011-2013 compared with 2001-2003
* Bladder cancer not shown due to a coding change in 2007. Source: Welsh Cancer Intelligence and Surveillance Unit’s Cancer Registry www.wcisu.wales.nhs.uk
Figure 27: The percentage change in the cancer
incidence rate (EASR) per 100,000 population by cancer type for men in Wales shows an increase of nearly three quarters for melanoma and two thirds increase for liver cancer in 2011-2013 compared with 2001-2003
* Bladder cancer not shown due to a coding change in 2007. Source: Welsh Cancer Intelligence and Surveillance Unit’s Cancer Registry www.wcisu.wales.nhs.uk
For women, lung cancer shows the largest absolute
increase in rate over the same time period (figure
28). The next largest increases were for breast,
uterus, melanoma, bowel, urinary tract (excluding
bladder) and liver cancer.
In women, liver cancer showed the largest
percentage increase (figure 29), followed by
urinary tract (excluding bladder), melanoma,
uterine, thyroid and endocrine, head and neck, and
lung cancers. There were notable percentage
decreases in stomach, oesophageal, cervical and
brain and CNS cancers .
Figure 28: The change in the incidence rate (EASR)
per 100,000 population by cancer type for women in Wales shows a large increase in lung cancer in
2011-2013 compared with 2001-2003
* Bladder cancer not shown due to a coding change in 2007. Source: Welsh Cancer Intelligence and Surveillance Unit’s Cancer Registry www.wcisu.wales.nhs.uk
Figure 29: The percentage change in the cancer
incidence rate (EASR) per 100,000 population by cancer type for women shows an increase of over a half for liver cancer in Wales in 2011-2013 compared with 2001-2003
* Bladder cancer not shown due to a coding change in 2007. Source: Welsh Cancer Intelligence and Surveillance Unit’s Cancer Registry www.wcisu.wales.nhs.uk
20
Welsh Cancer Intelligence and Surveillance Unit Official Statistics 2013 data
Published 4 February 2015
The deprivation gap is showing small
increases in incidence for some cancer types
...Cancer incidence is higher in the most deprived
areas for lung cancer and colorectal cancer but the
opposite pattern is true for female breast cancer
and prostate cancer where the lower rates are seen
in the most deprived areas.
The gap between the higher incidence rate in the
most deprived fifth in Wales and lower incidence
rate in the least deprived area is widest for lung
cancer, compared to other common cancers in
Wales (figure 30). This very large gap for lung
cancer has increased due to a decrease in the
incidence rate for the least deprived fifth and a
small increase in the most deprived fifth. The
deprivation gap has slightly increased for colorectal
cancer.
Figure 30: The cancer incidence rate (EASR) per 100,000 population for areas with increasing deprivation (fifths) by cancer type
Source: Welsh Cancer Intelligence and Surveillance Unit’s Cancer Registry www.wcisu.wales.nhs.uk
0
50
100
150
200
250
2002-2006 2009-2013 2002-2006 2009-2013 2002-2006 2009-2013 2002-2006 2009-2013
Lung Female Breast Prostate Bowel (Colorectal)
EA
SR
per
10
0,0
00
pop
ula
tion
Least deprived Next least deprived Middle deprived Next most deprived Most Deprived
21
Welsh Cancer Intelligence and Surveillance Unit Official Statistics 2013 data
Published 4 February 2015
Deaths from different types of
cancer
The most common cancer related death in Wales
was lung cancer with 1,842 deaths registered in
2013 (figure 31). Bowel cancer was the second
most common cancer death with 907 deaths and
female breast cancer was the third most common
with 573 deaths. Lung cancer deaths accounted for
more deaths than both bowel cancer and female
breast cancer combined. There were three deaths
from testicular cancer in Wales in 2013.
