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Lung cancer incidence and mortality rates affected by changing smoking habits

Lung cancer incidence, mortality and survival, England, 1971–2011

What is lung cancer?

Lung cancer is the second most common cancer for both men and women in England, accounting for 14% of all newly diagnosed male cancers and 12% of all newly diagnosed female cancers in 2011 (Office for National Statistics, 2013). The disease is characterized by the uncontrolled growth of abnormal cells in the trachea, bronchus or lungs. There are two main types of lung cancer: non-small cell lung cancer, which accounts for 80% of cases, and small cell lung cancer, which is less common but develops more rapidly (NHS Choices, 2013).

Incidence and mortality rates increase for women but decrease for men

In 2011, there were around 19,200 newly diagnosed cases of lung cancer among males and 15,700 among females. The incidence rate among men has decreased from 108 new cases per 100,000 men in 1971 to 56 new cases per 100,000 men in 2011. This amounts to a 48% decrease over this time period. The reverse is true for women: Incidence rates have increased by 105% from 19 new cases per 100,000 women in 1971 to 39 new cases per 100,000 women in 2011.

In 2011, around 15,700 men and around 12,500 women died of lung cancer in England. For both sexes, lung cancer was the most common cause of cancer death in England and Wales in 2011. It was also the second most common cause of death overall for males, and the fifth most common cause of death for females (Office for National Statistics, 2011).

Lung cancer mortality rates have followed a similar pattern to incidence rates. In 1971, there were 99 deaths per 100,000 men and 17 deaths per 100,000 women, while in 2011 there were 45 deaths per 100,000 men and 30 deaths per 100,000 women.  This represents a 55% decrease in mortality rates for men, while the mortality rate for women has increased by 76%.

Figure 1: Lung cancer incidence and mortality rates, England, 1971–2011

Figure 1: Lung cancer incidence and mortality rates, England, 1971–2011
Source: Office for National Statistics

Notes:

  1. Lung Cancer is coded to 162 in the International Classification of Diseases Eighth Revision (ICD-8 ), 162 in the International Classification of Diseases ninth Revision (ICD-9 ) and to C33-34 in the Tenth Revision (ICD-10).
  2. Age-standardised rates allow comparisons between areas or over time where populations have different age structures. The method used here is direct standardisation using the 1976 European Standard Population.

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Smoking is strongly associated with an increased risk of developing lung cancer

The majority of lung cancer cases in the UK occur as a result of tobacco smoking, with around one in five cases being attributable to diet and occupational exposures, such as radiation (Parkin, Boyd and Walker, 2011). 

Research suggests that socio-economic deprivation is associated with an increased risk of developing lung cancer. In 2008, 14.3% of males and 13.2% of females in affluent areas developed lung cancer compared to 25.2% of males and 26.3% of females in the most deprived areas (National Cancer Intelligence Centre, 2013). The link between socio-economic deprivation and lung cancer may be due to the higher prevalence of smoking and heavier smoking in lower socio-economic groups. 

In 2011, smoking prevalence was highest in households where the household reference person (HRP) was in the routine occupation category (31%) and lowest in households where the HRP was in the large employers and higher managerial and the higher professional occupation categories (10%) (General Lifestyle Survey, 2013). Similarly, in 2011 smokers in households where the HRP was in a routine or manual occupation smoked an average of 14 cigarettes per day compared with 11 cigarettes per day for households where the HRP was in a managerial or professional occupation (General Lifestyle Survey, 2013).

The narrowing gap in lung cancer incidence rates between males and females may be due to increasingly similar smoking habits between the two sexes. Men have historically smoked more than women. After the Second World War, however, women started to smoke in great numbers, whereas the number of men smoking reduced considerably (Wald and Nicolaides-Bouman, 1991). The recent changes in lung cancer incidence rates in males and females likely reflect these changing smoking patterns (Cancer Research UK, 2012). 

In 2011, 21% of men smoked cigarettes compared with 19% of women, whereas in 1974, 51% of men smoked compared with 41% of women (General Lifestyle Survey, 2013). The difference in the proportion of adults smoking heavily (20 cigarettes per day or more) has also narrowed between the genders: 26% of men smoked heavily in 1974 compared to 13% of women, whereas in 2011 6% of men smoked heavily compared to 4% of women (General Lifestyle Survey, 2013).   

Survival estimates for lung cancer are among the lowest of 21 common cancers   

Five-year survival of lung cancer is the second lowest of 21 commonly diagnosed cancers (Office For National Statistics, 2013). Among adults (aged 15–99 years) diagnosed with lung cancer between 2007 and 2011 and followed up to 2012, the five-year survival estimate was 10% for men and 13% for women (Office For National Statistics, 2013). In 2012, 39% of lung cancer cases were diagnosed through emergency presentation at either Accident and Emergency or an emergency GP (National Cancer Intelligence Network, 2012). This is because lung cancer does not usually cause noticeable symptoms until it has spread through much of the lungs. Low levels of survival may, therefore, be explained by late diagnosis, when the disease is advanced and curative treatment not possible (Cancer Research UK, 2012).

 

References

Cancer Research UK, (2012). Lung cancer incidence statistics.

National Cancer Intelligence Network, (2013) Routes to Diagnosis, Jon Shelton, 2013

National Cancer Intelligence Network, (2008) Trends in lung cancer survival between males and females 1999- 2008  

NHS Choices, (2013) Lung Cancer, NHS, 2013

Office for National Statistics, (2013) Cancer Registration Statistics, England, 2011.

Office for National Statistics, (2013). Cancer Survival in England: Patients Diagnosed 2007-2011 and Followed up to 2012.

Office for National Statistics, (2011) Deaths registered in England and Wales, Office for National Statistics, 2011 

Office for National Statistics (2013) General Lifestyle Survey, 2013.

Parkin DM, Boyd L, Walker LC, (2011). The Fraction of Cancer attributable to lifestyle and environmental factors in the UK

Wald, N. and Nicolaides-Bouman, A. (1991) UK Smoking Statistics. 2nd edition, Oxford University Press.

 

These statistics were compiled and analysed by the Cancer and End of Life Care Analysis team in the Life Events and Population Sources Division. If you’d like to find out more about our cancer statistics you can read our Annual Reference Volume and see further stories, for example on breast cancer. If you have any comments or suggestions, we’d like to hear them! Please email us at: cancer.newport@ons.gsi.gov.uk. 

Categories: Health and Social Care, Health of the Population, Conditions and Diseases, Cancer, Cancer Registrations
Content from the Office for National Statistics.
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