This bulletin presents one-year and five-year relative survival (per cent)  for adults (aged 15 – 99 years)  diagnosed with 1 of the 21 most common cancers in England during 2005–2009 and followed up to 2010. These cancers comprise over 90 per cent of all newly diagnosed cancers. Data are presented by sex, by age group and for all ages combined, both un-standardised and age-standardised.
 See Background Note 1
 See Background Note 2
 See Background Note 3
 See Background Note 4
For a graph of all 21 common cancers, please see Figure 1 in the associated Excel download.
Figure 1a shows age-standardised five-year relative survival estimates for men and women diagnosed with one of ten common cancers during 2005–2009. In Table 1, (see Excel download) the 21 most common cancers are presented with 95 per cent confidence intervals and compared with survival estimates for patients diagnosed during 2004–2008 (Office for National Statistics 2010) .
The general trend of increasing five-year relative survival (Rachet et al. 2009) continued for patients diagnosed during 2005–2009, with survival improving for nearly all of the 21 most common cancers compared to patients diagnosed during 2004–2008 (Table 1). The largest increases in five-year survival were for men diagnosed with leukaemia (rising 2.3 per cent to 44.0 per cent), non-Hodgkin lymphoma (rising 2.1 per cent to 61.5 per cent) and colon cancer (rising 2.0 per cent to 54.4 per cent). Generally increasing trends were also seen for one-year survival (data not presented).
Five-year relative survival is over 80 per cent for cancers of the breast (women), prostate and testis, and for Hodgkin lymphoma and melanoma of skin (Figure 1). Prognosis for cancers of the brain, lung, oesophagus, pancreas and stomach remains very poor, with five-year relative survival of 3.6 to 17.6 per cent. The other cancers have intermediate levels of survival, ranging from 37.1 to 66.8 per cent.
One-year and five-year relative survival estimates for the 21 most common cancers are presented by age group and sex (men, women, persons) in Table 2, with 95 per cent confidence intervals.
There are distinct patterns in relative survival by age, with generally higher survival among younger patients and lower survival among the elderly, even after taking into account the higher background mortality in older patients. The well-known exceptions to this pattern (Rachet et al. 2008) are for breast and prostate cancer: women aged 15–39 years with breast cancer had lower five-year relative survival (84 per cent) than women aged 40–69 years (89 to 90 per cent), and men aged 15–49 years with prostate cancer had lower survival (86 per cent) than men aged 50–69 years (91 to 92 per cent).
 See Background Note 5
 See Background Note 6
Further information about cancer survival estimates published by the Office for National Statistics (ONS) can be found in the Summary Quality Report for cancer survival.
Summary quality reports are overview notes which pull together key qualitative information on the various dimensions of the quality of statistics as well as providing a summary of the methods used to compile the output. Information about key users of these statistics is also provided.
In ‘Improving Outcomes: A Strategy for Cancer’ (January 2011), the Department of Health states that although improvements have been made in the quality of cancer services in England, a significant gap remains in survival compared with the European average. Survival estimates for cervical, colorectal and breast cancer are some of the lowest among member states of the Organisation for Economic Co-operation and Development (OECD). The Outcomes Strategy sets out how the Department of Health aims to improve outcomes for all cancer patients and improve cancer survival, with the aim of saving an additional 5,000 lives every year by 2014/15. Further details about ‘Improving Outcomes: A Strategy for Cancer’.
Outcomes strategies set out how the NHS, public health and social care services will contribute to the ambitions for progress agreed with the Secretary of State in each of the high-level outcomes frameworks. The indicator set for the National Health Service (NHS) Outcomes Framework includes one- and five-year relative survival from colorectal, breast and lung cancers. Further details about the NHS Outcomes Framework 2011/12.
