7.5%

7.7%

8.8%

10.2%

11.1%

Uterus

Stomach

Liver

Pancreas

Lung and trachea

Macmillan-NCIN UK Cancer Prevalence Project

Cancer prevalence describes people living with cancer (the number or

proportion of people alive on a specified date who have been

diagnosed with cancer at some time in the past). By linking cancer

registrations to mortality records we quantify how many people were

diagnosed with cancer between 1991 and 2010, and who were still

alive on 31st December 2010 – that is 20-year prevalence.

What’s new? For the first time we have detailed prevalence data

available by: cancer type, deprivation group and local area, as well as

age, sex, and time since diagnosis.

57%of people living with cancer in 2010 had

breast, prostate,

colorectal or skin cancer

Most prevalent cancers

A new way of counting prevalence

Our figures for different cancers are based on counting a person's first diagnosis of a specific cancer type

(in the period 1991-2010) even if they have had cancer in another part of their body in the past.

Lung cancer had the highest proportion of

diagnoses in people who had a previous

cancer diagnosis of a different site in the

period 1991-2010 - for around 1 in 9

people living with lung cancer (around

800 people) this was not their first

cancer (Figure 2).

For around 1 in 10 people living with

pancreatic cancer, and around 1 in 11

people living with liver cancer, this was

not their first cancer in the period.

An increasingly granular understanding of the cancer population

The number of people living with cancer (cancer prevalence) is

influenced by new cases diagnosed and the number of people dying

from cancer. This means that poor prognosis cancers such as lung

cancer – despite being one of the most commonly diagnosed cancers in

Scotland – are less prevalent (6,380 people).

In Scotland 2010, there were around:

37,000short-termsurvivorswho had been l iving with cancer for up to 2 years

45,000 long-termsurvivors

79,000mid-term survivorswho had been living with cancer for 2-10 years, and

Compared to previous statistics, the numberof people living with cancer in Scotland has

increased by 17% since 20061.

living with cancer for

10-20 years

Figure 1 - Most prevalent cancers diagnosed between 1991 and 2010, Scotland

Figure 2 - Cancers most likely to be a second or subsequent diagnosis for people living with cancer, diagnosed between 1991 and 2010, Scotland

1 NCIN. One, Five and Ten Year Cancer Prevalence by Cancer Network, UK, 2006. June 2010. (Available at http://www.ncin.org.uk/view?rid=76)

Around 93,000 people were living

with one of the four most

prevalent cancers in Scotland

(Figure 1) - breast, prostate,

colorectal or skin cancer (malignant

melanoma) - as their first cancer

diagnosis.

There were around 41,000 women

and around 20,000 men who

were living with breast and

prostate cancer respectively.

4.3%

42.2%

53.4%

Under 45 45 - 64 65+

Breast cancer

1.5%

23.6%

74.9%

Under 45 45 - 64 65+

Lung cancer

18.7%

38.7%42.6%

Under 45 45 - 64 65+

Skin cancer

Over half (57%) of people living with skin cancer were of working age2 - 6,330 people of which around 2,000 were under 45. Despite the high numbers in younger age groups, there were still 4,700 older people (65 or over) who were living with skin cancer, of which 2,600 were 75 or over.

Just under half (47%) of women living with breast cancer were of working age2. There were around 1,800 women under 45 living with breast cancer in 2010. Over 22,000 women living with breast cancer were 65 or over, of these 10,600 were 75 or over.

A quarter of people living with lung cancer were of working age2 –1,800 people. Although a low proportion, there were still around 100 people living with lung cancer under the age of 45. There were over 5,300 people with lung cancer who were 65 or over, of which 2,775 were 75 or over.

There were 5,750 women living with breast cancer who were of diagnosed under the age of 45, and around 23,500 women (over half) who were diagnosed between the age of 45 and 64. Around 12,750 (less than a third) of women living with breast cancer were diagnosed when they 65 or over.

There around 900 people living with colorectal cancer who were diagnosed under the age of 45. 8,440 were diagnosed between the age of 45 and 64, just over a third of the total. Around 13,600 people living with colorectal cancer were diagnosed with diagnosed when they were 65 or over, well over half of the total.

