Cancer Registration Statistics, England, 2021 - Full release

Counts of cancer incidence are presented for diagnoses registered in 2021.

Counts of mortality are presented for deaths from cancer registered in 2021.

The crude rate is the number of events in a specific population during a time period per 100,000 people. An event can either be a tumour diagnosis where the measure would be an incidence rate, or a death from cancer where the measure would be a mortality rate. A crude rate is calculated using the following equation:

(total number of events)/(total population) X 100,000

In this publication and the accompanying data tables, the non-standardised rate refers to the crude rate for all ages combined, where as the age-specific rate refers to the crude rate for individual age bands.

Age-standardised cancer incidence and mortality rates are presented. An age-standardised rate is a weighted average of the age-specific rates, where the weights uses age-specific proportions of a standardised population European Standard Population 2013 (ESP). Standardising rates with the ESP accounts for the differing age structure of different populations. This means that geographical and time comparisons of the rates can be made.

Most official statistics reporting on cancer use cancer sites that are based only on where the cancer started growing in the body. This can be a helpful way to summarise cancers but may sometimes hide the different types of cancer that grow in the same place. These different types of cancer can need different treatments even though they are found in the same part of the body. 

To better reflect the variety of cancers that patients are diagnosed and treated with, this publication introduces a wide range of subtypes of cancer that may require different treatments and may have different outcomes.  The next update of the cancer survival publication will examine these outcomes using the groupings in this publication. 

The different cancer groupings introduced have been consulted upon with patient representatives, charities and clinicians. These cancer groupings will gradually evolve to reflect changes in medical knowledge and clinical practice; some parts of the body have yet to mapped in detail and these will be added to over time. 

There are two levels of cancer grouping, a main level of up to 36 cancer groups which cover every registerable diagnosis and a detailed level that allow the reporting by appropriate sub-types of cancer. Table 2 presents these main and detailed cancer groups.

The coding systems used to define each main or detailed cancer group are ICD-10 for the location in the body (sometimes with the definitions of the cancer cell type from ICD-O-2) or ICD-O-3 for both the location in the body and the cancer cell type (where needed).

Table 2: A list of the main and detailed cancer groups used in this publication.

Breast cancer estimates for England are also given according to their hormone receptor status markers as set out in Table 3. The way in which a breast cancer is sensitive to different hormone receptor statuses influences the treatments offered to patients and their likely outcomes. The hormone statuses included in this publication are oestrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor 2 (HER2).

Table 3: combinations of hormone receptor statuses used with breast cancer in this publication.

More information can be found about hormone receptors ER and PR at https://breastcancernow.org/about-breast-cancer/diagnosis/hormone-receptors-and-breast-cancer/ and HER2 at https://breastcancernow.org/about-breast-cancer/diagnosis/her2/  

Prostate cancer estimates are also given according to their Gleason Grade Group (sometimes called a Cambridge Prognostic Group). Like hormone receptor statuses in breast cancer patients, they can influence the treatments offered to patients and indicate the likely outcomes.

Table 4: Gleason Grade Groups used in this publication for diagnoses of prostate cancer.

 More detail on Gleason Grade Groups can be found at https://www.cancerresearchuk.org/about-cancer/prostate-cancer/stages/grades