The burden of cancer in England in 2020

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The burden of cancer in England in 2020 Henrik
Møller Director, Thames Cancer Registry.
Professor of Cancer Epidemiology, Kings
College London and London School of Hygiene
Tropical Medicine.
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Co-authors

• Lesley Fairley, NYCRIS
• Victoria Coupland, TCR
• Catherine Okello, TCR
• Marianne Green, Department of Health
• David Forman, NYCRIS
• Bjørn Møller, Cancer Registry of Norway
• Freddie Bray, Cancer Registry of Norway

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Burden of cancer in England in 2020
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NORDPRED

• A set of R programmes with documentation
• Age-period-cohort model
• A set of recommendations for analysis
• Power link (instead of log link)
• Attenuation of the linear trend
• Based on systematic analysis of the accuracy of
  predictions from the past to the present

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Burden of cancer

• Incidence rate per capita measure risk to the
  individual person
• Numbers of cases per year
• rate future population
• Need costs
• numbers of cases unit cost

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Males
Females
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Males
Females
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Age distribution of the population 2000 and 2020
2020
2020
2000
2000
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Four main groups of cancers
2020 299,000 per year
-2003 224,000 per year
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Age distribution of the population 2000 and 2020
2020
2020
2000
2000
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Age distribution of cancer patients 2000 and 2020
2020
2020
2000
2000
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How accurate are these predictions (going to be)?

• Variability of the estimates is very low
• Bias some trends will be different from the
  assumptions
• 10-20 error to either side for individual cancer
  rates
• 5-10 error for total cancer rate
• Prostate cancer is not predictable and very
  influential
• Assumptions about trends in rates of birth, death
  and migration

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Main points in reverse order

• We expect the annual numbers of cancer cases to
  increase by 33 to around 300,000 cases in
  England in 2020.
• The main reason is the increasing population of
  middle-aged and old people.
• Age-standardised incidence rate of cancer is now
  stable.

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This work is based on 35 years of cancer
registration in England
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