Cancer prevalence

The England Cancer Prevalence Statistics provide counts and crude rates of people living with and beyond a cancer diagnosis on 31 December 2021, who were diagnosed since 01 January 1995. Data are presented for the following geographies in England: Cancer Alliance (CA), Integrated Care Board (ICB) and Local Authority (LTLA). Cancer prevalence statistics are provided for all cancers combined as well as 24 cancer sites

Acknowledgement

This work uses data that has been provided by patients and collected by the NHS as part of their care and support. The data are collated, maintained and quality assured by the National Disease Registration Service, which is part of NHS England.

This release was conducted in partnership between the National Disease Registration Service and Health Data Insight CiC.

Understanding the size of the population living with and beyond a cancer diagnosis at a point in time can support planning for the delivery of local health and social care services, quantify the ‘burden’ of disease in an area or population and could determine the number of people who may have unmet health needs that could potentially benefit from new treatment interventions.

Cancer prevalence counts the number of individuals diagnosed with a cancer who were believed to still be alive on a given index date. The index date of this release is 31 December 2021. 

These data report observed, limited-duration cancer prevalence for the maximum length that it is possible to reliably count individuals over time in the National Cancer Registration Dataset (1995-2021), as well as 20-year (2002-2021), 10-year (2012-2021) and 5-year (2017-2021) duration cancer prevalence.
 

Only those with a cancer diagnosed in the intervals specified are counted. Where an individual has multiple cancer diagnoses in the interval, only the earliest diagnosis is counted and the characteristics associated with this diagnosis are used.

These data differentiate between All cancers and cancer site prevalence as explained below: 

1. 'All cancers' prevalence counts and rates for all cancers combined include patients satisfying the inclusion criteria and diagnosed with a malignant cancer C00-C97 excluding C44 only.
2. When calculating cancer prevalence for all cancers combined, in the case of multiple cancer diagnoses, only the first cancer (C00-C97 excl. C44) diagnosed in the observation period is counted. Each patient is only counted once in the observation period.
3. Cancer site prevalence includes a broader range of cancer types. Where applicable, cancer site groupings have been chosen to align with the NCRAS Get Data Out programme, and therefore include some specific non-malignant tumours as outlined in the table below. Only the site codes in the cancer site table are included in the cancer site prevalence breakdowns.
4. When calculating cancer prevalence by site, patients with two or more diagnoses of different cancer types will be counted once for each cancer site group. If multiple tumours are recorded for an individual, only the first diagnosis will be counted.

For these reasons, cancer site prevalence will not sum to the 'All cancers combined' prevalence counts.

Inclusion

Patients were included in the cohort if they met the following criteria:

1. Diagnosed with cancer in the observation period.
2. Resident in England at time of diagnosis
3. Alive at the index date.
4. Finalised cancer registration.
5. Diagnosis age between 0 and 99 years.
6. Age at index date less than 105 years.
7. No known date of embarkation
8. For 'All cancers combined' prevalence, any tumour in the range C00-97, excluding C44 was included.
9. For cancer site prevalence, tumours falling into any of the tumour groups as defined in the cancer site table below were included.
10. Recorded male gender with cancer of cervix uteri, ovary or uterus and female gender with cancer of prostate or testis were not included.

Time Series

Changes in maximum duration prevalence over time should be interpreted differently to 5-, 10-, and 20-year prevalence. For 5-, 10-, and 20-year prevalence, the calendar period of the observation window changes accordingly with each index date. The observation window for maximum prevalence duration always starts at 1995.

Maximum duration prevalence, therefore, will almost certainly increase over time, 5-, 10- and 20-year prevalence could remain stable or even decrease. 20-year prevalence is not available prior to 2014, due to insufficient follow-up prior to this index year.

Rates

Prevalence proportions are calculated overall and for age and gender, using the LSOA 2021 mid-year population estimates. 

For other demographics (ethnicity, deprivation and time since diagnosis) the data is presented as counts and not as a proportion or rate in the underlying population. This is because the appropriate denominator population is not available for these demographic breakdowns.

Data suppression

Certain data have been suppressed or grouped further to ensure data are suitably anonymised.  Age above 85 years has been combined into one category for males and females at ICB level. Ethnicity data are not presented for ICBs where small geographic slivers occur, as well as one other ICB in the same Cancer Alliance. Demographic breakdowns are not provided at Local Authority level or for any cancer site reporting fewer than 30 total cases.

Cancer site

Due to the implementation of ICDO3 classification from 2013 some tumour site definitions are different for tumours diagnosed from 1995-2012 and 2013-2021 to reflect the use of the new coding system. For the affected groups, ICD10/O2 is used from 1995-2012 and then ICDO3 from 2013-2021. 

Geography

Geographical breakdowns are based on area of residence at time of the earliest relevant diagnosis in the observation period. There is the possibility that people have moved since their diagnosis and this should be noted when analysing these results, particularly if comparing across prevalence durations. 

Index of Multiple Deprivation

Deprivation is based on index of multiple deprivation (IMD), which ranks LSOAs in all of England by income deprivation and groups them into quintiles. Deprivation is assigned based on the LSOA of residence at the date of diagnosis. As these scores have changed over time, the score closest to the date of diagnosis is used.

• Diagnosis date 1995 - 2002 uses the 2004 IMD quintile
• Diagnosis date 2003 - 2006 uses the 2007 IMD quintile
• Diagnosis date 2007 - 2009 uses the 2010 IMD quintile
• Diagnosis date 2010 - 2013 uses the 2015 IMD quintile
• Diagnosis date 2014 - 2021 uses the 2019 IMD quintile

There may be a small discrepancy in IMD totals compared to overall population totals. This is due to a small number of records missing data for LSOA at diagnosis.

Stage at diagnosis

For stage at diagnosis  'Unknown' indicates unstaged cancers, combining tumours where stage is not recorded and those that are unstageable.

Data are reported for patients diagnosed between 2017 and 2021 (5-year prevalence duration) only. This is due to lower data completeness for stage prior to 2013.

Ethnicity

Ethnicity is grouped into 6 broad categories. Data are reported for patients diagnosed between 2012 and 2021 (5- and 10-year prevalence durations) only. This is due to lower data completeness for stage prior to 2010.

England Cancer Prevalence Statistics are updated annually.

The tool is produced by the National Disease Registration Service (NDRS). Please send any feedback or queries to [email protected] 

Please do not include sensitive or patient identifiable information.