Lung cancer incidence statistics

Lung cancer is the second most common cancer in the UK (2012), accounting for 13% of all new cases. It is the second most common cancer in both males (14% of all male cases) and females (12% of all female cases).[1-4]

In 2012, there were 44,488 new cases of lung cancer in the UK: 24,005 (54%) in men and 20,483 (46%) in women, giving a male:female ratio of around 12:10.[1-4] The crude incidence rate Open a glossary item shows that there are 77 new lung cancer cases for every 100,000 males in the UK, and 63 for every 100,000 females.

The European age-standardised incidence rates Open a glossary item (AS rates) are significantly higher in Scotland compared with the other constituent countries of the UK for both males and females. For females only, rates are significantly lower in England compared with the other GB countries.[1-4]

Lung Cancer (C33-C34), Number of New Cases, Crude and European Age-Standardised (AS) Incidence Rates per 100,000 Population, UK, 2012

England Wales Scotland Northern Ireland UK
Male Cases 19,547 1,251 2,573 634 24,005
Crude Rate 74.2 82.9 99.8 70.9 76.7
AS Rate 93.2 92.4 120.7 101.0 95.7
AS Rate - 95% LCL 91.9 87.3 116.1 93.2 94.5
AS Rate - 95% UCL 94.5 97.5 125.4 108.9 96.9
Female Cases 16,356 1,121 2,497 509 20,483
Crude Rate 60.2 71.7 91.2 54.8 63.2
AS Rate 63.6 69.3 92.1 64.4 66.5
AS Rate - 95% LCL 62.6 65.2 88.5 58.8 65.6
AS Rate - 95% UCL 64.6 73.3 95.7 70.0 67.4
Persons Cases 35,903 2,372 5,070 1,143 44,488
Crude Rate 67.1 77.2 95.4 62.7 69.8
AS Rate 76.3 78.8 104.0 79.3 78.9
AS Rate - 95% LCL 75.5 75.6 101.2 74.7 78.2
AS Rate - 95% UCL 77.1 82.0 106.9 83.9 79.7

95% LCL and 95% UCL are the 95% lower and upper confidence limits Open a glossary item around the AS rate Open a glossary item

ASR calculated with ESP2013. Not comparable with ASRs calculated with ESP1976.

Lung cancer incidence rates in Scotland are among the highest in the world,[5] reflecting the country’s history of high smoking prevalence.[6] Scotland is the only UK nation where lung cancer remains overall the most common cancer.[1-4] Lung cancer incidence is generally higher in urban than rural areas of Scotland, mainly due to higher smoking prevalence in urban areas.[7] For example, lung cancer incidence in Greater Glasgow & Clyde NHS Board is almost almost a third higher than the Scotland average (2007-2011) and smoking prevalence in this region is among the highest of all Scottish NHS boards.[8,9] Asbestos exposure among shipbuilding industry workers in this region may also have contributed to the higher lung cancer incidence rate.[10]

A north-south divide in lung cancer incidence has existed in Great Britain since at least the 1990s.[11,12] The latest analysis of lung cancer incidence rates throughout England reports significant variation across the UK, with the highest rates being in the north of England and lowest rates being in the east, south-east and south-west,[13,14] reflecting regional variation in smoking prevalence.[15]

References

  1. Data were provided by the Office for National Statistics on request, July 2014. Similar data can be found here:
    http://www.ons.gov.uk/ons/rel/vsob1/cancer-statistics-registrations--england--series-mb1-/index.html.
  2. Data were provided by ISD Scotland on request, April 2014. Similar data can be found here: http://www.isdscotland.org/Health-Topics/Cancer/Publications/index.asp.
  3. Data were provided by the Welsh Cancer Intelligence and Surveillance Unit on request, April 2014. Similar data can be found here:
    http://www.wales.nhs.uk/sites3/page.cfm?orgid=242&pid=59080.
  4. Data were provided by the Northern Ireland Cancer Registry on request, June 2014. Similar data can be found here:
    http://www.qub.ac.uk/research-centres/nicr/CancerData/OnlineStatistics/.
  5. Parkin DM, Whelan SL, Ferlay J, et al. Cancer Incidence in Five Continents Volume VIII. IARC Scientific Publications.Vol. 155. Lyon, France: International Agency for Research on Cancer, 2002.
  6. Scottish Executive Health Department. Cancer Scenarios: An aid to planning cancer services in Scotland in the next decade. Edinburgh: The Scottish Executive, 2001.
  7. Pearce J, Boyle P. Is the urban excess in lung cancer in Scotland explained by patterns of smoking? Soc Sci Med 2005;60(12):2833-43.
  8. ISD Scotland. Cancer statistics. Lung cancer and mesothelioma 2007-2011. Accessed February 2013.
  9. Scottish Public Health Observatory. ScotPHO Tobacco Profiles 2013. NHS Board & CHP Overview. Edinburgh: ISD Scotland, 2013.
  10. De Vos Irvine H, Lamont DW, Hole DJ, et al. Asbestos and lung cancer in Glasgow and the west of Scotland. BM 1993;306(6891):1503-6
  11. Quinn M, Wood H, Cooper N, et al, eds. Cancer Atlas of the United Kingdom and Ireland 1991-2000. Studies on Medical and Population Subjects No. 68. London: ONS; 2005.
  12. Quinn M, Babb P, Brock A et al. Cancer Trends in England & Wales 1950-1999. (PDF 5897KB) SMPS No. 66: TSO, 2001.
  13. National Cancer Intelligence Network (NCIN). Cancer e-Atlas. Accessed December 2013.
  14. National Cancer Intelligence Network (NCIN). Cancer Incidence and Mortality by Cancer Network, UK, 2005. London: NCIN; 2008.
  15. Office for National Statistics (ONS). General Lifestyle Survey 2010. London: ONS; 2012.
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Lung cancer incidence is strongly related to age, with the highest incidence rates being in older men and women. In the UK between 2010 and 2012, an average of 43% of cases were diagnosed in men and women aged 75 and over, and almost nine in ten cases were diagnosed in those aged 60 and over.[1-4]

