1. Main findings
- One-year and five-year net survival increased for eight common cancers in England for adults (15-99 years) diagnosed during the period 2005-2007
- For men, the largest increase was 1.3 per cent per year in one-year survival for cancer of the oesophagus, and 1.3 per cent per year in five-year survival for cancer of the colon
- For women, the largest increase was 1.2 per cent per year in one-year survival for cancer of the oesophagus, and 1.7 per cent per year in five-year survival for cancer of the cervix
- The geographic disparities in net survival between NHS Regions, Clinical Senates and Area Teams in England are wide
2. Summary
This bulletin presents age-standardised one- and five-year net survival estimates for men and women diagnosed with one of eight cancers in England during 2005–2007 and followed up to 2012. It includes data on cancers of the oesophagus, stomach, colon, lung, breast (women), cervix, prostate and bladder (Background notes 1, 2 and 3). Annual trends in unstandardised net survival during 2003–2007 are also presented (Background note 4). Results are presented for England as a whole and for three geographic levels of organisation of the NHS in England – NHS Region, Clinical Senate and Area Team (Background Note 5).
Figure 1: One-year net survival (per cent) for adults diagnosed in England during 2005–2007
Source: Office for National Statistics and London School of Hygiene and Tropical Medicine
Notes:
- Survival estimates were age-standardised using a standard population of cancer patients (see Background Note 4 of statistical bulletin).
- Adults aged 15–99 years.
Download this chart Figure 1: One-year net survival (per cent) for adults diagnosed in England during 2005–2007
Image .csv .xls
Figure 2: Five-year net survival (per cent) for adults diagnosed in England during 2005–2007
Source: Office for National Statistics, London School of Hygiene and Tropical Medicine
Notes:
- Adults aged 15-99 years.
- Survival estimates were age-standardised using a standard population of cancer patients (see Background Note 4).
Download this chart Figure 2: Five-year net survival (per cent) for adults diagnosed in England during 2005–2007
Image .csv .xls3. Results
One- and five-year net survival estimates are presented for patients diagnosed with cancer of the oesophagus, stomach, colon, lung, breast (women), cervix, prostate (Background note 7) or bladder in England during 2005–2007 and followed up to 2012 (Background notes 1 and 2). These cancers represent a large proportion of all cancers and correspond to a range of diagnosis and treatment pathways and trends in survival. The survival estimates are age-standardised to correct for changes in the age profile of cancer patients over time (Background note 3). We also present the unstandardised survival estimates for each year of the period 2003-2007, together with the annual percentage change (Background note 4).
For cancers of the colon, breast, cervix, prostate and bladder, survival in England is reasonably good: one-year survival above 67 per cent and five-year survival above 48 per cent (Figures 1 and 2). For cancers of the oesophagus, stomach and lung, however, survival in England remains very low, with one-year survival below 41 per cent and five-year survival below 19 per cent.
At the national level, a general upward trend in net survival was observed for most of the eight cancers. Sub-national variation in bladder cancer survival remained: this reflects progressive completion of changes in coding and classification by the regional cancer registries in England during this period (Background note 6).
Among men, the largest annual improvements in one-year net survival occurred for cancers of the oesophagus (1.3 per cent per year) and stomach (1.2 per cent per year). The largest improvement for five-year net survival for men was for cancer of the colon, with an increase of 1.3 per cent per year. Among women, the largest improvement in one-year net survival was for cancer of the oesophagus (1.2 per cent per year) and for five-year survival, cancer of the cervix (1.7 per cent per year).
Wide and persistent differences in net survival between the 25 Area Teams in England were seen for all cancers diagnosed during 2005-2007 (Tables 1 and 2). For women with cancers of the stomach, oesophagus and bladder, the range between the highest and lowest estimates was more than 14 per cent for one-year net survival, and 12-14 per cent for five-year survival. For men, the range between the highest and lowest estimates was 13 per cent for one-year net survival (stomach cancer) and 17 per cent for five-year net survival (prostate cancer).
The smallest differences in five-year net survival between the 25 Area Teams were seen for women with breast cancer (4.4 per cent) and for men and women with lung cancer (4.2 and 5.4 per cent, respectively).
Survival estimates for lung cancer remain low. The national estimate for one-year net survival for lung cancer was 28.0 per cent in men and 30.9 per cent in women. One-year net survival for lung cancer was much lower than the corresponding value for England in the Lancashire Area Team and in the Hertfordshire and the South Midlands Area Team: 4.6 per cent below the national level for men, and almost 7 per cent below the national level for women.
