This release summarises the diagnoses in 2019 registered by NDRS covering all registerable neoplasms (all cancers, all in situ tumours, some benign tumours and all tumours that have uncertain or unknown behaviours)

In 2019, approximately ** men and ** women per 100,000 population died from lung cancer in England. The North East of England had the highest mortality from lung cancer for both genders with a rate of approximately ** men and ** women per 100,000 population.

This release summarises the survival of adults diagnosed with cancer in England between 2016 and 2020 and followed to 2021, and children diagnosed with cancer in England between 2002 and 2020 and followed to 2021. Adult cancer survival estimates are presented by age, deprivation, gender, stage at diagnosis, and geography.

Age-standardised rate of mortality from oral cancer (ICD-10 codes C00-C14) in persons of all ages and sexes per 100,000 population.RationaleOver the last decade in the UK (between 2003-2005 and 2012-2014), oral cancer mortality rates have increased by 20% for males and 19% for females1Five year survival rates are 56%. Most oral cancers are triggered by tobacco and alcohol, which together account for 75% of cases2. Cigarette smoking is associated with an increased risk of the more common forms of oral cancer. The risk among cigarette smokers is estimated to be 10 times that for non-smokers. More intense use of tobacco increases the risk, while ceasing to smoke for 10 years or more reduces it to almost the same as that of non-smokers3. Oral cancer mortality rates can be used in conjunction with registration data to inform service planning as well as comparing survival rates across areas of England to assess the impact of public health prevention policies such as smoking cessation.References:(1) Cancer Research Campaign. Cancer Statistics: Oral – UK. London: CRC, 2000.(2) Blot WJ, McLaughlin JK, Winn DM et al. Smoking and drinking in relation to oral and pharyngeal cancer. Cancer Res 1988; 48: 3282-7. (3) La Vecchia C, Tavani A, Franceschi S et al. Epidemiology and prevention of oral cancer. Oral Oncology 1997; 33: 302-12.Definition of numeratorAll cancer mortality for lip, oral cavity and pharynx (ICD-10 C00-C14) in the respective calendar years aggregated into quinary age bands (0-4, 5-9,…, 85-89, 90+). This does not include secondary cancers or recurrences. Data are reported according to the calendar year in which the cancer was diagnosed.Counts of deaths for years up to and including 2019 have been adjusted where needed to take account of the MUSE ICD-10 coding change introduced in 2020. Detailed guidance on the MUSE implementation is available at: https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/deaths/articles/causeofdeathcodinginmortalitystatisticssoftwarechanges/january2020Counts of deaths for years up to and including 2013 have been double adjusted by applying comparability ratios from both the IRIS coding change and the MUSE coding change where needed to take account of both the MUSE ICD-10 coding change and the IRIS ICD-10 coding change introduced in 2014. The detailed guidance on the IRIS implementation is available at: https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/deaths/bulletins/impactoftheimplementationofirissoftwareforicd10causeofdeathcodingonmortalitystatisticsenglandandwales/2014-08-08Counts of deaths for years up to and including 2010 have been triple adjusted by applying comparability ratios from the 2011 coding change, the IRIS coding change and the MUSE coding change where needed to take account of the MUSE ICD-10 coding change, the IRIS ICD-10 coding change and the ICD-10 coding change introduced in 2011. The detailed guidance on the 2011 implementation is available at https://webarchive.nationalarchives.gov.uk/ukgwa/20160108084125/http://www.ons.gov.uk/ons/guide-method/classifications/international-standard-classifications/icd-10-for-mortality/comparability-ratios/index.htmlDefinition of denominatorPopulation-years (aggregated populations for the three years) for people of all ages, aggregated into quinary age bands (0-4, 5-9, …, 85-89, 90+)

Cancer diagnoses and age-standardised incidence rates for all types of cancer by age and sex including breast, prostate, lung and colorectal cancer.

In the period 2017 to 2019, the mortality rate from kidney cancer in the United Kingdom (UK) was **** deaths per 100,000 men and *** deaths per 100,000 women. Scotland was the UK country with the highest mortality rate in this year, with over **** kidney cancer deaths per 100,000 population.

One-year and five-year net survival for adults (15-99) in England diagnosed with one of 29 common cancers, by age and sex.

In 2018/19, the mortality rate from non-melanoma skin cancer in the United Kingdom was *** deaths per 100 thousand for men and *** deaths per 100 thousand for women. Across the provided time interval the mortality rate from non-melanoma skin cancer has decreased for women, while the rate for men has experienced more fluctuations but was a higher rate at the start and the end of the provided time interval.