Age-specific incidence rates rise steeply from around age 40 and peak in the 85-89 age group. Age-specific incidence rates are similar for men and women up to age 50-54, but thereafter incidence rates are higher for males than for females, and this gap widens with increasing age. At age 55-59, the male:female incidence ratio of age-specific rates (to account for the different proportions of males to females in each age group) is around 11:10; by ages 85-89, it is around 19:10.[1-4]

Lung Cancer (C33-C34), Average Number of New Cases per Year and Age-Specific Incidence Rates per 100,000 Population, UK, 2010-2012

ASR calculated with ESP2013. Not comparable with ASRs calculated with ESP1976.

References

  1. Data were provided by the Office for National Statistics on request, July 2014. Similar data can be found here:
    http://www.ons.gov.uk/ons/rel/vsob1/cancer-statistics-registrations--england--series-mb1-/index.html.
  2. Data were provided by ISD Scotland on request, April 2014. Similar data can be found here: http://www.isdscotland.org/Health-Topics/Cancer/Publications/index.asp.
  3. Data were provided by the Welsh Cancer Intelligence and Surveillance Unit on request, April 2014. Similar data can be found here:
    http://www.wales.nhs.uk/sites3/page.cfm?orgid=242&pid=59080.
  4. Data were provided by the Northern Ireland Cancer Registry on request, June 2014. Similar data can be found here:
    http://www.qub.ac.uk/research-centres/nicr/CancerData/OnlineStatistics/.
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Lung cancer was the most common cancer in the UK until 1997, when it was overtaken by breast cancer.[1-4]

Male lung cancer incidence rates have decreased overall in Great Britain since the late-1970s, whilst female rates have increased overall.[1-3] For males, European age standardised (AS) incidence rates decreased by 45% between 1979-1981 and 2010-2012. Incidence rates in males have almost continuously fallen between 1979-1981 and 2002-2004 (by 39%). Since then the decline has been more gradual, with rates in 2010--2012 being 9% lower than those in 2002-2004. In contrast, female rates increased by 64% between 1979-1981 and 2010-2012, with the increase being less sharp in the past decade.

Lung Cancer (C33-C34), European Age-Standardised Incidence Rates per 100,000 Population, By Sex, Great Britain, 1979-2012

ASR calculated with ESP2013. Not comparable with ASRs calculated with ESP1976.

Trends in lung cancer incidence rates reflect past trends in cigarette smoking prevalence. Smoking rates peaked earlier in males than in females, so lung cancer rates in men have been decreasing for some decades, but this decrease is yet to start in women.[1-3,5,6] In 1979, the male:female ratio for lung cancer cases was around 33:10, but has since fallen sharply (12:10 in 2012).

Lung Cancer (C33-C34) European Age-Standardised Incidence Rates and Smoking Prevalence, Great Britain, 1948-2010

Chart showing smoking prevalence trends

Over the last decade (between 2001-2003 and 2010-2012), the European AS incidence rates in the UK have decreased by 11% in males, but increased by 17% in females.[1-4]

Lung Cancer (C33-C34), European Age-Standardised Incidence Rates per 100,000 Population, by Sex, UK, 1993-2012

ASR calculated with ESP2013. Not comparable with ASRs calculated with ESP1976.

