Mortality trends over the last decade in the UK vary by cancer type and sex.[1-3] Mortality rates have decreased for twelve of the twenty cancer types in males and eleven in females. Apart from female lung cancer, all four of the most common causes of cancer deaths in the UK – male lung, bowel, female breast and prostate cancers – have seen decreases in mortality in the last decade.
The 20 Most Common Causes of Cancer Death, Percentage Change in European Age-Standardised Three-Year Average Mortality Rates, Males, UK, 2001-2003 and 2010-2012
The 20 Most Common Causes of Cancer Death, Percentage Change in European Age-Standardised Three-Year Average Mortality Rates, Females, UK 2001-2003 and 2010-2012
The largest falls in mortality have occurred for stomach cancer (age-standardised (AS) mortality rates decreasing by 35% and 30% in males and females, respectively, in the last decade),[1-3] reflecting similar decreases in incidence. Much of the decrease in incidence and mortality can be attributed to a decline in the prevalence of Helicobacter pylori, an increase in fresh food in the diet, and possible changes in coding and diagnostic practices.[4,5]
Other cancers showing large decreases in mortality in the last decade include cervical cancer (AS mortality rate decreasing by 21% in the last decade, with much of this decrease being attributed to screening), laryngeal cancer in males (25% decrease), and ovarian cancer (20% decrease).[1-3]
Even though prostate cancer has shown one of the biggest increases in incidence in the last decade (with AS incidence rates rising by 16% between 2000-2002 and 2009-2011), the AS mortality rate has fallen by more than a tenth (13%) over the last ten years.[1-3] The impacts of prostate-specific antigen (PSA) testing makes it difficult to untangle the reasons for the decrease in mortality. PSA testing leads to the over-diagnosis of some latent, non-lethal tumours, and accordingly some deaths in the early years of PSA testing around the early 1990s were erroneously attributed to prostate cancer, so mortality rates were artefactually increased. To an extent, the subsequent decrease in mortality rates may just represent a return to the background trend that would have been observed if PSA testing had not been used. It may also represent PSA testing affording earlier diagnosis and therefore more successful treatment, leading to a genuine decrease in mortality rates.[6-11]
Some cancers have seen increases in mortality over the past decade, which often reflect increases in incidence where there has been little or no improvement in survival.
Although mortality from liver cancer is rare in the UK (AS mortality rates are 6 and 3 per 100,000 males and females, respectively), it has shown the biggest rise in mortality in the last decade (with AS mortality rates increasing by 44% and 50% in males and females, respectively).
In females, the second biggest increase is from uterine cancer; this cancer also has a small mortality burden (4 per 100,000 females), and the AS mortality rate has increased by 15% in the last decade.[1-3]
Despite malignant melanoma being the second-fastest increasing cancer in both males and females in the last decade (with AS incidence rates rising by 57% and 39%, respectively, between 2000-2002 and 2009-2011), the increases in mortality are much less pronounced (with AS mortality rates rising by 20% and 2% in males and females, respectively, between 2001-2003 and 2010-2012).[1-3]
The third biggest increase in mortality in females and the fourth biggest in males is from cancer of other digestive organs, with the AS mortality rates rising by 11% and 13%, respectively, in the last decade. Cancer of other digestive organs include the spleen, unspecified parts of the intestinal tract, and overlapping and ill-defined sites within the digestive system. Since death certificates are often less specific than cancer registrations, many more deaths than cases are recorded for this site; mortality from this cancer is still very rare, however (4 and 3 per 100,000 males and females, respectively).[1-3]