Genre: Information/Explanation

On this page: Twenty most common cancers There are more than 200 different types of cancer, but four of them - breast , lung , bowel (colorectal) and prostate - account for over half (54%) of all new cases. 1-4 Breast cancer is the most common cancer in the UK, despite the fact that it is rare in men. The 20 most commonly diagnosed cancers in the UK are shown in Figure 2.1 . 1-4 Invasive tumours of the brain and central nervous system (CNS) rank 13th highest in males and 15th highest in females; however, when the non-invasive brain and CNS tumours are also included in the total, the ranks are 11th and 8th highest, respectively (data not shown). Figure 2.2: The 10 Most Commonly Diagnosed Cancers in Males, UK, 2009 *Bowel cancer including anal cancer (C18-C21) **3% of all male cases are registered without specification of the primary site Prostate cancer , with an age-standardised rate of 106 per 100,000 males, accounts for one in four (25%) male cases ( Figures 2.2 and 2.3 ), with the next most common cancers being lung (14%; even though the rate of lung cancer has fallen dramatically since the mid-1980s) and colorectal (14%). Bladder , oesophageal and stomach cancers are among the top ten most common cancers in males, but not in females. *Bowel cancer including anal cancer (C18-C21) **4% of all female cases are registered without specification of the primary site Breast cancer , with an age-standardised rate of 124 per 100,000 women, is by far the most commonly diagnosed cancer in females, accounting for almost a third (31%) of all female cases. The next most common cancers in women are colorectal and lung , accounting for similar proportions of cases (12%) each. Two of the top ten female cancer sites are sex-specific ( uterus and ovary ), compared with just one site ( prostate ) in males. Trends over time The percentage change in incidence rates in the last decade in the UK for the top twenty cancers show varying trends by cancer site and sex ( Figures 2.6 and 2.7 ). 1-4 There have been large increases in the incidence of many cancers strongly linked to lifestyle choices, such as kidney , liver , malignant melanoma , oral and uterine . 5 It is worth noting that the decrease in bladder cancer incidence will have been affected by a change in coding practice that reduced the number of registrations of malignant bladder cancer from 2000 onwards. This change was recommended by the European Network of Cancer Registries and subsequently adopted and implemented by the United Kingdom Association of Cancer Registries (UKACR). 6 Malignant melanoma is the fastest increasing cancer in males and the second fastest increasing cancer in females (with age-standardised rates rising by 67% and 51%, respectively, in the last decade). Some of the increase may be due to increased surveillance and early detection as well as improved diagnosis, but most is considered to be real and linked to changes in recreational or holiday exposure to UV rays (including sunlight and sunbeds). 7,8 Liver cancer, though rare in the UK (age-standardised rates are 7 per 100,000 males and 3 per 100,000 females) is the second fastest increasing cancer in males and the fourth fastest in females (increases of 40% and 30%, respectively, in the last decade). Cirrhosis of the liver (caused by excessive drinking, viral infections or inherited diseases) is a major risk factor for this cancer. 9 Kidney cancer is the fourth fastest increasing cancer in males and third fastest in females (age-standardised rates have increased by 26% and 31%, respectively, in the last decade). Established risk factors for kidney cancer include cigarette smoking and obesity. 10-12 Prostate cancer is the third fastest increasing cancer in males, with age-standardised rates rising by around a third (32%) in the last decade. The use of PSA testing for prostate cancer will have contributed to the marked increase in new diagnoses of this disease. 13,14 While thyroid cancer is the fastest increasing cancer in females, with the age-standardised rate rising by more than two-thirds (68%) in the last decade, it has a small disease burden (5 per 100,000 females). Increased breast cancer incidence (and subsequent treatment) may explain some of the increase. 15 Another rapidly increasing cancer with a small disease burden in females is mesothelioma , which is not among the 20 most common cancers, but the age-standardised rate (1 per 100,000 females) has increased by 44% in the last decade. Most cases of mesothelioma are caused by occupational exposure to asbestos (often second-hand in females, for example, by handling contaminated work clothes). Mesothelioma has an extremely long latency period (up to 50 years), which means that past exposure to toxic chemicals contributes new cases of this disease. 16 In the last decade there have been large decreases in stomach cancer incidence in both males and females (age-standardised rates decreasing by 32% and 27%, respectively). Much of this can be attributed to better living conditions and a decline in the prevalence of Helicobacter pylori (a major cause of stomach cancer). 