Case-mix adjusted percentage of cancers diagnosed at stages 1 and 2 in England, 2020

In England, there were 218,038 cancers diagnosed with a valid stage in 2020, which was 81% of all stageable cancers. This lower number of cancers with a valid stage reflects the reported fall in the total number of cancers registered for 2020. Of all cancers diagnosed in 20202 with a valid stage, 52% were diagnosed at stages 1 and 2, this is lower than in 2019 (54%). The range over the period 2013 to 2019 was 54% to 55%.

Comparisons between geographies using unadjusted values of the indicator may be misleading because of differences between the underlying population characteristics and distribution of risk factors. Populations within sub-ICBs consist of a differing mix of people in terms of their characteristics such as age, gender and deprivation.

Case-mix adjustment is a process which accounts for differences in these population characteristics when calculating outcomes (e.g. percentage of cancers diagnosed at early stage). This allows for fairer comparisons of outcomes between sub-ICBs that have populations with different characteristics negatively or positively associated with the performance indicator.

Up to diagnoses made in 2019, a total of 21 cancer sites/groups could be included in the ‘case-mix adjusted percentage of cancers diagnosed at stages 1 and 2’ indicator. For 2020, this number reduces to 18 cancer sites/groups because there were lower levels of staging in cervix, stomach and thyroid cancers that means these cancer sites/groups currently fail the inclusion criteria.

There are 18 cancer sites/groups included in the ‘case-mix adjusted percentage of cancers diagnosed at stages 1 and 2’ indicator, with 195,504 cancers diagnosed with a valid stage in 2020 in England. This is a reduction from 213,680 cancers in 2019 and 234,269 cancers in 2018 after adjusting for removing cervix, stomach and thyroid cancer sites/groups previously included.

The overall case-mix adjusted percentage of cancers diagnosed at stages 1 and 2 dropped to 54% for the most recent 3-year period (2018 to 2020) whereas it remained stable at 55% for all 3-year periods since 2013 to 2015.

During 2018 to 2020, the range of case-mix adjusted percentage of cancers diagnosed at stages 1 and 2 across the 106 sub-ICBs was 50% to 58% which is smaller than the unadjusted range (48% to 59%). This shows that some of the variation in the percentage of cancers diagnosed at stages 1 and 2 between sub-ICBs is associated with the population characteristics.

When assessing trends in sub-ICBs over individual years, the focus should be on overall trends rather than year-on-year variation. This is because the number of cases diagnosed each year in each sub-ICB is relatively small and the estimates are therefore less stable. There are no obvious geographical patterns to the sub-ICB variation.