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The level of need in the population

Adults :: Cancer :: The level of need in the population

Incidence of all cancers

There were 3992 new cases of cancer registered in Medway between 2012 and 2014. The majority of these, 2668 (67%), were in people aged under 75 years.

Over time, the incidence of all cancers has increased in both Medway and England as a whole. Figure 1 shows that, over the last decade, cancer incidence in Medway amongst people aged under 75 years has been similar to that of England.

Figure 1: Trends in new cases of cancer (under 75)
Figure 1: Trends in number of new cancer cases diagnosed in people aged under 75[1]

Prevalence

In 2016, 6,238 people in Medway were registered with their GP as having a cancer diagnosis. This equates to a prevalence of 2.1% of the registered population and compared with England prevalence of 2.4%.

All cancer mortality

Although the mortality rate from all cancers has been falling over time nationally, cancer still remains the leading cause of premature death for both males and females, accounting for almost half of deaths in women (47%) and two-fifths of deaths in men (40%) before the age of 75 years.

Figure 2 shows that over recent years, cancer mortality rates for Medway have remained consistently higher than the England average. There has been no significant increase in the gap in all cancer mortality rates between Medway and England over this period.

Figure 2: Trends in cancer deaths (under 75)
Figure 2: Trends in number of cancer deaths in people aged under 75[1]

Lung cancer incidence

Between 2012 and 2014, 519 new cases of lung cancer were registered in Medway, 319 (61%) of which were in people aged under 75 years. Figure 3 shows that the lung cancer incidence rate for under 75s in Medway has remained fairly similar to the England average over recent years.

Figure 3: Trends in new cases of lung cancer (under 75)
Figure 3: Trends in number of new lung cancer cases diagnosed in people aged under 75[1]

Lung cancer mortality

Lung cancer is the most common cause of all cancer deaths in England and in Medway. For the period between 2012 and 2014, lung cancer deaths accounted for 21% (Medway) and 21% (England) of all cancer deaths. Amongst under-75s, lung cancer deaths accounted for 21% (Medway) and 26% (England) of all cancer deaths amongst under-75s over the same period.

Between 2012 and 2014, 424 people died from lung cancer in Medway. Of these, 260 (61%) were deaths in people aged under 75 years

Figure 4: Trends in lung cancer deaths (under 75)
Figure 4: Trends in number of lung cancer deaths in people aged under 75[1]

The lung cancer mortality rate amongst people aged under 75 years in Medway has fluctuated on or above the England average since 2001 (figure 4). Several of these recent 'peaks' have been significantly higher than the national average.

Breast cancer incidence

Nationally, one in three women who develop breast cancer are aged 70 and over.

Between 2012 and 2014, 584 new cases of lung cancer were registered in Medway, 433 (74%) of which were in people aged under 75 years. There is a clear pattern over the last two decades in the incidence rate for breast cancer, with a three-year cycle of peaks and troughs rising above and falling below the England rate and with a slight upward trend (figure 5). This cyclical pattern reflects breast screening activity (which follows a three-yearly cycle) and is a known, national phenomenon.

Figure 5: Trends in new cases of breast cancer (under 75)
Figure 5: Trends in number of new breast cancer cases diagnosed in females aged under 75[1]

Breast cancer mortality

Breast cancer is now the second most common cause of death from cancer in women after lung cancer. Nationally, the number of women dying from breast cancer has fallen. This decline has in part been due to screening and improvements in treatment.

Between 2012 and 2014, 137 women died from lung cancer in Medway. Of these, 82 (60%) were deaths in women aged under 75 years. As shown in figure 6, there is a slight downward trend in breast cancer mortality amongst under-75s in Medway but with a lot of fluctuation above and below the national average.

Figure 6: Trends in breast cancer deaths (under 75)
Figure 6: Trends in number of breast cancer deaths in women aged under 75[1]

Colorectal cancer incidence

Between 2012 and 2014, 474 new cases of colorectal cancer were registered in Medway, 271 (57%) of which were in people aged under 75 years.

Figure 7 shows that a peak in the incidence rate of bowel cancer occurred for Medway in 2010. This peak coincides with the start of bowel cancer screening in 2009 in Medway, and suggests that cancers were being detected earlier than they would have been without screening. Since 2010, bowel cancer incidence has been falling in Medway and is currently similar to the England rate.

Figure 7: Trends in new cases of colorectal cancer (under 75)
Figure 7: Trends in number of new colorectal cancer cases diagnosed in people aged under 75[1]

Colorectal cancer mortality

Colorectal (also known as Bowel) cancer is the second most common cause of cancer death in the UK after lung cancer.

Between 2012 and 2014, 198 people died from colorectal cancer in Medway. Of these, 93 (47%) were deaths in people aged under 75 years.

Figure 8 shows that there is a slight downward trend in bowel cancer mortality in Medway. The rate is consistently higher than the England average but has reduced since peak in 2010.

Figure 8: Trends in lung colorectal deaths (under 75)
Figure 8: Trends in number of colorectal cancer deaths in people aged under 75[1]

Avoidable cancer deaths

During 2013-15, there were 1,019 cancer deaths in the under 75s, of which 625 (61%) could have been prevented, an average of 208 per year. Expressed as a rate per 100,000, this is the highest in the South East and fourth highest among other local authorities in the Chartered Institute of Public Finance and Accountancy (CIPFA) comparator group[2].

A death is considered to be preventable by the Office for National Statistics “if, in the light of understanding of the determinants of health at the time of death, all or most deaths from that cause (subject to age limits if appropriate) could be avoided by public health interventions in the broadest sense”[3]. In practice this definition includes the following cancers: lip, oral cavity, pharynx, oesophagus, stomach, colorectal, anus, liver, trachea, broncus and lung, skin, mesothelioma, breast and cervical.

Cancer survival

Net or relative survival in a population of cancer patients is their survival from the cancer of interest after adjustment for other causes of death. It is defined as the ratio of the observed survival and the survival that would have been expected if the cancer patients had experienced the same background mortality by age and sex as the general population. Net survival varies with age, sex and type of cancer and all of these factors can vary with time and between geographical areas, so the estimates are age, sex and cancer standardised to facilitate comparison.

Despite the one-year survival rate for all cancers rising every year in Medway since 1998, it is still one of the lowest in the country. Furthermore, Medway has the lowest lung cancer survial in the country and one of the lowest rates of colorectal cancer survival[4].


References

[1]   National Cancer Registration and Analysis Service. Cancer Stats
[2]   Public Health England. Public Health Outcomes Framework data tool
[3]   Office for National Statistics. Definition of preventable mortality
[4]   Office for National Statistics. Index of cancer survival for Clinical Commissioning Groups in England: Adults diagnosed 1998-2013 and followed up to 2014 2016;