Around 2,270 women living with cervical cancer were diagnosed under the age of 45, almost two thirds of the total. 91% of all women living with cervical cancer were diagnosed when they were of working age2. However, there were still around 300 women who were diagnosed when they were 65 or over.

13.7%

56.0%

30.3%

Under 45 45 - 64 65+

Breast cancer

3.9%

36.7%

59.3%

Under 45 45 - 64 65+

Colorectal cancer 64.7%

26.5%

8.7%

Under 45 45 - 64 65+

Cervical cancer

Prevalence by age at diagnosis

Although cancer diagnoses most often occur in later life, this does vary according to cancer type and even for common cancers there are significant numbers of people who were diagnosed at a younger age (Figure 3).

2 Working age is based on those aged 15 - 64

Prevalence by age at end of 2010

Although cancer is mostly associated with older people, there were significant numbers of people from all age groups who were living with cancer; this varies by cancer type (Figure 4).

Figure 4 – Age at end of 2010 for people living with cancer, diagnosed 1991- 2010, for selected cancers, Scotland

Figure 3 – Age at times of diagnosis for people living with cancer in 2010, diagnosed 1991-2010, for selected cancers, Scotland

Prevalence by deprivation

In Scotland, it is the least deprived group who constitute the highest proportion of cancer survivors for the 10-year period4 across most cancer types. This is likely due to the least deprived groups having a higher incidence in the better prognosis cancers, such as breast and skin cancer, and the most deprived groups having higher incidence in the poor prognosis cancers.

26% 21% 19% 16% 12% 6%Skin

24% 22% 20% 17% 13% 4%Prostate

21% 21% 20% 19% 16% 4%Breast

15% 19% 19% 20% 21% 7%Oesophagus

Cervical 13% 17% 19% 23% 27%

11% 13% 17% 22% 26% 12%Lung

People living with skin cancer were more than twice as likely to be from the least deprived group than the most deprived group (Figure 6). This was the largest the difference in the proportion of people in the least versus the most deprived group for people living with different cancers. People living with lung and cervical cancer were more likely to be from the most deprived group. Over a quarter of people from these cancer types were from the most deprived group, more than twice the proportion of those from the least deprived groups.

928 413 566 408 265 195

515 244 310 206 104 56

448 183 264 160 71 40

651 274 397 233 94 47

30 17 33 12 11 2

263 246 621 657 445 371

113 101 252 255 175 133

85 103 242 314 184 143

375 377 1,010 1,095 838 574

222 204 516 579 353 187

LUN

G

SK

IN

75+

70 -74

65 - 69

45 - 64

0 - 44

Age at end of 2010

0 to 1 1 to 2 2 to 5 5 to 10 10 to 15 15 to 20

Time Since Diagnosis (years)

0 to 1 1 to 2 2 to 5 5 to 10 10 to 15 15 to 20

Prevalence by time since diagnosis

Around 2,500 people living with lung cancer in 2010 had been diagnosed within the previous year, representing 36% of all people living with lung cancer. Just 13% (around 885 people) had been living with lung cancer for more than 10 years, and just 5% (340 people) had been living with lung cancer for more than 15 years, reflecting the poor survival associated with lung cancer. Skin cancer (malignant melanoma) has better survival rates than lung cancer, and around 3,400 people living with skin cancer in 2010 had been for more than 10 years – almost a third of the 20-year prevalence total. There were around 7,600 people who have been living with skin cancer for up to ten years, and just 10% of all people living with skin cancer in 2010 (around 1,000 people) had been diagnosed within the past year.

4 Those diagnosed more than 15 years prior to 2010 could not be assigned a deprivation quintile. Deprivation analysis presented here is for 10-year

prevalence only.

Figure 6 – 20-year prevalence by deprivation group for

selected cancers in 2010, Scotland

Figure 5 – 20-year prevalence by time since diagnosis for people living with lung and skin cancer, by age at end of 2010, Scotland3

3 Note that some figures in this chart have been suppressed, and small numbers may not be exact.

337.8 - 374.1

374.2 - 470.3

470.4 - 539.1

539.2 - 695.7

Colorectal cancerprevalence(crude rate per 100,000)

1326.9 - 1456.3

1456.4 - 1609.0

1609.1 - 1741.2

1741.3 - 2054.5

Breast cancerprevalence(crude rate per 100,000)

Women living with breast cancer The overall rates of breast cancer prevalence in Scotland are marginally highest in North of Scotland, although West of Scotland has the highest number of women living with breast cancer (around 19,000). Dumfries and Galloway NHS Board Area has some of the highest rates in Scotland. Although there were around 4,000 women living with breast cancer in Glasgow City – more than any other local council area – it had the lowest breast cancer prevalence rate. Argyll and Bute, and East Dunbartonshire, had some of the highest breast cancer prevalence rates in Scotland, where both of these local council areas also had around 1,000 women living with breast cancer in 2010.