This publication reports on newly diagnosed cancers registered in England in addition to cancer deaths registered in England during 2020. It includes this summary report showing key findings, spreadsheet tables with more detailed estimates, and a methodology document.

The end of life care profiles data update for May 2019 has been published by Public Health England (PHE).

This version includes 10 updated indicators with 2017 data for clinical commissioning groups (CCGs), local authorities (LAs) and higher geographies:

• percentage of deaths by place of occurrence (hospital, home, care home, hospice and other places)
• percentage of deaths by underlying cause of death (cancer, respiratory disease and circulatory disease)
• age standardised mortality rates (all ages and 0 to 64, 65 to 74, 75 to 84, 85 years and older)
• percentage of all deaths (0 to 64, 65 to 74, 75 to 84, 85 years and older)

The end of life care profiles are designed to improve the availability and accessibility of information around end of life care. The data is presented in an interactive tool that allows users to view and analyse it in a user-friendly format.

The profiles provide a snapshot overview of end of life care across England. They are intended to help local government and health services to improve care at the end of life.

In the period 2017 to 2019, the mortality rate from melanoma skin cancer in the United Kingdom was *** deaths per 100,000 for men and *** deaths per 100,000 for women. Across the overall provided time interval the mortality rate from skin cancer has increased significantly in the UK, although there has been a slight decline since 2012-2014.

This statistic shows the number of deaths from cervical cancer in England from 2014 to 2021. In 2021, the number of deaths from cervical cancer reached 702, an increase from 681 deaths in 2020.

Directly age and sex standardised mortality rate from Cancer for people aged under 75 in the respective calendar year per 100,000 registered patients March 2020: In addition to the changes in March 2019, the indicator production process has been fully automated. As a result there are two changes to this publication: 1) Data in this file are published from 2016 only; all data is based on the most recent methodology and comparable across years. For the historic time series of this indicator please refer to the zip files in the March 2019 publication: https://digital.nhs.uk/data-and-information/publications/clinical-indicators/ccg-outcomes-indicator-set/archive/ccg-outcomes-indicator-set---march-2019 2) Data are run against the CCG configuration at the time of processing; the 2016 and 2017 data points have been restated based on the new automated process. As of the March 2019 release the processing of the Primary Care Mortality Database (PCMD) and the standard population used to calculate the indicator for new data periods changed; this file now contains only those data periods processed under the new method. For the historic time series of this indicator please refer to the zip files in the March 2019 publication referenced above. Legacy unique identifier: P01808

Directly age-standardised registration rate for oral cancer (ICD-10 C00-C14), in persons of all ages, per 100,000 2013 European Standard PopulationRationaleTobacco is a known risk factor for oral cancers (1). In England, 65% of hospital admissions (2014–15) for oral cancer and 64 % of deaths (2014) due to oral cancer were attributed to smoking (2). Oral cancer registration is therefore a direct measure of smoking-related harm. Given the high proportion of these registrations that are due to smoking, a reduction in the prevalence of smoking would reduce the incidence of oral cancer.Towards a Smokefree Generation: A Tobacco Control Plan for England states that tobacco use remains one of our most significant public health challenges and that smoking is the single biggest cause of inequalities in death rates between the richest and poorest in our communities (3).In January 2012 the Public Health Outcomes Framework was published, then updated in 2016. Smoking and smoking related death plays a key role in two of the four domains: Health Improvement and Preventing premature mortality (4).References:(1) GBD 2013 Risk Factors Collaborators. Global, regional and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risk factors in 188 countries, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013. The Lancet 2015; 386:10010 2287–2323. (2) Statistics on smoking, England 2016, May 2016; http://content.digital.nhs.uk/catalogue/PUB20781 (3) Towards a Smokefree Generation: A Tobacco Control Plan for England, July 2017 https://www.gov.uk/government/publications/towards-a-smoke-free-generation-tobacco-control-plan-for-england (4) Public Health Outcomes Framework 2016 to 2019, August 2016; https://www.gov.uk/government/publications/public-health-outcomes-framework-2016-to-2019 Definition of numeratorCancer registrations for oral cancer (ICD-10, C00-C14) in the calendar years 2007-09 to 2017-2019. The National Cancer Registration and Analysis Service collects data relating to each new diagnosis of cancer that occurs in England. This does not include secondary cancers. Data are reported according to the calendar year in which the cancer was diagnosed.Definition of denominatorPopulation-years (ONS mid-year population estimates aggregated for the respective years) for people of all ages, aggregated into quinary age bands (0-4, 5-9,…, 85-89, 90+).CaveatsReviews of the quality of UK cancer registry data 1, 2 have concluded that registrations are largely complete, accurate and reliable. The data on cancer registration ‘quality indicators’ (mortality to incidence ratios, zero survival cases and unspecified site) demonstrate that although there is some variability, overall ascertainment and reliability is good. However cancer registrations are continuously being updated, so the number of registrations for each year may not be complete, as there is a small but steady stream of late registrations, some of which only come to light through death certification.1. Huggett C (1995). Review of the Quality and Comparability of Data held by Regional Cancer Registries. Bristol: Bristol Cancer Epidemiology Unit incorporating the South West Cancer Registry. 2. Seddon DJ, Williams EMI (1997). Data quality in population based cancer registration. British Journal of Cancer 76: 667-674.The data presented here replace versions previously published. Population data and the European Standard Population have been revised. ONS have provided an explanation of the change in standard population (available at http://www.ons.gov.uk/ons/guide-method/user-guidance/health-and-life-events/revised-european-standard-population-2013--2013-esp-/index.html )

