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 diet, physical 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).
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 clinical commissioning groups (CCGs) recording a prevalence significantly above the England average (2.6%). These are: 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 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 Lancashire-12, giving the area a directly standardised rate (DSR) per 100,000 of 621.6 in line with the England national average of 615.2. Blackburn with Darwen (626.0) was also similar to England, whilst Blackpool (687.1) recorded a rate significantly above.
Four cancer sites accounted for over half (52%) of all newly diagnosed cases across the Lancashire-12 during the 2013-15 period. These are: 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 rates for England shows:
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% in Blackburn with Darwen to 73.2% in West Lancashire. Blackburn with Darwen (69.4%), Blackpool (69.8%) and East Lancashire (70.3%) have survival rates significantly below England's rate (72.3%), while Morecambe Bay has a survival rate significantly above (73.0%).
Trend line analysis found that all eight CCGs continue to see long-term improvements and the STP as a whole has a survival rate which is 8.2 percentage points above where it was 10 years ago in 2006.
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 DSR of 287.0 per 100,000, in line with the England national rate of 280.8. Blackburn with Darwen (309.5) and Blackpool (347.8) both recorded rates significantly above the national average.
Over half (54%) of the cancer deaths recorded across Lancashire-12 (2013-15) can be attributed to just two tumour classes: cancers of the digestive organs (C15-C26), which accounted for 29% of all deaths and includes 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, with the highest number of deaths from lung cancer (C33-34). Individually, lung cancer accounts for the majority of all cancer deaths over the three-year period (24%, 2,384).
Benchmarking the all-age DSR of some of the more common cancers against the England rates, shows the Lancashire-12 area has significantly higher rates for the following:
There is a radial histogram visual on page two of our Neighbourhood Intelligence Mortality Dashboard that shows the standardised mortality ratio (SMR) for all cancers for wards in Lancashire.
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. 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.
Page updated January 2018