This release provides details of the number of cancer cases diagnosed each year, along with incidence rates from 1993 to 2020 for all cancers combined and a wide range of cancer types. The number of cases and rates for a range of geographic areas is also available. Survival trends by cancer type and prevalence (the number of people alive) for these cancers is also provided.

Key facts and figures are presented below.

Cancer incidence

• There were 9,843 (4,968 male, 4,874 female) patients diagnosed with cancer each year during 2016-2020.

• This excludes the frequently diagnosed but easily treated non-melanoma skin cancer (NMSC). There were on average 3,841 cases of NMSC diagnosed each year.

• The most common cancer types diagnosed during 2016-2020 were:

o Among men: Prostate cancer (1,259 cases per year, 25% of all male cancers ex NMSC), lung cancer (697 cases per year, 14%) and bowel cancer (651 cases per year, 13%);

o Among women: Breast cancer (1,457 cases per year, 30% of all female cancers ex NMSC), lung cancer (657 cases per year, 13%) and bowel cancer (515 cases per year, 11%).

• Cancer risk was strongly related to age with 34% of cases occurring among people aged 75 years and over. Incidence rates were greatest for those aged 85-89 years.

• Despite this younger people can still get cancer. On average 49 children (aged 0-14) were diagnosed with cancer each year.

• The odds of developing cancer by age 85 was 1 in 2.3 (2.1 for men, 2.5 for women).

• The average number of cancer cases (ex. NMSC) per year increased by 8% from 9,125 cases in 2011-2015 to 9,843 cases in 2016-2020. These increases are largely due to the ageing population. The percentage increase was similar for men and women.

• Cancer types with increases greater than 20% in the average number of cases per year between 2011-2015 and 2016-2020 were:

o For men: Thyroid cancer (77% increase), myeloma (34% increase) and pancreatic cancer (22% increase);

o For women: Thyroid cancer (82% increase), gallbladder cancer (26% increase), myeloma (22% increase) and lung cancer (20% increase).

• Incidence rates (age-standardised) of cancer in 2016-2020 were 7% higher among people living within the Belfast Health and Social Care Trust area compared to the Northern Ireland average. Incidence rates were lower than average among people living in the South-Eastern and Northern Trust areas.

• Cancer incidence rates were 13% higher in the most deprived areas compared to the Northern Ireland average and were 6% lower than average in the least deprived areas.

• The relationship with deprivation varies by cancer type with incidence of lung, head & neck, oesophageal, stomach, liver (male only) and cervical cancers higher than average in the most deprived areas. Incidence of melanoma, prostate cancer and lymphoma were higher than average in the least deprived areas.

• During 2016-2020 the proportion of patients diagnosed with late stage disease (stage IV) ranged from 3% for melanoma patients to 50% for pancreatic cancer patients.

• For the four most common cancer types the proportion of patients diagnosed at stage IV during 2016-2020 was 44% for lung cancer, 21% for bowel cancer, 18% for prostate cancer and 5% for female breast cancer.

Cancer survival

• Among patients diagnosed with cancer during 2011-2015, one-year net survival after diagnosis was 73%, while five-year net survival was 57%. However, one in five (20%) patients died within 6 months of diagnosis.

• Five-year net survival for patients diagnosed in 2011-2015 for the most common cancers was as follows:

o Female breast cancer = 84%;

o Male bowel cancer = 62%, Female bowel cancer = 62%;

o Prostate cancer = 87%;

o Male lung cancer = 12%, Female lung cancer = 17%.

• Five-year net survival was highest for testicular cancer (93%) and melanoma (93%), but remained poor for gallbladder cancer (15%), liver cancer (14%) and pancreatic cancer (8%).

• Cancer survival improved significantly between 2006-2010 and 2011-2015, with five-year survival increasing among men from 53% to 55% and among women from 56% to 59%.

• There were significant improvements in five-year survival between 2006-2010 and 2011-2015 for male bowel cancer, male liver cancer, female lung cancer and female kidney cancer. No cancer type demonstrated significant reductions in cancer survival during his period.