Figure 31: Lung cancer is the most common cancer death in Wales in 2013
Source: Welsh Cancer Intelligence and Surveillance Unit’s Cancer Registry www.wcisu.wales.nhs.uk
1011
486
529
223
285
186
203
159
143
149
160
128
115
69
48
10
10
3
831
421
573
223
117
117
96
114
119
95
243
54
83
88
56
90
6
50
14
5
Lung
Bowel (Colorectal)
Female Breast
Prostate
Pancreas
Oesophagus
Stomach
Bladder
Liver
Non-Hodgkin Lymphoma
Leukaemia
Ovary
Head & Neck
Brain & CNS
Urinary Tract exc Bladder
Melanoma
Uterus
Larynx
Cervix
Thyroid & Endocrine
Hodgkin Lymphoma
Testis
Men WomenNumber of
22
Welsh Cancer Intelligence and Surveillance Unit Official Statistics 2013 data
Published 4 February 2015
Over a fifth of all cancer deaths among men in
Wales were lung cancer in 2013 (figure 32). Over
10 per cent of all cancer deaths were for prostate
cancer and a similar proportion were for colorectal
cancer. Oesophageal cancer was the cause of
approximately one in 16 cancer deaths. These four
cancer types accounted for just over half of all
cancer deaths in men. Figure 32: Over a fifth of all cancer deaths in men in Wales were from lung cancer in 2013
Source: Welsh Cancer Intelligence and Surveillance Unit’s Cancer Registry www.wcisu.wales.nhs.uk
Over a fifth of all cancer deaths among women in
Wales were lung cancer in 2013 (figure 33). Nearly
one in seven cancer deaths were breast cancer in
women and over 10 per cent were bowel cancer.
Ovarian cancer was the fourth most common
cancer death in women and these four cancers
accounted for just over half of all cancer deaths in
women in 2013.
Figure 33: Over a fifth of all cancer deaths in women in Wales were from lung cancer in 2013
Source: Welsh Cancer Intelligence and Surveillance Unit’s Cancer Registry www.wcisu.wales.nhs.uk
The largest change in the absolute number of
deaths in men was liver cancer which also showed
the largest percentage increase (figures 34 and
35). Pancreatic cancer also showed an increase in
the number of deaths resulting in a 28 per cent
increase in terms of numbers for men. Melanoma
and testicular cancer also showed large percentage
increases in men; however note that testicular
cancer is based on very small numbers. Stomach
cancer has showed a large percentage decrease.
For women, the largest change in the numbers was
lung cancer. This number was nearly the same as
the total increase in all other cancer deaths in
women. The largest percentage increase for women
was for liver cancer followed by Hodgkin lymphoma
and uterine cancer. However, the numbers for
Hodgkin lymphoma are very small so caution is
advised in terms of the interpretation. Large
percentage decreases are seen for stomach,
cervical and thyroid and endocrine cancer.
23
Welsh Cancer Intelligence and Surveillance Unit Official Statistics 2013 data
Published 4 February 2015
Figure 34: The largest change in the average number of cancer deaths is for lung cancer in women in 2011-2013 compared with 2001-2003
Source: Welsh Cancer Intelligence and Surveillance Unit’s Cancer Registry www.wcisu.wales.nhs.uk
Figure 35: The largest percentage change in the average number of cancer deaths is for liver cancer for both men and women in Wales in 2011-2013 compared with 2001-2003
Source: Welsh Cancer Intelligence and Surveillance Unit’s Cancer Registry www.wcisu.wales.nhs.uk
24
Welsh Cancer Intelligence and Surveillance Unit Official Statistics 2013 data
Published 4 February 2015
Lung cancer has the highest age adjusted mortality
rate in Wales in 2013, compared to other cancer
types. This rate had decreased by 12.3 per cent
compared to ten years previously. Prostate cancer
was the second most common cancer death rate,
and this had decreased by nearly a third compared
to 2004. Female breast cancer mortality rates
were the third highest in 2013 (figure 36).
Figure 36: The cancer mortality rate (EASR) per 100,000 population is highest for lung cancer in Wales in 2013 and 2004 compared to other cancer
types
Source: Welsh Cancer Intelligence and Surveillance Unit’s Cancer Registry www.wcisu.wales.nhs.uk
Liver cancer in men shows the largest increase in
mortality rate between the time periods examined
(figure 37), and the largest percentage increase for
men, increasing by over a half. Testicular cancer
shows the second largest percentage increase,
however, numbers are low for this cancer type
(figure 38). Melanoma shows the third largest
percentage increase of nearly a third. The mortality
rate for all cancers combined has shown a large
decrease of over 12 per cent.
