Cancer Incidence


This data was last updated on 21 October 2021.

What is presented?

Number of tumours

This is a count of the number of tumours. Numbers can be presented for different cancer sites, time periods and geographies. Numbers can be useful when trying to estimate the burden of cancer.

Rates

These are presented as how many tumours per 100,000 population for a given combination of cancer site, time period and geography.

Types of rates

  • Age-specific - This is the rate per 100,000 within the specific age group
  • Non-standardised - This is the rate per 100,000 population without age standardisation being applied.
  • Age-standardised - This is the rate per 100,000 population with age standardisation applied.

Details

An incident case of cancer is a new case of cancer, counted once when the cancer is diagnosed.

Incident cases of cancer are counted for each separate primary tumour. One person may be diagnosed with more than one tumour, and would then appear twice in the incidence statistics. Recurrences of a previous cancer are not counted as new incident cases.

Standardised rates for England are standardised according to 2013 European Standard Population (ESP). Standardised rates for Clinical Commissioning Groups (CCGs) are standardised according to an approximate 2013 European Standard Population. This approximation is created by grouping the five year age bands in the ESP into the 5 age bands published on this tool.

Data presented are taken from the National Cancer Registration Service Cancer Analysis System, snapshot CAS2109.

Populations data has been sourced from ONS Mid 2019 Lower Super Output Area Population Estimates, released 26/06/2020.

Postcode lookups are as defined in the ONS National Statistics Postcode Lookup (NSPL) as of May 2021.

Flag definitions:

  • "u" potentially unreliable
  • "IS" invalid sex

Flag definitions:

  • "u" potentially unreliable
  • "IS" invalid sex

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.