Cancer definition:
These tables report cancers by their anatomic location (site). The coding system used is the International Classification of Diseases 10th Revision (ICD-10).We report at the three-digit level of ICD-10 and the four-digit level of ICD-10.
In 2013 there was an update of the ICD10 revision to the 4th version. As a result of the changes in coding the trend data and rolling averages may be misleading around the time of the revision change (2013).
In England, National Cancer Registration and Analysis Service (NCRAS) registers all cases of tumours that invade into surrounding tissues. These cancers or malignant neoplasms have ICD-10 codes C00 to C97.
Paget's disease of the nipple, which is coded as C50 using the ICD-10 coding system, is staged as a non-invasive cancer (stage group 0). It can however include invasive elements, hence it has been included in the counts. This may cause a small discrepancy in counts and totals compared to other publications. There are less than 200 of these tumours diagnosed per year.
Cases of non-melanoma skin cancer (NMSC), C44, have been inconsistently recorded over time and geography. Users can make consistent comparisons over time and geography by using "all cancers excluding NMSC" (C00 to C97 excluding C44).
All in situ tumours, ICD-10 D00 to D09, and tumours of uncertain or unknown behaviour, D37 to D48, are registerable. In situ means that the tumour is in its earliest stages. The tumour has not yet spread from the surface layer of cells in an organ or other tissue and is usually curable. Selected benign tumours (D32 to D33, D35.2 to D35.4) are registerable.
These tables do not include the non-mandatory non-malignant neoplasms (D04, D10 to D31, D34 to D35.1 and D35.5 to D36).
Notation in reference tables:
If a sex specific cancer site has been selected for "persons" or the opposite sex the results will be blank and "IS" will appear in the Flag column to show invalid sex.
The tables present age-specific rates where there are at least three diagnoses. Age-specific rates based on numbers lower than three are susceptible to inaccurate interpretation. Where there are fewer than three diagnoses, the tables display (u).
The tables present age-standardised rates where there are at least 10 diagnoses. Age-standardised rates based on numbers lower than 10 are susceptible to inaccurate interpretation. Where there are fewer than 10 diagnoses, the tables display (u).
The tables flag age-standardised rates with fewer than 20 diagnoses with (u). This is a warning to users that the small number of diagnoses may affect the reliability of these rates.
Information on quality:
Cancer registrations in England can take up to five years after the end of a calendar year to reach 100% completeness. This is because of the continuing accrual of late registrations. Further changes may still occur after five years following later diagnostic testing. These late changes are uncommon.
Methods for calculating rates
All rates are presented per 100,000 population.
Crude rates:
The non-standardised "all ages" (or crude) rate is the total number of registrations per 100,000 population:
(Total registrations / Total population) x 100,000
Age-specific rates:
To calculate an age-specific rate, divide the number of cancer diagnoses by the size of the population of the same age and sex:
ASRk
= (
rk
/
pk
) x 100,000
where
-
ASRk
= age-specific rate for age group k
-
rk
= registrations in age group k
-
pk
= population in age group k
- k = the age groups i.e. 0, 1-4, 5-9, ... , 85-89, and 90 and over
Directly age-standardised rates:
The incidence of cancer varies with age. The age structure of populations can change over time or between geographies. To let users make unbiased comparisons, these changes need to be controlled. (Direct) age-standardisation achieves this control.
Each age- and sex-specific rate are multiplied by a "standard" population. These are then summed to give a standardised rate. The standard population used in these tables is the European Standard Population 2013.
The (directly) age-standardised incidence rate is calculated by:
(
∑k
ASRk
pk
) /
∑k
pk
where
-
ASRk
= age-specific rate for age group k
-
rk
= registrations in age group k
-
pk
= population in age group k
- k = the age groups i.e. 0, 1-4, 5-9, ... , 85-89, and 90 and over
Acknowledgements:
Data for this work is based on patient-level information collected by the NHS, as part of the care and support of cancer patients. The data is collated, maintained and quality assured by the National Cancer Registration and Analysis Service (NCRAS), PHE.