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Profile of Cervical Cancer in England Incidence, Mortality and Survival

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Profile of Cervical Cancer in England Incidence, Mortality and Survival Profile of Cervical Cancer in England Incidence, Mortality and Survival October 2012 Profile of Cervical Cancer in England Incidence, Mortality and Survival October 2012 Authors This report has been produced by Trent Cancer Registry, the National Cancer Intelligence Network’s lead registry in England for gynaecological cancers, in collaboration with the NHS Cervical Cancer Screening Programme. Enquiries Enquiries about this report should be addressed to: Mr Jason Poole, Head of Cancer Analysis, Trent Cancer Registry, [email protected], www.empho.org.uk/tcr/aboutUs.aspx Prof Julietta Patnick, Director for the NHS Cancer Screening Programme, [email protected], www.cancerscreening.nhs.uk/cervical Further information on the work of the National Cancer Intelligence Network (NCIN) can be found at www.ncin.org.uk Erratum This document, issued 09 November 2012, is a corrected version of the report, which was published on 8th October 2012. In the original, Figure 24 was found to have the five‐year survival columns in the incorrect order, so that the columns did not match with the data in the table. This is the sole change that has been made to the publication. Published by Trent Cancer Registry 5 Old Fulwood Road Sheffield S10 3TG Tel: 0114 226 3560 Fax: 0114 226 3561 NHS Cancer Screening Programmes Old Fulwood Road Sheffield S10 3TH Tel: 0114 271 1060 Fax: 0114 271 1089 © Trent Cancer Registry 2012 Acknowledgements The authors would like to thank Rebecca Elleray (Principal Cancer Intelligence Analyst), Marta Emmett (Cancer Intelligence Analyst), Sue Wild (Information Outputs Officer), Andrew Nordin (Chair, NCIN Gynaecological Cancer Site Specific Clinical Reference Group; Consultant Gynaecological Oncologist, East Kent Hospitals University NHS Foundation Trust) and Lynn Hirschowitz (Consultant Pathologist, Royal College of Pathologists) for their help in compiling this report. October 2012 Profile of Cervical Cancer in England CONTENTS FOREWORD .............................................................................................................................................. vii EXECUTIVE SUMMARY ............................................................................................................................... 1 OVERALL TRENDS IN CERVICAL CANCER INCIDENCE AND MORTALITY ..................................................... 2 Trends in incidence and mortality, England, 1989 to 2009/2010 ............................................................. 2 CERVICAL CANCER INCIDENCE ................................................................................................................... 5 Incidence by Strategic Health Authority, 2005‐2009 ................................................................................ 5 Incidence by Cancer Network, 2005‐2009 ................................................................................................ 7 Incidence by age, 2009 ............................................................................................................................ 10 Trends in incidence by age, England 1989 to 2009 ................................................................................. 11 Monthly incidence by age, 2007‐2009 .................................................................................................... 13 Comparing incidence and deprivation by Primary Care Trust, 2005‐2009 ............................................. 14 MORPHOLOGY ......................................................................................................................................... 15 Trends in Incidence by Morphology, 1988‐2009 ..................................................................................... 15 Incidence by Age and Morphology, 2005‐2009 ....................................................................................... 17 Incidence by Deprivation and Morphology, 2005‐2009 .......................................................................... 19 CERVICAL CANCER MORTALITY ............................................................................................................... 21 Mortality by Strategic Health Authority, 2006‐2010 ............................................................................... 21 Mortality by Cancer Network, 2006‐2010 ............................................................................................... 23 Mortality by age, England 2008‐2010 ..................................................................................................... 26 Trends in mortality by age, England 1988‐1990 to 2008‐2010 ............................................................... 27 Comparing mortality and deprivation by Primary Care Trust, 2006‐2010 .............................................. 29 CERVICAL CANCER SURVIVAL .................................................................................................................. 30 Trends in one‐ and five‐year relative survival, England 1987‐1989 to 2007‐2009/2003‐2005 ............... 30 Trends in one‐year relative survival by Cancer Network, 1987‐1989 to 2007‐2009............................... 33 One‐Year Relative Survival by Cancer Network, 2007‐2009 ................................................................... 34 Trends in five‐year relative survival by Cancer Network, 1988‐1990 to 2003‐2005 ............................... 35 Five‐year relative survival by Cancer Network, 2003‐2005 ..................................................................... 36 Relative survival by age, England, 2007‐2009 and 2003‐2005 ................................................................ 37 Trends in one‐year relative survival by age, England, 1987‐1989 to 2007‐2009 .................................... 38 Trends in five‐year relative survival by age, England, 1988‐1990 to 2003‐2005 .................................... 39 Relative survival by deprivation, England, 2007‐2009 and 2003‐2005 ................................................... 40 iii October 2012 Profile of Cervical Cancer in England APPENDIX 1: METHODOLOGY ................................................................................................................. 42 Source of Results ..................................................................................................................................... 42 Definition of Cervical Cancer ................................................................................................................... 42 Definition of Morphology ........................................................................................................................ 42 Age‐standardisation ................................................................................................................................ 44 Chi‐squared test for trend ....................................................................................................................... 45 Confidence intervals ................................................................................................................................ 45 Correlation ............................................................................................................................................... 45 Funnel Plots ............................................................................................................................................. 45 Deprivation .............................................................................................................................................. 46 Relative survival ....................................................................................................................................... 46 Quality Assurance References Centre (QARCs) ....................................................................................... 46 APPENDIX 2: GUIDE TO CANCER NETWORKS AND STRATEGIC HEALTH AUTHORITIES ........................... 47 REFERENCES............................................................................................................................................. 50 iv October 2012 Profile of Cervical Cancer in England TABLE OF FIGURES Figure 1 Trends in incidence and mortality, England, 1989 to 2010 ...................................................... 4 Figure 2 Funnel plot of incidence by SHA, 2005‐2009 ............................................................................ 6 Figure 3 Funnel plot of incidence by CN, 2005‐2009 .............................................................................. 8 Figure 4 Map of incidence by CN, 2005‐2009 ......................................................................................... 9 Figure 5 Age‐specific incidence rates and number of cases diagnosed by five year age group, England 2009 ...................................................................................................................................................... 10 Figure 6 Trends in incidence in women under 40, England, 1989 to 2009 .......................................... 12 Figure 7 Number of cases by month, England, 2007 to 2009 ............................................................... 13 Figure 8 Scatter plot of incidence against measure of deprivation by PCT, 2005‐2009 ....................... 14 Figure 9 Number of cases by morphology, England, 1988‐2009 .......................................................... 16 Figure 10 Distribution of morphology by age group, England, 2005‐2009 .........................................
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