• Cancer survival varies considerably depending upon age at diagnosis. For the four most common cancer types five-year survival for younger and older age groups diagnosed in 2011-2015 was as follows:

o Breast cancer: 90% for 15-54 year olds, compared to 71% for 75+ year olds;

o Bowel cancer: 66% for 15-54 year olds, compared to 50% for 75+ year olds;

o Lung cancer: 25% for 15-54 year olds, compared to 7% for 75+ year olds;

o Prostate cancer: 94% for 15-54 year olds, compared to 74% for 75+ year olds.

• However, stage at diagnosis remains the biggest factor in cancer survival. The contrast in five-year survival between early and late stage disease for patients diagnosed in 2011-2015 was as follows:

o 20% for late stage breast cancer, compared to 99% for early stage;

o 8% for late stage bowel cancer, compared to 95% for early stage;

o 1% for late stage lung cancer, compared to 50% for early stage;

o 45% for late stage prostate cancer, compared to 99% for early stage.

• At the end of 2020 there were 69,168 people living in Northern Ireland who had been diagnosed with cancer since 1996 (i.e. over the last 25 years). Of these, 45% were male, 34% were aged 75 and over and 10% had been diagnosed in the previous year.

• The most prevalent types of cancer were prostate cancer with 12,056 men living with the disease, and breast cancer with 17,135 women living with the disease.

Impact of Covid-19 on cancer incidence and survival

Due to the Covid-19 pandemic, which began in 2020, a further report has been compiled detailing how incidence and survival from cancer has changed between April-December 2018-2019 and 2020 thereby providing an overview of the impact of the pandemic on cancer patients and cancer services in general. Key facts and figures from this report are presented below.

· The number of cases of cancer (ex NMSC) diagnosed decreased by 13% from 7,724 per year in Apr-Dec 2018-2019 to 6,748 in Apr-Dec 2020. The decrease was similar among females (14% decrease) and males (11% decrease).

· The number of cancers (ex NMSC) diagnosed among people aged 0 to 54 decreased by 19% from 1,359 per year in Apr-Dec 2018-2019 to 1,106 in Apr-Dec 2020. Between the same two time periods the number of cases among people aged 75 and over decreased by 8% from 2,617 per year to 2,416.

· Between Apr-Dec 2018-2019 and Apr-Dec 2020 the number of cases of:

o Female breast cancer decreased 11% from 1,118 cases per year to 995;

o Lung cancer decreased 7% from 1,029 cases per year to 952;

o Prostate cancer decreased 14% from 1,035 cases per year to 885;

o Colorectal cancer decreased 12% from 906 cases per year to 797.

· The proportion of cancer cases diagnosed at Stage I decreased from 29% in Apr-Dec 2018-2019 to 25% in Apr-Dec 2020, while the proportion of cases diagnosed with stage IV disease increased from 21% to 23%. This represents a significant shift towards diagnosis at a later stage in 2020.

· The proportion of cancer patients receiving treatment within six months of diagnosis decreased from 71% among those diagnosed in Apr-Dec 2018-2019 to 67% among those diagnosed in Apr-Dec 2020. Specifically:

o The proportion receiving surgery decreased from 41% to 38%, while the proportion receiving radiotherapy decreased from 24% to 22%.

o The proportion of patients receiving chemotherapy or hormone therapy did not change significantly between the two time periods.

· Observed survival (which considers death from any cause) among cancer patients one month after diagnosis decreased from 94% among those diagnosed in Apr-Dec of 2018-2019 to 92% among those diagnosed in Apr-Dec of 2020, while three-month survival decreased from 87% to 83%.

· During 2020 there were a total of 403 deaths from Covid-19 among cancer patients diagnosed at any point since 1993. Among the patients who died of Covid-19, 70 were diagnosed with cancer in 2020, while 45 were diagnosed in 2019.

Media

Media inquiries to Sian Devlin at s.devlin@qub.ac.uk