Table 1: Range in one-year net survival (%) across the area teams in England: adults diagnosed during 2005–2007 and followed up to 2012, eight common cancers, by sex
| Age-standardised net survival (%) | |||||||||
| Cancer | Men | Women | Persons | ||||||
| Mean | Min | Max | Mean | Min | Max | Mean | Min | Max | |
| Oesophagus | 38.5 | 32.8 | 44.0 | 36.6 | 28.4 | 42.8 | 37.6 | 33.1 | 43.3 |
| Stomach | 40.1 | 33.1 | 46.0 | 39.3 | 32.4 | 46.5 | 39.8 | 33.6 | 46.0 |
| Colon | 70.8 | 63.8 | 75.7 | 69.6 | 63.9 | 74.3 | 70.2 | 64.4 | 73.7 |
| Lung | 27.9 | 23.4 | 31.3 | 30.7 | 24.2 | 34.1 | 29.1 | 23.7 | 31.3 |
| Breast | -- | -- | -- | 95.0 | 93.0 | 96.0 | -- | -- | -- |
| Cervix | -- | -- | -- | 81.3 | 77.6 | 86.4 | -- | -- | -- |
| Prostate | 92.0 | 86.6 | 96.0 | -- | -- | -- | -- | -- | -- |
| Bladder | 77.1 | 72.1 | 81.2 | 66.8 | 58.9 | 73.3 | 74.4 | 69.2 | 78.2 |
| Source: Office for National Statistics and London School of Hygiene and Tropical Medicine | |||||||||
| Notes: | |||||||||
| 1. Adults aged 15-99 years. | |||||||||
| 2. Survival estimates were age-standardised using a standard population of cancer patients (see Background Note 4 of statistical bulletin). | |||||||||
| 3. The symbol “--” means not available. | |||||||||
Download this table Table 1: Range in one-year net survival (%) across the area teams in England: adults diagnosed during 2005–2007 and followed up to 2012, eight common cancers, by sex
.xls (28.2 kB)
Table 2: Range in five-year net survival (%) across the Area Teams in England: adults diagnosed during 2005–2007 and followed up to 2012, eight common cancers, by sex
| Age-standardised net survival (%) | |||||||||
| Cancer | Men | Women | Persons | ||||||
| Mean | Min | Max | Mean | Min | Max | Mean | Min | Max | |
| Oesophagus | 11.7 | 7.6 | 14.9 | 12.4 | 5.8 | 17.9 | 11.9 | 8.4 | 14.8 |
| Stomach | 16.0 | 10.8 | 21.7 | 17.2 | 10.7 | 24.4 | 16.5 | 12.1 | 22.4 |
| Colon | 51.8 | 47.9 | 57.2 | 51.9 | 46.2 | 59.1 | 52 | 48.5 | 57.3 |
| Lung | 7.6 | 5.6 | 9.8 | 9.1 | 6.2 | 11.6 | 8.2 | 5.8 | 10.5 |
| Breast | -- | -- | -- | 83.3 | 80.9 | 85.2 | -- | -- | -- |
| Cervix | -- | -- | -- | 63.2 | 57.6 | 68.3 | -- | -- | -- |
| Prostate | 78.3 | 68.3 | 85.4 | -- | -- | -- | -- | -- | -- |
| Bladder | 55.8 | 52.3 | 62.4 | 48.2 | 41.9 | 53.5 | 53.9 | 50.3 | 59.0 |
| Source: Office for National Statistics and London School of Hygiene and Tropical Medicine | |||||||||
| Notes: | |||||||||
| 1. Adults aged 15-99 years. | |||||||||
| 2. Survival estimates were age-standardised using a standard population of cancer patients (see Background Note 4 of statistical bulletin). | |||||||||
| 3. The symbol “--” means not available. | |||||||||
Download this table Table 2: Range in five-year net survival (%) across the Area Teams in England: adults diagnosed during 2005–2007 and followed up to 2012, eight common cancers, by sex
.xls (35.3 kB)4. Policy context
The Department of Health's cancer strategy for 2011, “Improving Outcomes: A Strategy for Cancer”, points out that while improvements in the quality of cancer services in England have been made, a significant gap remains in survival compared with the European average. Survival probabilities for cervical, colorectal and breast cancer in the UK as a whole are some of the lowest among the 34 member states of the Organisation for Economic Co-operation and Development (OECD). Survival for colon, lung and breast cancers in England, Northern Ireland and Wales during 1995-2007 was reported as lower than in Australia, Canada, Norway and Sweden in a recent study (Coleman et al., 2011).
As part of The National Cancer Strategy, in the document "Improving Outcomes: A Strategy for Cancer", the Department of Health sets out how it aims to improve survival for all cancer patients, with the aim of "saving an additional 5,000 lives every year" by 2014/15.
'Outcomes strategies' set out how the National Health Service (NHS) and the public health and social care services intend to contribute to the ambitions for progress in cancer control agreed with the Secretary of State in each of the high-level outcomes frameworks. The set of indicators included in the NHS Outcomes Framework 2012 to 2013 includes one- and five-year relative survival from colorectal, breast and lung cancers.
Back to table of contents6. Acknowledgements
The National Cancer Registry at the Office for National Statistics and the Cancer Survival Group at the London School of Hygiene and Tropical Medicine wish to acknowledge the sustained efforts in data collection and quality control over many years in the regional cancer registries in England, which provided the raw data for these analyses.
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