Cancer

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 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 data are from the Quality and Outcomes Framework (QOF) disease registers.

  • The latest figures (2018/19) indicate that there are just over 49,000 known cases of cancer across the six clinical commissioning groups (CCGs) in the Lancashire-12 area.*
  • Looking at each CCG shows NHS Fylde & Wyre CCG (4.4%) has the highest proportion of cancer, followed by NHS Chorley and South Ribble CCG (3.6%), NHS West Lancashire CCG (3.6%), NHS Morecambe Bay CCG (3.5%),NHS East Lancashire CCG (2.9%) and NHS Greater Preston CCG (2.6%). The prevalence for England is 3.0%.*
  • Across the Lancashire & South Cumbria Integrated Care System (ICS), which includes NHS Blackburn with Darwen CCG and NHS Blackpool CCG, the prevalence is 3.3%.*

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, the data are all new diagnoses of malignant cancer (ICD10 C00-C97), excluding skin cancers other than malignant melanoma, from the National Cancer Registration Service. The rates below are a crude rate per 100,000 of the population (all ages) (2017/18). 

  • There were 9,806 new cases of cancer in the Lancashire & South Cumbria ICS area.
  • For the six CCGs in the Lancashire-12 area, NHS Fylde & Wyre CCG (674), NHS Morecambe Bay CCG (607), and NHS West Lancashire CCG (587) have a significantly higher rate compared to England (507).NHS Chorley and South Ribble CCG (549), NHS East Lancashire CCG (526) and NHS Greater Preston (462) and  are similar to England.
  • NHS Blackpool CCG (577) is significantly higher, while NHS Blackburn with Darwen CCG is significantly lower (447). 
*there is a data quality issue with this/these value(s). There is a potential underestimate of the value due to double counting of patients in QOF (Quality and Outcomes Framework). NHS Digital is working towards resolving this issue, but there is no date for the correction. This means the current data cannot be directly compared with previous years.

Cancer survival

The latest CCG-level one-year cancer survival figures (for lung, breast and colorectal) refer to adults (aged 15-99) diagnosed 2002 to 2017 and followed up to 2018.

  • Survival rates vary between the different CCGs, with NHS East Lancashire CCG (71.4%) having a significantly lower one-year survival rate compared to England (73.3%) (all three cancers combined).
  • NHS Morecambe Bay CCG (75.0%) has a survival rate significantly above England, while the remaining four are similar:
    • NHS Chorley and South Ribble CCG - 73.8%
    • NHS Fylde & Wyre CCG - 73.0%
    • NHS Greater Preston CCG - 73.6%
    • NHS West Lancashire CCG - 74.1%
  • Trend line analysis shows that all six CCGs continue to see long-term improvements in the survival rates one year from diagnosis.

All-age mortality

The rates below are directly standardised and are for 100,000 of the population (all ages) for 2015-17.

  • In the Lancashire-12 area, 6,520 deaths were attributed to smoking, giving the county a rate of 299.5, significantly higher than England (262.6). Of these, 2,309 deaths were attributed to lung cancer, giving the area a rate of 63.4, significantly higher than England (56.3).
  • For oral cancer, Lancashire-12's rate (4.9) is similar to England (4.6). 

Premature mortality

Reducing premature mortality - referred to as mortality in persons aged 74 or under - is a major priority for both Public Health England and the NHS, with many deaths caused by diseases and illnesses that are considered avoidable. The rates below are directly standardised and are for 100,000 of the population (under-75 years).

  • During 2016-18, there were 4,718 premature deaths from cancer across Lancashire-12 and of these, 2,808 were considered preventable. 
  • The rate of premature mortality from cancer in Lancashire-12 (138.3) is significantly higher compared to the England value (132.3). 
  • The rate of premature mortality from cancer considered preventable in Lancashire-12 (82.4) is significantly higher than England (76.3).
  • Blackpool (106.9) and Blackburn with Darwen (97.1) also recorded rates significantly above England for premature mortality from cancer considered preventable.

The Neighbourhood Intelligence Mortality Dashboard shows the standardised mortality ratio (SMR) for all cancers for wards in Lancashire (2013-17).

Public Health England also produces the Cancer Services profiles for further details.

For CCG, county and unitary data and further information please see below.

 Page updated January 2020