Overview


This page is to help you understand the content of the 'Index of cancer survival' pages.

These cancer survival estimates are an interactive presentation of the National Statistics publication "Index of cancer survival for Clinical Commissioning Groups in England". The full release, with data tables and statistical commentary, is published here. National Statistics are a subset of official statistics, which have been certified by the UK Statistics Authority as compliant with its Code of Practice for Statistics.

For queries relating to this bulletin or to provide feedback, please contact us via email at ncrasenquiries@phe.gov.uk.

This content focuses on trends in the Index of cancer survival between 2003 and 2018 for adults (aged 15 to 99 years), for each of the 135 Clinical Commissioning Groups (CCGs), the 42 Sustainability and Transformation Partnerships (STPs), 21 Cancer Alliances (CAs) and for England as a whole:

  • Variation in survival by CCG for the index of cancer survival or one of breast, colorectal and lung cancer.
  • Trends of cancer survival in England and a selected comparator geographic area (from one of CCGs, CAs or STPs) for the index of cancer survival or one of breast, colorectal and lung cancer.
  • Trends of cancer survival for CCGs within a "parent" CA or STP for the index of cancer survival or one of breast, colorectal and lung cancer.

The data underlying each of these presentations can be downloaded and on the Data tab, the complete set of estimates can be downloaded.

The Index of cancer survival provides a convenient, single number that summarises the overall pattern of net cancer survival. It combines net survival estimates for breast cancer (women only), colorectal (bowel) cancer, lung cancer and other cancers (excluding non-melanoma skin cancer and prostate cancer).

Separate net survival estimates for breast (women only), colorectal (bowel) and lung cancers are also presented in this publication. These estimates are age-standardised (breast cancer) or age-sex-standardised (colorectal and lung cancers).

Net survival is the survival of cancer patients compared with the expected survival of the general population.

In this publication, net survival is estimated using regression models based on adults who were diagnosed with cancer between 2003 and 2018 followed up to 31 December 2019. Interpretation should primarily focus on trends, rather than the survival estimate for a particular year. It may not be statistically appropriate to compare survival estimates across geographical areas.

Alternative sources of cancer information

The Cancer survival in England publication provides national estimates of adult cancer survival for 31 cancer sites, including survival by stage at diagnosis where possible, cancer survival for children, and estimates of cancer survival for 22 cancer sites for CAs and STPs. Information on the contents and uses of all the cancer publications can be found in the article: Cancer statistics explained: different data sources and when they should be used.

Data for this study 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, which is part of Public Health England (PHE).




Variation in survival by CCG relative to England


The charts here show how the variation of survival by CCG changes over time for the index of cancer survival, breast, colorectal (bowel) and lung cancers separately, which can be selected by choosing from the drop-down menu. The CCGs are coloured and shaped depending on whether their survival was better, worse, or no different from the reference survival taken from England in 2003.

Hover over a plot for information about the data points. Click on the camera icon at the top of a plot to save the plot as a .png file.






Please note that the y-axis for this graph does not start at 0 and varies to automatically to select a good range for comparing survival trends among the selected areas.




Survival trends for selected geographies compared to England


Here you can choose to compare the trends in cancer survival in a geographical area of your choice with that of England.

The map shows cancer survival for a selected year, in your chosen type of geography. A particular geographical area can be highlighted, the chart will then show the trend over the whole 16-year period for your chosen area and England. If no geographical area is chosen the chart will just display the trend for England.

You can choose to study the trends of the index in cancer survival, breast, colorectal (bowel) or lung cancer

The survival displayed is standardised for age (all), sex (index, colorectal & lung only) and site (index only).

The slider allows you to select a year. Hover over the map to see the survival for particular areas.

Click on the camera symbol to save the plot as a .png file.



Regional trends in survival

Here you can compare the trends of 1-year cancer survival for all the CCGs within either a Cancer Alliance or STP of your choice.

You can choose to study the trends of the index in cancer survival, breast, colorectal (bowel) or lung cancer

The survival displayed is standardised for age (all), sex (index, colorectal & lung only) and site (index only).

Hover over the graph to see survival estimates for the selected areas for particular years. Click on the camera symbol to save the plot as a .png file.

The chart below may take a few moments to load before it appears.




Please note that the y-axis for this graph does not start at 0 and varies to automatically to select a good range for comparing survival trends among the selected areas.



Data


The complete set of survival results that was used to produce the National Statistics release "Index of cancer survival for Clinical Commissioning Groups in England" here.

This OpenDocument Spreadsheet file format is readable by standard business software, including free opensource packages.


Background notes


This page is to help you better understand the technical side of the "Index of cancer survival" content.

Research on population-based cancer survival trends in England and Wales found that for most cancers, survival is either stable or rising steadily from year to year. This trend is reflected in the index of cancer survival. The index is designed to reflect real progress in cancer outcomes by long-term monitoring of progress in overall cancer survival. It provides a summary measure of cancer survival that takes account of shifts in the pattern of cancers in a given geography.

The index of cancer survival can be compared over time, because it is adjusted for any changes in the profile of cancer patients by age, sex or type of cancer. This adjustment is necessary because survival varies widely by all three factors meaning that, without standardisation, changes in survival could result from changes in the profile of cancer patients, even if survival at each age, for each cancer and in each sex did not change.

All adults (aged 15 to 99 years) who were diagnosed with a first, primary, invasive malignancy were eligible for inclusion. Patients diagnosed with malignancy of the skin other than melanoma were excluded. Cancer of the prostate was also excluded from the index, because the widespread introduction of prostate-specific antigen (PSA) testing since the early 1990s has led to difficulty in the interpretation of survival trends, as explained in Excess cases of prostate cancer and estimated over diagnosis associated with PSA testing in East Anglia.

It was sometimes impossible to produce robust estimates of survival for one or more of the age groups, most often because of the relatively small number of patients diagnosed in the age group 15 to 44 years. In this situation, the missing value for a CCG is replaced by the corresponding value for their "parent" Cancer Alliance (CA) or, if that is also missing, the missing value for both the CCG and CA is replaced by the value for England. Similarly, any missing values for Sustainability and Transformation Partnerships (STPs) are replaced by the value for England.

Substituted values are identified in the data tables containing the complete data in the column "Substituted by Parent Geography" and a full commentary is available in the full release.

More information on methodology can be found in the Quality and Methodology Information report, which also contains important information on:

  • the strengths and limitations of the data and how it compares with related data
  • uses and users of the data
  • how the output was created
  • the quality of the output including the accuracy of the data