17 Other cancers showing large decreases in incidence in the last decade include lung and laryngeal in males (age-standardised rates decreasing by 16% and 14%, respectively), and ovarian in females (10% decrease). Non-melanoma skin cancer On these incidence pages 'cancer' includes all malignant neoplasms excluding non-melanoma skin cancer (NMSC). NMSCs are often excluded from cancer statistics for several reasons: studies have shown that NMSCs are greatly under-ascertained in cancer registration data (this is because they are often treated at GP surgeries or on an outpatient basis and the lack of a discharge record means that information is generally not conveyed to cancer registries); NMSCs are very common and some cancer registries only record the basal cell carcinoma primary; NMSCs are also curable in the vast majority of cases. Cancer of unknown primary Cancer of unknown primary (CUP, also known as malignancy of unknown origin or cancer registered without specification of primary site) is a diverse group of cancers that are diagnosed from one or more secondary cancers (often in the lymph nodes, liver, lung or bone) and the primary site cannot be found, or is registered without the site being specified. Some cancers are initially registered as CUP but then changed to a specific cancer if tests reveal the primary site. CUP accounts for 3% of new cancer cases. 1-4 CUP is quite rare under the age of 40, with more than half (55%) of cases being diagnosed in persons aged 75 and over. There is no standard definition of CUP, which means that the true incidence of this disease may be underestimated. A recent NICE guideline stated that the majority can be defined by the ICD-10 codes C77-C80. 18 Variation in the UK Across the UK, the lowest age-standardised rates are seen in England for both sexes (424 and 367 per 100,000 males and females, respectively), and the highest in Scotland (452 and 407 per 100,000, respectively). 1-4 The numbers of new cases and incidence rates are summarised by cancer site and country in the UK Countries Summary Table: Numbers of Cases and Rates. England The incidence of colorectal cancer is significantly lower in males compared with the three other UK countries, with incidence rates ranging from 57 per 100,000 in England to 68 per 100,000 in Scotland; colorectal cancer incidence is also lowest in females in England, though the differences between the countries are not significant (rates ranging from 38 per 100,000 in England to 45 per 100,000 in Scotland). Other sites with the lowest incidence rates in England include lung cancer in males and cervix in situ. Very few cancers have particularly high incidence rates in England in comparison with the rest of the UK. Wales The incidence rates for nearly all cancers in Wales show no significant differences in comparison with the three other UK countries. Cancers with the highest rates include leukaemia in males (with rates ranging from 11 per 100,000 in Northern Ireland to 15 per 100,000 in Wales) and ovarian (rates ranging from 16 per 100,000 in Northern Ireland to 19 per 100,000 in Wales). Scotland The high prevalence of smoking in Scotland (25%, compared with 20% in England 19 ) means that smoking-related cancers have particularly high incidence rates. Lung cancer incidence is significantly higher in Scotland in comparison with the rest of the UK, with incidence rates in males ranging from 56 per 100,000 in England to 81 per 100,000 in Scotland, and in females from 38 per 100,000 in England to 57 per 100,000 in Scotland. Oral cancer incidence is also significantly higher in Scottish men, with incidence rates ranging from 11 per 100,000 in England to 17 per 100,000 in Scotland. The incidence of malignant melanoma is highest in males and females living in Scotland in comparison with the rest of the UK (though the incidence rates are not significantly higher). A survey of children and young people found that Scotland has the highest percentage of young sunbed users in Great Britain (almost 14%). 7 Prostate cancer has a significantly lower incidence rate in Scotland in comparison with the three other UK countries, with rates ranging from 87 per 100,000 in Scotland to 114 per 100,000 in Northern Ireland. Some of this variation may be explained by differences in the availability and uptake of prostate-specific antigen (PSA) testing across the UK. 13 Northern Ireland The incidence of non-Hodgkin lymphoma is significantly higher in Northern Ireland in comparison with the rest of the UK, with incidence rates in males ranging from 16 per 100,000 in Wales to 27 per 100,000 in Northern Ireland, and rates in females ranging from 12 per 100,000 in Wales to 22 per 100,000 in Northern Ireland. In situ cervical tumours also have significantly higher incidence rates in Northern Ireland in comparison with the three other UK countries. The incidence of breast cancer has been lowest in Northern Ireland compared with the three other UK countries for almost two decades, 20 with rates in 2009 ranging from 119 per 100,000 in Northern Ireland to 127 per 100,000 in Scotland. Cancer Research UK is a registered charity in England and Wales (1089464), Scotland (SC041666) and the Isle of Man (1103). 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