Cancer survival rates - trends

Cancer Survival for common cancers

Cancer survival improved steadily for most cancers in both sexes between 1986 and 1999 (also see Ten-year survival).

For men, five-year survival increased between 1986 and 1999 for 13 of 16 cancers examined and the average increase every five years was statistically significant for 11 of these.

For women, five-year survival increased for 13 of the 17 cancers examined over the same period and the average increase every five years was statistically significant for 11 of these (in Figure 4.1 the solid bars show statistically significant change while the outline bars show where changes are not significant).

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Figures 4.2 to 4.11 below show the relative survival curves up to ten years after diagnosis for patients diagnosed 1986-1990, 1991-1995, 1996-1999, and estimated survival for patients alive at some point during 2000-2001 using  period analysis.

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 Cancer Survival - Prostate cancer

The most rapid increase in five-year survival in men was for prostate cancer. Five-year relative survival rates increased by an average of 12% every five years between 1986 and 1999, from 42% to 65%.

Figure 4.2 shows the age-standardised relative survival in men diagnosed with prostate cancer in England and Wales from 1986-1999.

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These rapid increases should be interpreted with caution. Widespread use of PSA testing (Prostate Specific Antigen) blood tests has led to the diagnosis and treatment of many asymptomatic prostatic cancers that might never have been diagnosed in life 1. This has led to a rapid increase in recorded incidence of prostate cancer and a change in the clinical spectrum of reported disease.

Prostate cancer is now the most commonly diagnosed cancer in UK men, with almost 35,000 cases diagnosed each year. Since the PSA test detected asymptomatic tumours have an inherently excellent prognosis, population-based survival rates have increased.

These trends are not an artefact but reflect a shift in the biological spectrum of prostate tumours now being detected and treated as a result of new diagnostic techniques 2.

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 Cancer Survival - Colon and Rectum cancers

Cancer of the large bowel (colon and rectum) is the third most common type of cancer in the UK with around 36,000 people diagnosed each year. There have been substantial improvements in five-year survival rates for cancers of the colon and rectum in both men and women with the latest rates approaching 50%.

On average, increases in five-year survival of around 4% every five years for colon cancer and around 5-6% for cancer of the rectum occurred in both men and women.

Figure 4.3 shows age-standardised relative survival in men diagnosed with colon cancer in England and Wales from 1986-1999.

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Figure 4.4 shows age-standardised relative survival in women diagnosed with colon cancer in England and Wales from 1986-1999.

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Figure 4.5 shows the age-standardised relative survival in men diagnosed with rectal cancer, England and Wales, 1986-1999.

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Figure 4.6 shows the age-standardised relative survival in women diagnosed with rectal cancer, England and Wales, 1986-1999.

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Cancer Survival - Breast cancer

In women the largest improvements in survival after rectal cancer were for breast cancer. As it is newly diagnosed in over 44,000 women each year in the UK, even small improvements in breast cancer survival rates will benefit thousands of women.

Five-year relative survival rates for breast cancer increased by an average of 6% every five years between 1986-1999 to 77%. The breast cancer survival section has survival rates for 2001-2003.

Figure 4.7 shows the age-standardised relative survival in women diagnosed with breast cancer, England and Wales, 1986-1999.

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 Cancer Survival - Cancers with no improvement

For a small group of cancers there were small falls in survival between 1986 and 1999.

Survival from brain tumours for both men and women fell slightly but steadily over the 1990s; possible explanations for this fall are outlined elsewhere 8.

The significant fall in the five-year survival rate for bladder cancer in women is likely to be the result of changes in coding practice. Some cases classified and coded previously as invasive bladder cancer are now coded as carcinoma in situ of the bladder or neoplasms of uncertain or unknown behaviour of the bladder. This has led to a fall in the recorded incidence of invasive bladder cancer, and has led to the reduction in survival.

There were no significant changes in the survival rates for multiple myeloma, oesophageal cancer, and cervical cancer, in women between the two periods 1985-1990 and 1996-1999 and, no significant change for laryngeal, lung, and bladder cancer, in men.

Survival estimates based on period analysis for 2000-2001 are slightly higher for most cancers than the complete survival estimates for patients diagnosed during 1996-1999.

The five-year survival rates predicted from survival experience during 2000-2001 suggest that the improvements observed over the period 1986-1999 are likely to continue.

In addition to variations in five-year survival by cancer type, there are large differences in survival beyond five years. For cancers of the colon and rectum ten-year survival rates are very similar to those at five years ( Figures 4.3 to 4.6), indicating that the life expectancy of patients who reach the fifth anniversary of diagnosis is similar to that of the general population.

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However, survival rates in men with prostate cancer and women with breast cancer continue to fall steadily beyond five years after diagnosis ( Figures 4.2 and 4.7), indicating that these patients continue to have an increased risk of death, compared to the general population.

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For some cancers the survival rates have increased to such high levels that further gains may be difficult to make, for example malignant melanoma in women ( Figure 4.8 and 4.9) and testicular cancer ( Figure 4.10).

Figure 4.8 shows the age-standardised relative survival in men diagnosed with malignant melanoma , England and Wales, 1986-1999.

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Figure 4.9 shows the age-standardised relative survival in women diagnosed with malignant melanoma, England and Wales, 1986-1999.

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Figure 4.10 shows the age-standardised relative survival in men diagnosed with testicular cancer, England and Wales, 1986-1999.

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Figure 4.11 shows the age-standardised relative survival in women diagnosed with ovarian cancer, England and Wales, 1986-1999.

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