The cancer services profiles have been updated with data for the 2018 to 2019 financial year.

These profiles present data at GP, Clinical Commissioning Group (CCG) and national level on:

• cancer incidence and screening
• Two Week Wait (TWW) referrals
• diagnostic services
• emergency presentations and admissions

The https://fingertips.phe.org.uk/profile/cancerservices">cancer services profiles have been designed to support commissioners and health professionals to assess the impact of cancer on their local population and make decisions about services.

These profiles replace the GP cancer profiles that were previously presented in the Cancer Commissioning Toolkit.

SUMMARYThis analysis, designed and executed by Ribble Rivers Trust, identifies areas across England with the greatest levels of cancer (in persons of all ages). Please read the below information to gain a full understanding of what the data shows and how it should be interpreted.ANALYSIS METHODOLOGYThe analysis was carried out using Quality and Outcomes Framework (QOF) data, derived from NHS Digital, relating to cancer (in persons of all ages).This information was recorded at the GP practice level. However, GP catchment areas are not mutually exclusive: they overlap, with some areas covered by 30+ GP practices. Therefore, to increase the clarity and usability of the data, the GP-level statistics were converted into statistics based on Middle Layer Super Output Area (MSOA) census boundaries.The percentage of each MSOA’s population (all ages) with cancer was estimated. This was achieved by calculating a weighted average based on:The percentage of the MSOA area that was covered by each GP practice’s catchment areaOf the GPs that covered part of that MSOA: the percentage of registered patients that have that illness The estimated percentage of each MSOA’s population with cancer was then combined with Office for National Statistics Mid-Year Population Estimates (2019) data for MSOAs, to estimate the number of people in each MSOA with cancer, within the relevant age range.Each MSOA was assigned a relative score between 1 and 0 (1 = worst, 0 = best) based on:A) the PERCENTAGE of the population within that MSOA who are estimated to have cancerB) the NUMBER of people within that MSOA who are estimated to have cancerAn average of scores A & B was taken, and converted to a relative score between 1 and 0 (1= worst, 0 = best). The closer to 1 the score, the greater both the number and percentage of the population in the MSOA that are estimated to have cancer, compared to other MSOAs. In other words, those are areas where it’s estimated a large number of people suffer from cancer, and where those people make up a large percentage of the population, indicating there is a real issue with cancer within the population and the investment of resources to address that issue could have the greatest benefits.LIMITATIONS1. GP data for the financial year 1st April 2018 – 31st March 2019 was used in preference to data for the financial year 1st April 2019 – 31st March 2020, as the onset of the COVID19 pandemic during the latter year could have affected the reporting of medical statistics by GPs. However, for 53 GPs (out of 7670) that did not submit data in 2018/19, data from 2019/20 was used instead. Note also that some GPs (997 out of 7670) did not submit data in either year. This dataset should be viewed in conjunction with the ‘Health and wellbeing statistics (GP-level, England): Missing data and potential outliers’ dataset, to determine areas where data from 2019/20 was used, where one or more GPs did not submit data in either year, or where there were large discrepancies between the 2018/19 and 2019/20 data (differences in statistics that were > mean +/- 1 St.Dev.), which suggests erroneous data in one of those years (it was not feasible for this study to investigate this further), and thus where data should be interpreted with caution. Note also that there are some rural areas (with little or no population) that do not officially fall into any GP catchment area (although this will not affect the results of this analysis if there are no people living in those areas).2. Although all of the obesity/inactivity-related illnesses listed can be caused or exacerbated by inactivity and obesity, it was not possible to distinguish from the data the cause of