Statistical Release

An update of cancer incidence in Scotland is published on the web today. These statistics are published by NHS National Services Scotland, Information Services (ISD) and are available at the following address:  

http://www.isdscotland.org/cancer

The updated figures show cancer incidence (1980-2003) for each cancer site and replace information previously available on the ISD Scotland website.

Key points:

• Around 12,600 males and 13,300 females were diagnosed with cancer (excluding non-melanoma skin cancer) in 2003.  These figures are similar to 2002 but may increase slightly due to the continuing accrual of late registrations.
• Over the last decade (1993-2003) age-standardised incidence of cancer has fallen steadily in men (significant 11% decrease) and has begun to fall in women (significant 3.5% decrease)¹.  Note however that due to an ageing population the number of cases of cancer diagnosed has risen.
• Lung cancer is the most common cancer in men and the second most common cancer in women.  The long-term decline in men has continued with a significant fall in incidence of 27% in the last ten years.  In women, the increasing trend in incidence may have reached a peak as there was no significant change in the last ten years.
• Breast cancer is the most common cancer in women.  Incidence continues to rise with a significant 10% increase in the last ten years.
• Prostate cancer is the second most common cancer in men.  Incidence continues to rise with a significant 9.5% rise in the last decade. At least in part, this may represent an increase in detection through use of the prostate specific antigen (PSA) test rather than a genuine increase in the risk of developing the disease. 
• Colorectal cancer is the third most common cancer in both men and women.  Incidence in men is unchanged in the last ten years whilst incidence in women has fallen significantly with an 11% decrease in ten years.
• Stomach cancer is the 7th most common cancer in men and the 9th most common cancer in women.  Incidence continues to fall significantly with decreases over the last ten years of 27% and 28% in men and women respectively.
• Malignant melanoma of the skin is the 11th most common cancer in men and the 6th most common in women.  Incidence continues to increase significantly in both men and women with rises of 36% and 13% respectively over the last ten years.  
• Non-melanoma skin cancer is not routinely included in cancer incidence figures as there is a degree of under recording.  Around 3,900 cases were recorded in men in 2003 and 3,500 cases in women.  Incidence is rising steeply in both men and women with increases of 25% and 32% respectively over the last ten years. 
• The decline in bladder cancer incidence since 1997 is an artefact due to a change in coding practice across cancer registries in the UK.  Around a quarter of bladder tumours are no longer coded as invasive bladder cancers.  This also impacts on the figures for all cancers.

¹  All ten-year changes in incidence have been estimated using Poisson regression.

Background

1. Although cancer registrations are believed to beessentiallycomplete(>95%) for the year 2003, it is important to note that the cancer registration database is dynamic.  In common with cancer registries in other countries, cancer incidence rates in Scotland can take up to five years after the end of a given calendar year to reach 100% completeness and stability due to the continuing accrual of late registrations coming to light, for example through death certification.  At this stage, it may be misleading to focus too much attention on any apparent changes in incidence between 2002 and 2003.  It is more informative to examine trends in incidence observed over a number of years.  Striking changes from one year to the next may occur in the case of rare cancers, but these are likely to reflect random fluctuation caused by small numbers of cases - in such cases, it is even more important to examine incidence rates for a number of years aggregated together, rather than focusing on a single year of incidence.
2. Data on cancer incidence were previously published from 1975 onwards and data on cancer mortality from 1979 onwards.  Data for both incidence and mortality are now published from 1980 onwards.   Earlier data are available on request.
3. This is an ISD National Statistics release. National Statistics are produced to high professional standards and adhere to codes of practice. They undergo regular quality assurance reviews to ensure that they meet customer needs. They are produced free from any political interference.
4. ISD Scotland is a division of NHS National Service Scotland.  ISD collects, collates and maintains a wide range of health service data sets, which form the national corporate database for NHSScotland. By providing information, statistical services and effective use of information management and technology, ISD contributes to health improvement by informing decision-making, research and debate within the NHSScotland, government departments and other organisations. 

For more information about ISD Scotland see the website at: http://www.isdscotland.org/isd/

For further information contact :

Dr David Brewster
Director of the Scottish Cancer Registry
David.Brewster@isd.csa.scot.nhs.uk 
phone 0131 275 6092

Fiona Campbell
Principal Statistician
Epidemiology and Statistics Group
Fiona.Campbell@isd.csa.scot.nhs.uk
phone 0131 275 6125

Main contact: Fiona Campbell

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