Figure 37: Prostate and lung cancers show the largest absolute decreases in cancer mortality (EASR) rate per 100,000 men in Wales from 2001-
2003 to 2011-2013
Source: Welsh Cancer Intelligence and Surveillance Unit’s Cancer Registry www.wcisu.wales.nhs.uk
Figure 38: The largest percentage increase in the cancer mortality rate (EASR) per 100,000 men is for liver cancer from 2001-2003 to 2011-2013
Source: Welsh Cancer Intelligence and Surveillance Unit’s Cancer Registry www.wcisu.wales.nhs.uk
Lung cancer in women shows the largest increase
in the mortality rate over time but liver cancer has
the largest percentage increase of nearly two thirds
(figure 39 and 40). Hodgkin lymphoma and uterine
cancer also show large percentage increases but
the numbers are very small for Hodgkin lymphoma.
The mortality rate for all cancers combined has
shown a decrease of nearly 8 per cent.
... Liver cancer in men shows the
largest increase in mortality rate between 2004 and 2013 but for
women its lung cancer which shows the largest increase in the
mortality rate over time. Liver cancer has the largest percentage
increase by nearly two thirds...”
25
Welsh Cancer Intelligence and Surveillance Unit Official Statistics 2013 data
Published 4 February 2015
Figure 39: Breast cancer has the largest absolute decrease in cancer mortality (EASR) rate per 100,000 women in Wales from 2001-2003 to 2011-
2013
Source: Welsh Cancer Intelligence and Surveillance Unit’s Cancer Registry www.wcisu.wales.nhs.uk
Figure 40: The largest percentage increase in the
cancer mortality rate (EASR) per 100,000 women is for liver cancer from 2001-2003 to 2011-2013
Source: Welsh Cancer Intelligence and Surveillance Unit’s Cancer Registry www.wcisu.wales.nhs.uk
Large differences exist between least deprived and most deprived fifths for
lung cancer mortality
Cancer mortality is higher in the most deprived
fifths for lung cancer and bowel cancer with a
gradient in between (figure 41). The gap is very
large for lung cancer and has widened between
2002-2006 and 2009-2013. The modest gap in
bowel cancer mortality rate narrowed slightly.
There is a small degree of variation for female
breast cancer and prostate cancer mortality rate
between deprivation fifths of areas, but no clear
gradients.
Figure 41: The cancer mortality rate (EASR) per 100,000 shows the difference between the least deprived and most deprived fifth for lung cancer is
increasing in Wales
Source: Welsh Cancer Intelligence and Surveillance Unit’s Cancer Registry www.wcisu.wales.nhs.uk
Survival from pancreas, lung and liver cancer is still very poor
The cancers with the lowest one year survival are
pancreas, lung and liver for both time periods we
examined (figure 42). Despite this, these three
cancers have shown improvements in one year
survival. Testicular cancer has the highest one year
survival rate of 98 per cent, followed closely by
melanoma, prostate cancer and female breast
cancer (all over 96 per cent) in 2008-2012. Three
quarters of people diagnosed with bowel cancer
now survive for at least one year.
26
Welsh Cancer Intelligence and Surveillance Unit Official Statistics 2013 data
Published 4 February 2015
Figure 42: Improvements in one-year survival (%) are seen for the majority of cancer types
*There was a bladder coding change in 2007, hence the large change in survival. Source: Welsh Cancer Intelligence and Surveillance Unit’s Cancer Registry www.wcisu.wales.nhs.uk
Similar to one year survival, the lowest five year
survival rates are for cancers of the pancreas, liver
and lung (figure 43) for both time periods
examined. Five year survival from liver cancer is
now just under 6 per cent, a slight decrease
compared to 2000-2004. For lung cancer the
figures remain unchanged over time. Five year
survival for testicular cancer is again high at 96 per
cent for the latest period of 2004-2008. Five year
survival for prostate cancer and female breast
cancer is over 85 per cent each for 2004-2008. For
bowel cancer, only a small improvement occurred,
rising to 52 per cent in 2004-2008.