Lung cancer incidence rates have decreased overall for all of the broad age groups in males in Great Britain since the late-1970s.[1-3] Differing trends by age group reflect smoking behaviour in birth cohorts. For males aged 80 and over lung cancer incidence rates increased by 13% between 1979-1981 and 1985-1987 and have since decreased by 29%. For males aged 70-79, the rate declined by 42% between 1979-1981 and 2007-2009, and have since remained stable. For males in all other age groups, rates have fallen almost continuously since the late-1970s, by 62%, 62% and 55% in the 25-49, 50-59 and 60-69 age groups, respectively, between 1979-1981and 2010-2012.

Lung Cancer (C33-C34), European Age-Standardised Incidence Rates per 100,000 Population, by Age, Males, Great Britain, 1979- 2012

ASR calculated with ESP2013. Not comparable with ASRs calculated with ESP1976.

Conversely, lung cancer incidence rates have increased overall for many of the broad age groups in females in Great Britain since the late-1970s.[1-3] Again these difference by age group reflect smoking behaviour in birth cohorts. For women aged 80 and over, lung cancer incidence rates have almost tripled since the late-1970s (173% increase between 1979-1981 and 2010-2012), and continue to increase. In the 70-79 age group, incidence rates have more than doubled since the late-1970s (108% increase between 1979-1981 and 2010-2012), though almost all of this increase took place before the late-1990s. Among women aged 60-69, rates increased by 35% overall between 1979-1981 and 2010-2012, with most of the increase occurring by the late 1980s, followed by a decrease during the 1990s and an increase since the early 2000s. Rates for females aged 25-49 decreased by 22%, and those for women aged 50-59 decreased by 8%, between 1979-1981 and 2010-2012.

Lung Cancer (C33-C34), European Age-Standardised Incidence Rates per 100,000 Population, by Age, Females, Great Britain, 1979- 2012

ASR calculated with ESP2013. Not comparable with ASRs calculated with ESP1976.

References

  1. Data were provided by the Office for National Statistics on request, July 2014. Similar data can be found here:
    http://www.ons.gov.uk/ons/rel/vsob1/cancer-statistics-registrations--england--series-mb1-/index.html.
  2. Data were provided by ISD Scotland on request, April 2014. Similar data can be found here: http://www.isdscotland.org/Health-Topics/Cancer/Publications/index.asp.
  3. Data were provided by the Welsh Cancer Intelligence and Surveillance Unit on request, April 2014. Similar data can be found here:
    http://www.wales.nhs.uk/sites3/page.cfm?orgid=242&pid=59080.
  4. Data were provided by the Northern Ireland Cancer Registry on request, June 2014. Similar data can be found here:
    http://www.qub.ac.uk/research-centres/nicr/CancerData/OnlineStatistics/.
  5. Office for National Statistics (ONS). General Lifestyle Survey 2010. London: ONS; 2012.
  6. Smoking data prior to 1974 from Wald N, Nicolaides-Bouman A. UK Smoking Statistics. 1991: OUP.
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Lifetime risk is an estimation of the risk that a newborn child has of being diagnosed with cancer at some point during their life. It is a summary of risk in the population but genetic and lifestyle factors affect the risk of cancer and so the risk for every individual is different.

In 2010, in the UK, the lifetime risk of developing lung cancer is 1 in 14 for men and 1 in 18 for women.[1]

The lifetime risk for lung cancer has been calculated by the Statistical Information Team using the ‘Adjusted for Multiple Primaries’ (AMP) method; this accounts for the possibility that someone can have more than one diagnosis of lung cancer over the course of their lifetime.[2]

References

  1. Lifetime risk was calculated by the Statistical Information Team at Cancer Research UK, 2012.
  2. Sasieni PD, Shelton J, Ormiston-Smith N, et al. What is the lifetime risk of developing cancer?: The effect of adjusting for multiple primaries. Br J Cancer 2011;105(3):460-5. 
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More than one in ten (12%) lung cancer cases are classified as small cell lung cancer (SCLC), data from the National Lung Cancer Audit (LUCADA) for England in 2011 show.[1] The remaining cases are classified as non-small cell lung cancer (NSCLC, 87%) and carcinoid (1%). There are different types of NSCLC, including squamous cell carcinoma Open a glossary item and  adenocarcinoma Open a glossary item.

References

  1. Health and Social Information Centre. National lung cancer audit report 2012 (report for the audit period 2011). Leeds; 2012.
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Staging for lung cancer describes how big the tumour has grown and whether it has spread.