Coleman MP, Babb P, Damiecki P, Grosclaude P, Honjo S, Jones J, Knerer G, Pitard A, Quinn MJ, Sloggett A, De Stavola BL (1999) 'Cancer survival trends in England and Wales, 1971–1995: deprivation and NHS Region', Studies in Medical and Population Subjects no. 61. London: The Stationery Office
Rachet B, Woods LM, Mitry E, Riga M, Cooper C, Quinn MJ, Steward JA, Brenner H, Estève J, Sullivan R, Coleman MP (2008) 'Cancer survival in England and Wales at the end of the 20th century', Br J Cancer; 99(Suppl. 1):S2-S10.
Rachet B, Maringe C, Nur U, Quaresma M, Shah A, Woods LM, Ellis L, Walters S, Forman D, Steward JA, Coleman MP (2009) 'Population-based cancer survival trends in England and Wales up to 2007: an assessment of the NHS cancer plan for England', The Lancet Oncology; 10:351–369.
Jonathan Moorea, Bernard Racheta, Liam Crosbya, Emma Gordonb, Natalie Jakomisb, Michel P Colemana
a Cancer Research UK Cancer Survival Group, London School of Hygiene and Tropical Medicine
b Cancer Analysis Team, Office for National Statistics
The National Cancer Registry at the Office for National Statistics and the London School of Hygiene and Tropical Medicine wish to acknowledge the work of the regional cancer registries in England, which provide the raw data for these analyses.
1. Relative survival is an estimate of the probability of survival from the cancer alone. For convenience, it is expressed as a percentage in the range 0–100 per cent. It can be interpreted as the survival of cancer patients after taking into account the background mortality that the patients would have experienced had they not had cancer. Background mortality is derived from life tables of all-cause mortality rates in the general population. Relative survival varies with age, and the age profile of cancer patients can vary with time and between geographical areas, so the estimates are age-standardised to facilitate comparison (see Background Note 4). Estimates are shown with their 95 per cent confidence intervals (see Background Note 5).
2. All adults (aged 15–99 years) in England who were diagnosed during 2005–2009 with one of the 21 most common cancers as an invasive, primary, malignant neoplasm were eligible for analysis. Ineligible patients were those whose tumour was benign (not malignant) or in situ (malignant but not invasive) or of uncertain behaviour (uncertain whether benign or malignant), or for which the organ of origin was unknown. For further details of exclusion criteria, see reference (Coleman et al. 1999)
3. Cancers were defined by codes in the International Classification of Diseases, Tenth Revision (ICD-10) and International Classification of Diseases for Oncology, Second Edition (ICD-O-2). See Table 3.
4. Age-standardisation requires a survival estimate for each age group. Age-specific estimates may not be obtained if there are too few events (deaths) in a given age group; this can happen because survival is very high (there are very few deaths) or because it is very low (most of the patients die early in the five-year period of follow-up). When age-standardisation was not possible, un-standardised estimates are reported instead, italicised and underlined.
5. A 95 per cent confidence interval is a measure of the uncertainty around an estimate. It provides a range of values which contains the true population parameter with a 95 per cent level of confidence.
6. Differences between survival estimates for the two periods are taken as the arithmetic difference, for example 12 per cent is shown as 2 per cent (not 20 per cent) higher than 10 per cent. Survival figures are rounded to one decimal place, but the differences are based on exact underlying figures.
7. When the data for this report were extracted for analysis on 11 July 2011, the cancer registrations for 2009 were believed to be 97 per cent complete, and the patient’s vital status at 31 December 2010 was known for 99 per cent of cancers registered for the period 2005-2009. As in other countries, the cancer registration database is dynamic, and a small number of late registrations may arrive up to five years after the end of a given calendar year. The figure of 97 per cent is based on the average number of cases for the three previous years (2006–2008), including late registrations received after publication of the data for those years.
8. Details of the policy governing the release of new data are available from the Media Relations Office.
9. National Statistics are produced to high professional standards set out in the Code of Practice for Official Statistics. They undergo regular quality assurance reviews to ensure that they meet customer needs. They are produced free from any political interference.
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