People living with colorectal cancer The overall rates of colorectal prevalence are highest in the North of Scotland regional cancer network, although West of Scotland has the highest number of people living with colorectal cancer (almost 10,000 people). Colorectal prevalence rates are particularly high in the Western Isles NHS Board Area. There are around 2,200 people living with colorectal cancer in Glasgow City (local council area) – more than any other local council area, although this had one of the lowest rates in Scotland. This is likely due to the younger population in Glasgow. Comhairle nan Eilean Siar had the highest rates of colorectal cancer prevalence out of all local council areas in Scotland, where just under 200 people were living with colorectal cancer in 2010.

Prevalence by local area

The 20-year cancer prevalence data is broken down to a sub-national level, allowing us to identify the

number of people living with a specific cancer type in a region or local area (based on their location of

residence at time of diagnosis). Cancer prevalence can also be based on crude rates (per 100,000

population) which allows for some comparison between areas, although it does not account for different

age profiles of local areas.

Figure 7 – 20-year prevalence for people living with colorectal

cancer by local council area, 2010, Scotland

Figure 8 – 20-year prevalence for women living with breast cancer by

local council area, 2010, Scotland

All maps contain National Statistics and Ordnance Survey data © Crown copyright and database right 2015. Additional mapping data copyright Experian Ltd, Navteq 2013 Q4

Find out more All the data and analysis presented in this high level summary are available alongside much more detail in a series of data tables. This includes between 16 and 47 cancer sites for different analyses, 7 age groups, and three different geographical breakdowns (regional cancer network, NHS board area and local council area) for Scotland. The following additional resources are now available: - National-level and UK combined data tables for common and detailed cancer types, age, sex, time since diagnosis, nation and UK summary: http://www.ncin.org.uk/about_ncin/segmentation - Sub-geographical data tables for England, Northern Ireland, Scotland and Wales which contain variables for: sex, common cancer types, time since diagnosis and sub-geographical area: http://www.ncin.org.uk/about_ncin/segmentation - A UK summary data briefing and equivalent nation specific briefings for England, Northern Ireland and Wales: http://www.macmillan.org.uk/Aboutus/Ouresearchandevaluation/Ourresearchpartners/NCIN.aspx - A full guidance document and FAQ on using the prevalence data referred to here and included in the data files: http://www.ncin.org.uk/about_ncin/segmentation - Location maps (in PDF format) describing the areas referred to here and in the data files: http://www.ncin.org.uk/about_ncin/segmentation Other useful resources within the Macmillan-NCIN partnership: Public Health England’s National Cancer Intelligence Network (NCIN) is a UK-wide initiative, working to drive improvements in cancer awareness, prevention, diagnosis and clinical outcomes by improving and using the information collected about cancer patients for analysis, publication and research. http://www.ncin.org.uk/about_ncin/understanding_the_cancer_population Macmillan does more research into the needs and experiences of people living with cancer and their carers than any other charity in the UK. We fund a range of research projects and work in partnership with leading national research organisations and academics. Our research covers health and social care services, patient experience, cancer survivorship, the economics of cancer, the demographics of the cancer population and many more areas. http://www.macmillan.org.uk/research

The Macmillan-NCIN UK Cancer Prevalence Project is part of the Macmillan Cancer Support and Public Health England’s National Cancer Intelligence Network Partnership Work Plan. The Project is supported by the Knowledge & Intelligence Team (East) at Public Health England. Data are sourced and presented in collaboration with the Welsh Cancer Intelligence and Surveillance Unit, Health Intelligence Division, Public Health Wales, the Scottish Cancer Registry and the Northern Ireland Cancer Registry, funded by the Public Health Agency for Northern Ireland.