Non-small cell lung cancer (NSCLC) is staged according to the TNM staging system which classifies disease as Stage I, II, III or IV, whilst small cell lung cancer (SCLC) has historically been staged using the Veterans’ Administration Lung Study Group definitions, which divides SCLC into limited stage or extensive stage disease. However, it has been proposed that the TNM staging system should be adopted for the future staging of SCLC.[1]

The majority (49%) of patients diagnosed with lung cancer present at Stage IV or SCLC-extensive.[2] More people are diagnosed at an advanced stage (69% are diagnosed at Stages III or IV or SCLC-extensive) than an early stage. Similar data have been reported from the former Anglia Cancer Network.[3]

Lung Cancer (C33-C34), Proportion of Cases Diagnosed at Each Stage, Adults (Aged 15-99), England and Wales, 2011

Stage Adults
Stage I 14.5%
Stage II 7.3%
Stage III 31.8%
Stage IV 35.8%
Stage Not Known 10.6%
All Stages 100.0%

References

  1. Developed for NICE by the National Collaborating Centre for Cancer. The diagnosis and treatment of lung cancer (update of NICE clinical guideline 24). Cardiff: National Collaborating Centre for Cancer; 2011.
  2. Health and Social Information Centre. National lung cancer audit report 2012 (report for the audit period 2011). Leeds; 2012.
  3. The National Cancer Registration Service, Eastern Office. Personal communication.
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Lung cancer is the fourth most common cancer in Europe, with more than 410,000 new cases diagnosed in 2012 (12% of the total). In Europe (2012), the highest World age-standardised incidence rates for lung cancer are in Hungary for men and Denmark for women; the lowest rates are in Sweden for men and Ukraine for women. UK lung cancer incidence rates are estimated to be 7th lowest in males in Europe, and seventh highest in females.[1] These data are broadly in line with Europe-specific data available elsewhere.[2]

Lung cancer is the most common cancer worldwide, with nearly 1,825,000 new cases diagnosed in 2012 (13% of the total). Lung cancer incidence rates are highest in Northern America and lowest in Middle Africa, but this partly reflects varying data quality worldwide.[2]

Variation between countries may reflect different prevalence of risk factors, use of screening, and diagnostic methods.

References

  1. Ferlay J, Soerjomataram I, Ervik M, et al. GLOBOCAN 2012 v1.0, Cancer Incidence and Mortality Worldwide: IARC CancerBase No. 11 [Internet]. Lyon, France: International Agency for Research on Cancer; 2013. Available from: http://globocan.iarc.fr, accessed December 2013.
  2. Ferlay J, Steliarova-Foucher E, Lortet-Tieulent J, et al.Cancer incidence and mortality patterns in Europe: Estimates for 40 countries in 2012. European Journal of Cancer (2013) 49, 1374-1403.
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There is evidence for a strong association between lung cancer incidence and deprivation for both males and females in England.[1] England-wide data for 2006-2010 show European age-standardised rates are 166% higher for males living in the most deprived areas compared with the least deprived, and 173% higher for females.[1] Male differences in deprivation are similar to females.

Lung Cancer (C33-C34), European Age-Standardised Incidence Rates by Deprivation Quintile, England, 2006-2010

The estimated gap in lung cancer incidence between people living in the most and least deprived areas in England has not changed in the period 1996-2010. It has been estimated that there would have been around 11,700 fewer lung cancer cases each year in England during 2006-2010 if all people experienced the same incidence rates as the least deprived.[1]

Associations with deprivation have also been investigated for mortality.

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Age-standardised rates for White males with lung cancer range from 61.1 to 62.6 per 100,000. Rates for Asian males are significantly lower, ranging from 23.1 to 37.2 per 100,000 and the rates for Black males are also significantly lower, ranging from 30.1 to 48.9 per 100,000. For females there is a similar pattern - the age-standardised rates for White females range from 35.2 to 36.0 per 100,000, while rates for Asian and Black females are also significantly lower ranging from 6.9 to 12.4 per 100,000 and 8.5 to 15.1 per 100,000 respectively.[1]

Ranges are given because of the analysis methodology used to account for missing and unknown data. For lung cancer, 155,679 cases were identified; 23% had no known ethnicity.

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Prevalence refers to the number of people who have previously received a diagnosis of cancer and who are still alive at a given time point. Some patients will have been cured of their disease and others will not.

In the UK around 38,100 people were still alive at the end of 2006, up to ten years after being diagnosed with lung cancer.[1]

Lung Cancer (C33-C34), One, Five and Ten Year Cancer Prevalence, UK, 31st December 2006

1 Year Prevalence 5 Year Prevalence 10 Year Prevalence
Male 8,958 16,977 21,197
Female 6,844 13,692 16,944
Persons 15,802 30,669 38,141

Worldwide, it is estimated that there were nearly 1.68 million men and women still alive in 2008, up to five years after their diagnosis.[2]

References

  1. National Cancer Intelligence Network (NCIN) One, Five and Ten Year Cancer Prevalence. London: NCIN; 2010.
  2. Ferlay J, Shin HR, Bray F, et al. GLOBOCAN 2008 v1.2, Cancer Incidence and Mortality Worldwide: IARC CancerBase No. 10 [Internet]. Lyon, France: International Agency for Research on Cancer; 2010. Available from http://globocan.iarc.fr. Accessed May 2011.
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