the illnesses in patients: obesity and inactivity are highly unlikely to be the cause of all cases of each illness. By combining the data with data relating to levels of obesity and inactivity in adults and children (see the ‘Levels of obesity, inactivity and associated illnesses: Summary (England)’ dataset), we can identify where obesity/inactivity could be a contributing factor, and where interventions to reduce obesity and increase activity could be most beneficial for the health of the local population.3. It was not feasible to incorporate ultra-fine-scale geographic distribution of populations that are registered with each GP practice or who live within each MSOA. Populations might be concentrated in certain areas of a GP practice’s catchment area or MSOA and relatively sparse in other areas. Therefore, the dataset should be used to identify general areas where there are high levels of cancer, rather than interpreting the boundaries between areas as ‘hard’ boundaries that mark definite divisions between areas with differing levels of cancer.TO BE VIEWED IN COMBINATION WITH:This dataset should be viewed alongside the following datasets, which highlight areas of missing data and potential outliers in the data:Health and wellbeing statistics (GP-level, England): Missing data and potential outliersLevels of obesity, inactivity and associated illnesses (England): Missing dataDOWNLOADING THIS DATATo access this data on your desktop GIS, download the ‘Levels of obesity, inactivity and associated illnesses: Summary (England)’ dataset.DATA SOURCESThis dataset was produced using:Quality and Outcomes Framework data: Copyright © 2020, Health and Social Care Information Centre. The Health and Social Care Information Centre is a non-departmental body created by statute, also known as NHS Digital.GP Catchment Outlines. Copyright © 2020, Health and Social Care Information Centre. The Health and Social Care Information Centre is a non-departmental body created by statute, also known as NHS Digital. Data was cleaned by Ribble Rivers Trust before use.MSOA boundaries: © Office for National Statistics licensed under the Open Government Licence v3.0. Contains OS data © Crown copyright and database right 2021.Population data: Mid-2019 (June 30) Population Estimates for Middle Layer Super Output Areas in England and Wales. © Office for National Statistics licensed under the Open Government Licence v3.0. © Crown Copyright 2020.COPYRIGHT NOTICEThe reproduction of this data must be accompanied by the following statement:© Ribble Rivers Trust 2021. Analysis carried out using data that is: Copyright © 2020, Health and Social Care Information Centre. The Health and Social Care Information Centre is a non-departmental body created by statute, also known as NHS Digital; © Office for National Statistics licensed under the Open Government Licence v3.0. Contains OS data © Crown copyright and database right 2021. © Crown Copyright 2020.CaBA HEALTH & WELLBEING EVIDENCE BASEThis dataset forms part of the wider CaBA Health and Wellbeing Evidence Base.

National Cancer Registration And Analysis Service (NCRAS). (2019). Cancer Registration: Cancer Incidence in England (1971-2016) [Data set]. Public Health England. https://doi.org/10.25503/10.25503/skk4-6x09 • DIAGNOSISYEAR (Calendar year of cancer diagnosis) • SEX (Coded as 1=Male, 2=Female) • AGE (Five year age bands 0-4, 5-9, 10-14,....... 90+) • TUMOUR SITE (3 digit code describing tumour site according to coding system in TUMOUR SITE CODE DESC) • TUMOUR SITE CODE DESC (Coding system for field TUMOUR SITE. Coding system used is ICD8 for diagnoses 1971-1978, ICD9 for 1979-1994 and ICD10 for 1995-2016) • MORPHOLOGY (4/5 digit code describing tumour morphology according to coding system in MORPHOLOGY CODE DESC) • MORPHOLOGY CODE DESC (Coding system for field MORPHOLOGY. Coding system used is MOTNAC for diagnoses 1971-1989, ICD00 for 1990-1994 and ICDO2 for 1995-2016) • INCIDENCE (Tumour incidence count) Whenever it is possible and practicable to do so, data released by PHE will be anonymous and made available under an Open Government License. To render the data anonymous it must be stripped of direct identifiers and privacy by design methods applied in line with the rules layed out in the ISB Anonymisation Standard for Publishing Health and Social Care Data Specification (2013).