- For all childhood cancers combined, the general trend of increasing 5-year survival has continued for all children (aged 0 to 14 years) diagnosed in the 19 years from 1990 to 2008
- The improvements in 5-year survival for children reflect improvements for children diagnosed in each of the age groups (0 to 4 years, 5 to 9 years and 10 to 14 years)
- Interpretation should be focused on overall trends up to 2008, rather than the survival estimates for any particular year. This is because the number of children diagnosed each year is relatively small and the survival estimates for single calendar years are therefore less stable
This bulletin includes data on survival for all children (0 to 14 years) diagnosed with cancer (Background note 1) in England during the 19-year period from 1990 to 2008 and followed up to 31 December 2013. It presents estimates of 5-year overall survival (Background note 2) for all cancers combined. Survival estimates are reported by age group and for all ages combined, both unstandardised and age-standardised (Background note 3).
This is our second bulletin on childhood cancer survival in England. These statistics were prompted by the introduction of an indicator on 5-year cancer survival for patients under 15 years in the NHS Outcomes Framework 2013 to 2014. The NHS Outcomes Framework was established to monitor overall changes in performance of the NHS and the quality of health outcomes.
The data for our first bulletin (ONS 2013) were provided by the Childhood Cancer Research Group, University of Oxford, using data from the National Registry of Childhood Tumours (NRCT). The Childhood Cancer Research Group was disbanded in 2014, and the NRCT dataset was frozen, with 2010 the most recent complete year of incidence registrations. To allow the continued production of 5-year survival for the NHS Outcomes Framework indicator data were used from the National Cancer Registration Service to produce the estimates in this publication (Background note 6).Back to table of contents
The cancer registration data in this publication have been collected by the National Cancer Registration Service in Public Health England. This publication is produced in partnership with the Cancer Research UK Cancer Survival Group, at the London School of Hygiene and Tropical Medicine.
Back to table of contents
The trend in 5-year cancer survival for children has shown steady improvement throughout the period 1990 to 2008. For the first 5 years (1990 to 1994), 5-year age-standardised survival was consistently below 75% (Figures 1 and 2). For the last 5 years (2004 to 2008), 5-year survival was consistently above 78%. The increases in 5-year survival for children reflect improvements in each of the age groups (0 to 4 years, 5 to 9 years and 10 to 14 years). Increases in survival could be due to improvements in treatment and supportive care.
The increases in survival for many of the principal types of childhood cancer occurred in parallel with clinical trials in the same period of time (Stiller et al, 2012). More than half of all childhood cancers diagnosed between 1990 and 2008 were either leukaemias (32%) or malignant neoplasms of the brain and central nervous system (24%; ONS, 2012).
There are year-on-year fluctuations in cancer survival; however the overall trend of improvement is still evident (Figure 2). The fluctuations in cancer survival are due to the small numbers of cancer diagnoses and deaths each year among children in England. Therefore the focus should be on the overall trend rather than on the survival estimates for any individual year. For example, care should be taken when interpreting the large increase observed in cancer survival in all age groups in the year 2008. This may be due to fluctuation in the time series rather than a genuine acceleration in improving cancer survival. We cannot be certain that there has been a genuine change in this trend until 5 years of follow-up data are available for children diagnosed in more recent years.Back to table of contents
The main users of cancer survival estimates include the Department of Health, academics and researchers, cancer charities, cancer registries, other government organisations and our own researchers, the media and the general public. The Department of Health uses cancer survival figures to brief government ministers, and as part of the evidence base to inform cancer policy and programmes, for example in drives to improve survival.
Our cancer survival estimates are also included as indicators in the NHS Outcomes Framework and the Clinical Commissioning Group Indicator Set, which are used to hold the NHS and commissioners to account. Academics and researchers use the figures to inform their research. Similarly Public Health England and other government organisations use the figures to carry out individual and collaborative projects.
Charities use the data to provide reliable and accessible information about cancer to a wide range of groups, including patients and health professionals via health awareness campaigns and cancer information leaflets and web pages. Our own researchers use the data to support further research and to publish alongside other National Statistics.Back to table of contents
In Improving Outcomes: A Strategy for Cancer (January 2011), the Department of Health stated 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 cancers are some of the lowest among member states of the Organisation for Economic Co-operation and Development (OECD). The strategy document 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 the financial year ending 2015.
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 NHS Outcomes Framework focuses on measuring health outcomes includes 1- and 5-year cancer survival indicators for all cancers combined, and for colorectal, breast and lung cancers combined.Back to table of contents
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 National Cancer Registration Service in Public Health England, which provides the raw data for analyses.Back to table of contents
Contact details for this Statistical bulletin
Telephone: +44 (0)1633 455704