NHS faces huge cancer challenge as cases set to jump by 45 per cent

Cancer Research UK

The NHS must start planning now to deal with a predicted leap of 45 per cent in the number of new cancer cases in the UK over the next two decades, Cancer Research UK warns today (Friday).

The number of cancer cases is projected to climb from around 298,000 in 2007 to around 432,000 by 2030 – an increase that, without planning, could threaten to overwhelm NHS resources.

Male cancer cases will see the biggest rise – by 55 per cent to over 230,000 in 2030 according to the Cancer Research UK study, published in the British Journal of Cancer.

The main reason for the rise in cancer cases is that people are getting older.

But the good news is that survival is on the increase - cancer survival rates have doubled over the last 40 years in the UK – a trend that is likely to continue.

Cancer cases among women are also forecast to increase by 35 per cent from around 149,000 in 2007 to over 200,000 in 2030.

Study author Professor Peter Sasieni, a Cancer Research UK epidemiologist based at Queen Mary, University of London, said: “Projections of cancer cases are important for planning health services so we can understand where the future burden is on the NHS and also where health awareness messages need to be raised.”

Prostate cancer is predicted to be one of the biggest risers over the 23-year period with over 25,000 more cases of the disease in 2030 compared to 2007. Cases will increase from around 36,000 in 2007 to over 61,000. This is mainly due to the ageing and growing population.1

While cancer cases are set to rise, cancer rates, adjusting for the growing and ageing population, remain broadly stable over the 23-year period at around 400 per 100,000 men per year and 350 per 100,000 women per year.2

Despite this, some individual cancers will see an increase in rates.

Over the next 20 years, some of the largest increases in cancer rates will be from oral, liver, malignant melanoma and kidney cancers – especially among men.

The rate of malignant melanoma – the most dangerous form of skin cancer - has the biggest projected increase, rising by a staggering 52 per cent for both men and women.

The rate of oral cancer in men is predicted to rise by 25 per cent from 10.9 per 100,000 men per year in 2007 to 13.6 per 100,000 in 2030. (Cases will rise by 75 per cent from around 3,600 to 6,300).

Male kidney cancer rates are estimated to rise by 28 per cent (cases will rise by 90 per cent from 5,145 to almost 10,000) while liver cancer rates in men are set to increase by 27 per cent by 2030 (cases will rise by 94 per cent from around 2,150 to almost 4,200).

In women, liver cancer rates are predicted to fall by two per cent, while kidney cancer rates will rise by 18 per cent over the next 23 years.

The study also predicted that the rate of breast cancer will decline by seven per cent from 120 cases per 100,000 women per year in 2007 to 111 cases per 100,000 in 2030.

The researchers said that most of the decline in the age group 55-64 is due to a significant reduction in the use of HRT in recent years. HRT is an important risk factor for breast cancer first identified in the 1980s.

Professor Peter Johnson, Cancer Research UK’s chief clinician, said: “We’ve witnessed huge improvements in recent decades, with cancer survival doubling over the last 40 years. Cancer Research UK has been at the heart of the progress through investment in research into more effective radiotherapy, many new drugs and improved surgery.

"But it’s also important to be aware of the signs and symptoms of cancer, so we can spot it early. Generally, the earlier cancer is spotted the easier it is to treat successfully, so know what is normal for you and if you spot anything unusual, get it checked out by your doctor."

Harpal Kumar, Cancer Research UK’s chief executive, said: “The NHS faces a perfect storm over the next 20 years. The main reason for the rising number of cases is simply that people are living longer - and the greatest risk factor for cancer is age.

“At a time when the finances of the health service are being squeezed, it is absolutely crucial that health commissioners plan now for a massive increase in demand for cancer services, to ensure we provide high quality care to all.

“And as we develop ever more sophisticated ways to detect and treat cancer successfully, health planners must deploy resources more effectively to enable all patients to benefit from the latest developments and cutting edge new treatments.”

ENDS

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References

  • Mistry, M et al., Cancer incidence in the UK: Projections to the year 2030 (2011) British J Cancer DOI: 10.1038/bjc.2011.430

Notes to Editor

The authors present the results of careful modelling of trends in cancer rates. All the figures given for cancer cases and rates are projections and not inevitable. The authors emphasise that changes to cancer prevention over the next 10 years could substantially impact the number of cases in 2030.

Overall cancer cases in the UK will rise to around 432,000 in 2030 from around 298,000 in 2007.

The study looked at the changes in 23 of the most common types of cancer from 1984 to current figures (2007) and estimated figures for 2030.

The number of cancer cases in men will rise to over 231,000 in 2030 from almost 150,000 in 2007.

1. Although increasing use of PSA testing has led to a substantial increase in the number of cases of prostate cancers in recent years, the projections were made on the basis of the proportion of men receiving PSA testing remaining the same as it was in 2004 to 2007. If PSA testing becomes more common, the numbers of prostate cancers will increase even more.

Prostate cancer – which was just 11 per cent of all male cancers in 1984 – will account for 26 per cent by 2030.

2. The rates given are age-standardised. Age-standardisation adjusts rates to take into account how many old or young people are in the population being looked at. When rates are age-standardised, you know that differences in the rates over time or between geographical areas do not simply reflect variations in the age structure of the populations. This is important when looking at cancer rates because cancer is a disease that predominantly affects the elderly. So if cancer rates are not age-standardised, a higher rate in one time period is likely to reflect the fact that it has a greater proportion of older people.

In 2007 male melanoma rates were 14.6 per 100,000, they are estimated to increase to 22.3 per 100,000 in 2030 (increase of 52 per cent). Cases will rise from around 5,000 to nearly 11,000. For females: 15.4 per 100,000 in 2007 rising to 23.4 per 100,000 in 2030 (increase of 52 per cent). Cases will rise from over 5,700 to almost 10,900.

The increase in melanoma has a particularly marked effect on male cancers – in 1984 melanoma was the 16th most common cancer in men (just under one per cent of cancers in men). But it is predicted to become the fourth most common cancer in men in 2030 accounting for nearly five per cent.

In 1984 melanoma was the 13th most common cancer (almost two per cent of all female cancer cases) in women, in 2030 it will be the 5th most common (around 5 per cent).
Oral cancer includes lip, mouth and pharynx cancers.

Female oral cancer rates will rise from 4.6 per 100,000 in 2007 to 5.5 per 100,000 in 2030 (change of 21 per cent).

Male kidney cancer rates will rise from 14.5 per 100,000 in 2007 to 18.5 per 100,000 in 2030 (increase of 28 per cent).

Female kidney cancer rates will increase from 7.3 per 100,000 in 2007 to 8.6 per 100,000 in 2030 (increase of 18 per cent).

Male liver cancer rates will increase from 5.9 per 100,000 in 2007 to 7.5 per 100,000 in 2030 (increase of 27 per cent).

Female liver cancer rates will fall from 2.7 per 100,000 in 2007 to 2.6 per 100,000 in 2030 (a drop of two per cent).

Researchers estimate that in the 1990s, HRT use caused about 20,000 breast cancer cases in the UK. 15,000 of these were caused by combined HRT.

The National Awareness and Early Diagnosis Initiative - NAEDI - is a public sector/third sector partnership between the Department of Health, National Cancer Action Team, and Cancer Research UK.

The role of NAEDI is to coordinate and provide support to activities and research that promote the earlier diagnosis of cancer by improving symptom awareness among the public, encourage prompt visits to the doctor and support GPs to diagnose cancer as early as possible.