Oral cancer registrations - WMCA

Directly age-standardised registration rate for oral cancer (ICD-10 C00-C14), in persons of all ages, per 100,000 2013 European Standard Population ## Rationale Tobacco is a known risk factor for oral cancers (1). In England, 65% of hospital admissions (2014–15) for oral cancer and 64 % of deaths (2014) due to oral cancer were attributed to smoking (2). Oral cancer registration is therefore a direct measure of smoking-related harm. Given the high proportion of these registrations that are due to smoking, a reduction in the prevalence of smoking would reduce the incidence of oral cancer. Towards a Smokefree Generation: A Tobacco Control Plan for England states that tobacco use remains one of our most significant public health challenges and that smoking is the single biggest cause of inequalities in death rates between the richest and poorest in our communities (3).In January 2012 the Public Health Outcomes Framework was published, then updated in 2016. Smoking and smoking related death plays a key role in two of the four domains: Health Improvement and Preventing premature mortality (4). References:(1) GBD 2013 Risk Factors Collaborators. Global, regional and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risk factors in 188 countries, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013. The Lancet 2015; 386:10010 2287–2323. (2) Statistics on smoking, England 2016, May 2016; http://content.digital.nhs.uk/catalogue/PUB20781 (3) Towards a Smokefree Generation: A Tobacco Control Plan for England, July 2017 [https://www.gov.uk/government/publications/towards-a-smoke-free-generation-tobacco-control-plan-for-england] (4) Public Health Outcomes Framework 2016 to 2019, August 2016; [https://www.gov.uk/government/publications/public-health-outcomes-framework-2016-to-2019] ## Definition of numerator Cancer registrations for oral cancer (ICD-10, C00-C14) in the calendar years 2007-09 to 2017-2019. The National Cancer Registration and Analysis Service collects data relating to each new diagnosis of cancer that occurs in England. This does not include secondary cancers. Data are reported according to the calendar year in which the cancer was diagnosed. ## Definition of denominator Population-years (ONS mid-year population estimates aggregated for the respective years) for people of all ages, aggregated into quinary age bands (0-4, 5-9,…, 85-89, 90+). ## Caveats Reviews of the quality of UK cancer registry data 1, 2 have concluded that registrations are largely complete, accurate and reliable. The data on cancer registration ‘quality indicators’ (mortality to incidence ratios, zero survival cases and unspecified site) demonstrate that although there is some variability, overall ascertainment and reliability is good. However cancer registrations are continuously being updated, so the number of registrations for each year may not be complete, as there is a small but steady stream of late registrations, some of which only come to light through death certification. 1. Huggett C (1995). Review of the Quality and Comparability of Data held by Regional Cancer Registries. Bristol: Bristol Cancer Epidemiology Unit incorporating the South West Cancer Registry. 2. Seddon DJ, Williams EMI (1997). Data quality in population based cancer registration. British Journal of Cancer 76: 667-674. The data presented here replace versions previously published. Population data and the European Standard Population have been revised. ONS have provided an explanation of the change in standard population (available at [http://www.ons.gov.uk/ons/guide-method/user-guidance/health-and-life-events/revised-european-standard-population-2013--2013-esp-/index.html ])