Cancer diagnoses trending upwards in the UK

King Charles, recently diagnosed with cancer himself, is now the patron of Cancer Research UK: the world's leading independent cancer charity. We thought we’d put in a call to them to talk us through the latest trends and statistics in this country. Jon Shelton, head of cancer intelligence at Cancer Research UK, spoke with Chris Smith…

Jon - It's a bit of a mixed picture, really. We have an ageing and growing population, so the number of new cases that we are seeing each year is increasing. Currently, we see about 375,000 new cancer cases diagnosed every year across the UK, but we project that this is going to rise over the coming years, up to around half a million cases per year by 2040. But when we account for the changing population, it's more useful to look at age standardised rates, and we're starting to see signs of falling after seeing it rise to a peak in about 2012 about 10 years ago. This is very much influenced by the largest four cancer sites: breast, lung, colorectal, and prostate cancer. These four cancers themselves account for just over half of all cancers. If we take those cancers out, overall rates over the last 25 years have been pretty steady. There's lots of different reasons and causes behind trends in each one. Lung cancer, for example, has been falling for men for decades and only more recently for females, but that's very reflective of historical smoking prevalence. There's different things that are happening, more we can do, and things like smoke-free legislation, which will help accelerate this decrease over coming years.

Chris - In summary, we're seeing a downward trend in rates of cancer among younger people but, because we have an ageing population overall, we still see enormous numbers of cancers. In some respects, some reasons to be quite pleased because we are seeing those improvements which probably also reflect a number of lifestyle factors, doesn't it? With reduced smoking rates, perhaps better living conditions which are helping a bit. But what are jumping out as the main concerns for you? Are there any areas where things are not going in the right direction?

Jon - As I said, it is a mixed picture. We are seeing increases in some sites such as liver cancer, kidney, thyroid (which have seen jumps of about 25% over the last decade.) Generally, these are smaller cancer sites, but any of these sites that are showing this change, we really need to understand what's happening. That's the importance of research, understanding what's the cause behind these changes? Is it associated with preventable risk factors? Are there genetic links? What's really causing this growth in these cancers? As we make progress with, say, smoking, there are other areas like overweight and obesity which is the largest preventable risk factor after smoking. Relatively speaking, we've got a high prevalence of overweight and obesity in the UK compared to other European countries. There are other concerns that we have as well. We're seeing increases in some cancer sites in earlier ages, colorectal cancer of about 30% over the last decade in people under 50. Some of that might actually be because of better awareness of symptoms. It might be about better diagnosis: we've got the faecal immunochemical test (FIT) which is used for screening but can be used in younger people who present at their GP with symptoms. But it also can be more concerning aspects. For example, changes in our diet. This leads to changes in bacteria in our gut. Again, it's that research that's really important: understanding what is causing these changes, what is causing these increases so that we can try to understand and try to reverse the trends we are seeing.

Chris - Are you referring here though to cases, modalities, or both? In other words, if we're seeing more cases of cancer, that's a worry, but if we're much better at picking them up and dealing with them and curing people, then that's arguably a reason to be very pleased.

Jon - So, mortality rates, we have seen some really good progress. Cancer survival, for example, has doubled and this therefore is reflected in mortality. Yes, we might be diagnosing more people, we might be seeing that slight increase in rates, but we have seen this reduction in mortality. It's about 1% per year over the last decade. For example, in that 35-69 year-old group, we've seen a reduction of about a third over the last 25 years, which is fantastic progress and we've seen that over a lot of cancer sites. But despite these improvements, there's still a lot more to go. We've still got around one in four deaths in the UK caused by cancer. We've really got to focus on how we can reduce cancer mortality, whether that's through prevention, whether it's through early detection and diagnosis, or indeed developing those new treatments to help improve outcomes for patients when they are diagnosed with it.

Chris - Presumably it does help when high profile people talk about their diagnosis and their treatment and so on. That must also stimulate behavioural change in the population around risk factors, but also maybe make people more disease aware so they are more likely to avail themselves of screening opportunities and so on?

Jon - It's always sad to hear the news of anyone diagnosed with cancer and a cancer diagnosis is one that can be difficult to share with family and loved ones, let alone the public. But when well-known figures do share that cancer diagnosis it leads to a much greater awareness of cancer in general. This can lead to positively affecting people's behaviour. When Jade Goody, for example, was diagnosed and very sadly died with cervical cancer, the discussion in public led to a much larger uptake of cervical screening, which was hugely positive coming out of such a sad story. We've seen it with Dame Deborah James in her discussions and being so clear in her communication about her bowel cancer which didn't just raise awareness of bowel cancer, but of cancer in general and gave strength to so many people in going through that diagnosis and treatment. And we're seeing it more recently: we've had the King and Princess announcing bravely, sharing the news of their cancer diagnoses this year. It leads to that discussion, that greater awareness about cancer and reinforces those messages that we can give to people that you know your body best and reminding people to seek help from their doctor if there's a change in their body that does concern them.