Variation in survival between health boards for some cancers
Although one year survival for all cancers combined
varies little between health board population, for
some cancer types there is wide variation, for
example, oesophageal cancer (figure 44), whereas
all health boards tend to have similar one year
survival rates for prostate cancer (95 per cent and
over).
27
Welsh Cancer Intelligence and Surveillance Unit Official Statistics 2013 data
Published 4 February 2015
Figure 43: Improvements in five-year survival (%) are seen for the majority of cancer types
*There was a bladder coding change in 2007, hence the change in survival. Source: Welsh Cancer Intelligence and Surveillance Unit’s Cancer Registry www.wcisu.wales.nhs.uk
Figure 44: Large variation is seen for one year survival from oesophageal cancer by health board
Source: Welsh Cancer Intelligence and Surveillance Unit’s Cancer Registry www.wcisu.wales.nhs.uk
However, the five year survival for prostate cancer
shows wide variation between health boards (from
78.4 per cent in Powys Teaching health board to
91.5 per cent in Cardiff and Vale University health
board)(figure 45). There is also wide variation for
head and neck cancer and leukaemia. Further
information on cancer survival rates for each health
board can be found on the Welsh Cancer
Intelligence and Surveillance Unit’s interactive
dashboard1. Figure 45: There is a large variation in five year survival by health board population for prostate cancer
Source: Welsh Cancer Intelligence and Surveillance Unit’s Cancer Registry www.wcisu.wales.nhs.uk
1 http://www.wcisu.wales.nhs.uk/cancer-statistics
28
Welsh Cancer Intelligence and Surveillance Unit Official Statistics 2013 data
Published 4 February 2015
An improvement is seen in all deprivation fifths for one year
survival
Lung cancer has a wide gap in incidence between
the most deprived fifth in Wales compared to the
least deprived – with the highest incidence in the
most deprived areas (see previously). The one-year
survival from lung cancer is also lowest in the most
deprived areas, although the gap is much less than
for the incidence rate, and the deprivation gap in
survival has decreased (figure 46). Our recent
detailed report on lung cancer survival that
included 2012 data is available at
http://www.wcisu.wales.nhs.uk/lung-cancer-
overview.
Like lung cancer, female breast cancer and prostate
cancer incidence has a deprivation gap, but unlike
lung cancer, the higher incidence is in the least
deprived areas. Despite this, one-year survival
from these cancers is still lowest in the most
deprived areas, but gaps have narrowed.
Bowel cancer has a deprivation gap in one year and
five year survival, both worse in the most deprived
areas. While the gap in incidence is much smaller
than for lung cancer, the deprivation gap in one
year survival for bowel cancer is wider.
Figure 46: Lung, female breast and prostate cancer show decreases in the deprivation gap for one year relative survival over time in Wales
Source: Welsh Cancer Intelligence and Surveillance Unit’s Cancer Registry www.wcisu.wales.nhs.uk
Little improvement is seen by deprivation fifth for five year relative
survival for some cancer types
The least deprived fifths have the best survival and
the most deprived fifths have the worst survival for
five year relative survival for all cancer types.
Excluding lung cancer, the majority of deprivation
fifths show an increase in five year relative survival
over time.
For lung cancer there has been very little change in
five year relative survival over time with a slight
widening of the gap (figure 47). The deprivation
gap for five year relative survival shows a larger
gap than in one year relative survival for all other
cancer types excluding lung cancer; the gap for
lung cancer is smaller than one year relative
survival for some time periods. The deprivation
gap has slightly increased over time for bowel
cancer and female breast cancer but has slightly
decreased for prostate cancer. Figure 47: Wide variation exists between the least
and most deprived fifths for five year relative survival (%) in Wales for female breast, prostate and bowel cancer
Source: Welsh Cancer Intelligence and Surveillance Unit’s Cancer Registry www.wcisu.wales.nhs.uk
... the least deprived fifths have the best survival and the most
deprived fifths have the worst survival for five year relative
survival for all cancer types...”
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