New analysis sheds light on cancer incidence and mortality trends in the UK

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In a recent study published in BMJ, researchers investigated trends in cancer incidence and deaths in the United Kingdom (UK) among individuals aged between 35 and 69 years.

Study: 25 year trends in cancer incidence and mortality among adults aged 35-69 years in the UK, 1993-2018: retrospective secondary analysis. Image Credit: Image Point Fr/Shutterstock.comStudy: 25 year trends in cancer incidence and mortality among adults aged 35-69 years in the UK, 1993-2018: retrospective secondary analysis. Image Credit: Image Point Fr/Shutterstock.com

Background

Over the last 25 years, the UK has seen remarkable improvements in cancer risk factors, including a decline in smoking prevalence as a result of tariff rises, advertising restrictions, and smoke-free laws. Diet and exercise are leading to an increase in the number of overweight or obese individuals.

Between 1993 and 2018, three screening programs for cervical, breast, and bowel cancer were implemented, with the ability to detect non-harmful cases. However, there is limited recent research on cancer incidences and deaths among those aged 35 to 69.

About the study

In the present study, researchers examined changes in cancer incidences and deaths in the United Kingdom between 1993 and 2018 for individuals aged 35 to 69 years.

The researchers examined cancer registration, deaths, and nationwide population-level data from the Public Health Wales, Office for National Statistics (ONS), North Ireland Cancer Registry, Public Health Scotland, the General Register Office for North Ireland, and National Health Service (NHS) England.

They investigated 23 cancer locations in the United Kingdom to determine cancer incidence and deaths among individuals aged 35 to 69 who received cancer diagnoses or died from cancers between 1993 and 2018.

The team used the International Classification of Diseases, Tenth Revision (ICD-10) codes to diagnose cancers. The primary outcomes were changes in cancer incidences and deaths based on age across time.

Sex-specific cancer groups were evaluated without breast and prostate cancers to examine general trends in the absence of the most prevalent cancer site for each gender.

Mesothelioma was a new particular code released in ICD-10, and there were no credible mortality statistics available for this site before 2001; hence, the researchers did not include this kind of malignancy.

They included non-malignant brain and spinal cord tumor codes, despite their benign character, because their presence in the cranial cavity can lead to death.

The researchers omitted non-melanoma skin cancer from the incidence statistics due to incomplete documentation of these tumors, making the data unreliable. To account for yearly volatility in low-case sites, the researchers estimated three-year rolling average age-standardized rates per 100,000 population. They used generalized linear modeling for analysis.

Results

Cancer incidence among individuals aged 35 to 69 years increased by 57% (86,297 from 55,014) for males and 48% (88,970 from 60,187) for women, with an average yearly growth of 0.80% for both genders.

Between 2003 and 2013, prostate and breast cancers grew in both sexes, with the male age-standardized incidence rate falling before 2000 and rising among women. Less frequent malignancies, such as melanoma, skin, liver, mouth, and kidney, have also shown alarming rises.

For males aged 35 to 69 years, the highest mean yearly percentage elevations were for malignancies of hepatic tissues (4.70%), prostate (4.20%), and skin melanomas (4.20%). The highest yearly declines were for stomach (4.2%), bladder (4.10%), and lung (2.10%) cancers.

For females, the highest average yearly percentage increases were for the liver (3.90%), skin melanomas (3.50%), and mouth (3.30%) cancers, whereas the highest annual declines were for bladder (3.60%) and stomach (3.10%).

Over the past 25 years, cancer fatalities were reduced by 20% (26,322 from 32,878) in men and 17% (23,719 from 28,516) in women. Age-standardized mortality rates for all malignancies were decreased by 37% (2.0% each year) in men and 33% (1.6% per year) in women.

The study discovered that after omitting prostate cancer from mortality trends, men's death rates fell considerably, whereas women's mortality decreased by 1.3% each year. The highest decline in mortality happened before 2000, with 14% in males and 11% in females.

The most significant declines were shown in bladder, mesothelioma, and stomach malignancies in males, as well as stomach, cervical, and non-Hodgkin lymphoma in women.

For males, the cancers with mean yearly percentage decreases in death rates of ≥1.0% per year were stomach (5.10%), mesothelioma (4.20%), bladder (3.20%), lung (3.10%), non-Hodgkin lymphoma (2.90%), testis (2.80%), Hodgkin lymphoma (2.60%), larynx (2.50%), bowel (2.50%), prostate (1.80%), myeloma (1.70%), and leukemia (1.60%).

For females, the cancers with mean yearly reductions in death rates of ≥1.0% were of the stomach (4.20%), cervix (3.60%), non-Hodgkin lymphomas (3.20%), ovaries (2.80%), breast (2.80%), myeloma (2.30%), bowel (2.20%), mesothelioma (2.0%), laryngeal tissues (2.0%), leukemia (2.0%), bladder (1.60%), esophagus (1.20%), and kidneys (1.00%).

In both sexes, liver (2.70%) and mouth (1.20%) malignancies had mean yearly mortality increases of ≥1.0%.

Conclusion

The study findings showed that cancer mortality in males and females aged 35 to 69 years decreased significantly over the last 25 years, primarily due to cancer prevention, early diagnosis, improved diagnostic testing, and successful treatment.

However, an increase in nonsmoking risk factors may result in a rise in some malignancies. The research provides a baseline for the coming years, assessing the influence of coronavirus disease 2019 (COVID-19) on cancer incidences and outcomes.

There are increased concerns regarding specific cancer sites, with the highest concern being the need to expedite the decline in female lung cancer.

Journal reference:
Pooja Toshniwal Paharia

Written by

Pooja Toshniwal Paharia

Dr. based clinical-radiological diagnosis and management of oral lesions and conditions and associated maxillofacial disorders.

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