Cancer

Summary

There are over 200 different types of cancer, each with its own risk factors, methods of diagnosis and treatment. Some of the known causes of cancer are excessive , excessive alcohol consumption, exposure to asbestos, unhealthy dietphysical inactivity, being overweight or obese, being exposed to natural and man-made radiation, smoking and tobacco use, ultraviolet light (including sun exposure and use of sun beds), and viruses such as human papilloma virus (HPV).

Key findings - prevalence

Prevalence refers to the number of cases of a disease that are present in a particular population at a given time. In the case of cancer, the population used is the total GP registered population and the number of cases comes from the Quality and Outcomes Framework (QOF) disease registers. The latest figures (2016/17) indicate that there are 49,832 known cases of cancer across the Lancashire and South Cumbria Sustainability and Transformation Plan (STP) accounting for 2.9% of the total registered population of the eight CCGs, with six CCGs recording a prevalence significantly above the England average (2.6%). These being Blackpool (2.9%), Chorley & South Ribble (3.0%), East Lancashire (2.7%), Fylde & Wyre (3.8%), Morecambe Bay (3.1%) and West Lancashire (3.0%).

Incidence

Incidence refers to the total number of new confirmed (diagnosed) cases of a disease, in a population at a given period of time. For cancer, this tends to be the estimated resident populations and all new diagnosis of malignant cancer (ICD10 C00-C97) excluding skin cancers other than malignant melanoma.

Between 2013 and 2015 there were 21,566 newly diagnosed cases of cancer across the Lancashire-12, giving the area a directly standardised rate (DSR) per 100,000 of 621.57 in line with the England national average of 615.15. Blackburn with Darwen (625.98) recorded a rate in line England, whilst Blackpool (687.14) recorded a rate significantly above it.

Four cancer sites accounted for over half (52%) of all newly diagnosed cases across the Lancashire-12 during the 2013-15 period. These being; lung (2,993 cases, 14% of the total), breast excluding male cases (3,101, 14%), prostate (2,697, 13%) and colorectal (2,492, 12%).

Benchmarking these four areas against the national rate for England revealed the following :

  • Lancashire-12 has significantly higher all-person, female and male lung cancer incidence rates.
  • Lancashire-12 breast (female) cancer rate is in line with England's.
  • Lancashire-12 has a significantly lower rate of prostate cancer incidence
  • Lancashire-12 has all-person, female and male colorectal cancer rates in line with England.

Cancer survival

The latest CCG level one-year cancer survival figures refer to adults (aged 15-99) diagnosed 2000 to 2015 and followed up to 2016. They show that in 2015, the Lancashire and South Cumbria STP (71.7%) had a significantly lower one year cancer survival rate than the national average (72.3%).

Survival rates vary between the different CCGs ranging from 69.4% for Blackburn with Darwen to 73.2% for West Lancashire. Benchmarking the CCG rates against the England national average shows that three CCGs have rates significantly below the national average. These being; Blackburn with Darwen (69.4%), Blackpool (69.8%) and East Lancashire (70.3%). Whilst Morecambe Bay has a survival rate which is significantly above the national rate (73.0%).

Trend line analysis found that all eight CCGs continue to see long term improvements and that the STP as a whole has a survival rate which is 8.2 percentage points above where it was 10 years ago in 2006.

All-age mortality

During the three year period 2013-15, a total of 9,793 persons from Lancashire-12 died from malignant cancer (ICD10 C00-C97), giving the area an all-age directly standardised rate (DSR) of 286.95 per 100,000 in line with the England national rate of 280.83. Whilst Blackburn with Darwen (309.47) and Blackpool (347.75) both recorded rates significantly above the national average.


Over half (54%) of all cancer deaths (2013-15) recorded across Lancashire-12, can be attributed to just two tumour classes; cancers of the digestive organs (C15-C26) which accounted for 29% of all deaths and include colorectal and anus cancer (993 deaths), cancer of the oesophagus (531 deaths) and stomach cancer (261 deaths). And cancers of the respiratory and intrathoracic organs (C30-C39) which accounted for 25% of all cancer deaths and is primarily made up of deaths from lung cancer (C33-34). Which individually, accounted for the majority of all cancer deaths over the three period (24%, 2,384).
Benchmarking the all-age DSR of some of the more common cancers against the England national rates, revealed that the Lancashire-12 has significantly higher rates for the following;

Benchmarking the all-age DSR of some of the more common cancers against the England national rates, revealed that the Lancashire-12 has significantly higher rates for the following;

  • All-person (69.25) and male (79.87) lung cancer, England (60.36, 72.44)
  • All-person (15.63) and male (22.84) oesophagus cancer, England (13.54, 19.74)

There is a radial histogram visual on slide 2 of our Neighbourhood Intelligence Mortality Dashboard that shows the Standardised Mortality Ratio (SMR) for all cancers for wards in Lancashire.

Premature mortality

Reducing premature mortality, referred to as mortality in persons aged 74 or under, is a major priority of both Public Health England and the NHS, with many deaths caused by diseases and illnesses that are considered avoidable[1]. During the period 2013-15, there were 4,645 premature deaths across Lancashire-12 giving the area a directly standardised rate of 143.4 per 100,000, significantly above the England average of 138.8. 

Blackburn with Darwen (169.5) and Blackpool (190.8), also recorded rates that were significantly above the national average.

Further analysis

Page updated January 2018