1. Insert name of presentation on Master Slide February 2015 Cancer in Wales A summary of population cancer incidence, mortality and survival – includes new 2013 data released as Official Statistics on 3 February 2015

2. Cancer in Wales A summary report of the population cancer incidence, mortality and survival – includes new 2013 data released as Official Statistics on 3 February 2015

3. Cancer in Wales Using these slides These slides accompany the Cancer in Wales report. These slides are a resource to demonstrate findings from the Cancer in Wales report. The presentation can be used as a whole or as individual slides. Please acknowledge the work of the Welsh Cancer Intelligence and Surveillance Unit when using these slides.

4. Cancer in Wales Index Slides 7 - 12:Incidence, mortality and survival for all cancers combined Slides 13 - 21:Cancer geography in Wales Slides 22 - 26:Incidence, mortality and survival by area deprivation Slides 27 - 53:Incidence, mortality and survival of different cancer types

5. Cancer in Wales Instructions to copy a slide To copy a slide for use in a presentation: 1. Right-click on the slide you wish to copy from the list on the left-hand side (the ‘slides’ tab) when in normal view and select ‘Copy’ from the list. 2.Go to your presentation and right-click where you want the copied slide to appear in the ‘slides’ tab and select ‘paste’ from the list. 3.On being pasted into your presentation a small clipboard icon with a black arrow will appear near the bottom right-hand corner of the newly pasted slide. Click on the arrow to show the drop-down menu and select “Keep Source Formatting” from the list. The slide will then appear as seen in the original presentation.

6. Cancer in Wales Acknowledgements Project team Dr Ceri White, Rebecca Thomas, Tamsin Long, Ciaràn Slyne, Julie Howe, Helen Crowther, Dr Dyfed Wyn Huws Acknowledgements A special thanks to the Welsh Cancer Intelligence and Surveillance Unit’s staff, especially the registration team without whom the data used within this report would not be produced. Thanks to the following people for their help with this publication: Dr Clare Elliot, Gwenllian Evans, Dr Judith Greenacre, Dr Ciarán Humphreys, Isabel Puscas, Hannah Thomas and Janet Warlow

7. Cancer in Wales Source: Welsh Cancer Intelligence and Surveillance Unit’s Cancer Registry www.wcisu.wales.nhs.uk Incidence, mortality and survival for all cancers combined Figure 1: Gradual increase in one and five year relative survival (%) for all cancers in Wales over time.

8. Cancer in Wales Figure 2: The most common age at diagnosis has fallen from 75-79 years in 2004 to 65-69 years in 2013 for both men and women. Source: Welsh Cancer Intelligence and Surveillance Unit’s Cancer Registry www.wcisu.wales.nhs.uk Incidence, mortality and survival for all cancers combined

9. Cancer in Wales Figure 3: The age-specific cancer rate rises more steeply for men than for women with increasing age. Source: Welsh Cancer Intelligence and Surveillance Unit’s Cancer Registry www.wcisu.wales.nhs.uk Incidence, mortality and survival for all cancers combined

10. Cancer in Wales Figure 4: The number of registered cancer deaths by age group shows small fluctuations over time in both men and women. Source: Welsh Cancer Intelligence and Surveillance Unit’s Cancer Registry www.wcisu.wales.nhs.uk Incidence, mortality and survival for all cancers combined

11. Cancer in Wales Figure 5: The age specific cancer mortality rates show little change over time in men and women. Source: Welsh Cancer Intelligence and Surveillance Unit’s Cancer Registry www.wcisu.wales.nhs.uk Incidence, mortality and survival for all cancers combined

12. Cancer in Wales Table 1: Increases for one and five year relative survival from cancer for men and women over time, with the increases greater in men. Source: Welsh Cancer Intelligence and Surveillance Unit’s Cancer Registry www.wcisu.wales.nhs.uk Incidence, mortality and survival for all cancers combined

13. Cancer in Wales Cancer geography in Wales Figure 6: Change in the number of new cancer cases diagnosed in Wales at local authority and health board level over time. ©Crown Copyright and database right 2015. Ordnance Survey 100044810 Source: Welsh Cancer Intelligence and Surveillance Unit’s Cancer Registry www.wcisu.wales.nhs.uk

14. Cancer in Wales Cancer geography in Wales Figure 7: The cancer incidence rate (EASR) per 100,000 population is statistically significantly higher than Wales for two health boards in 2009-2013. Source: Welsh Cancer Intelligence and Surveillance Unit’s Cancer Registry www.wcisu.wales.nhs.uk

15. Cancer in Wales Cancer geography in Wales Figure 8: The highest local authority incidence rate in Merthyr Tydfil is almost 20 per cent higher than the lowest in Ceredigion in 2009-2013. ©Crown Copyright and database right 2015. Ordnance Survey 100044810 Source: Welsh Cancer Intelligence and Surveillance Unit’s Cancer Registry www.wcisu.wales.nhs.uk

16. Cancer in Wales Cancer geography in Wales Figure 9: The cancer incidence rate at Middle Super Output Area (MSOA) shows considerable variation across Wales ©Crown Copyright and database right 2015. Ordnance Survey 100044810 Source: Welsh Cancer Intelligence and Surveillance Unit’s Cancer Registry www.wcisu.wales.nhs.uk

17. Cancer in Wales Cancer geography in Wales Figure 10: The cancer mortality rate (EASR) per 100,000 population is statistically significantly higher than Wales in Cwm Taf university health board for 2009-2013. Source: Welsh Cancer Intelligence and Surveillance Unit’s Cancer Registry www.wcisu.wales.nhs.uk

18. Cancer in Wales Cancer geography in Wales Figure 11: Variation seen in the number of cancer deaths registered in Wales at local authority and health board level over time. ©Crown Copyright and database right 2015. Ordnance Survey 100044810 Source: Welsh Cancer Intelligence and Surveillance Unit’s Cancer Registry www.wcisu.wales.nhs.uk

19. Cancer in Wales ©Crown Copyright and database right 2015. Ordnance Survey 100044810 Source: Welsh Cancer Intelligence and Surveillance Unit’s Cancer Registry www.wcisu.wales.nhs.uk Cancer geography in Wales Figure 12: The highest local authority mortality rate in Blaenau Gwent is over a third higher than the lowest in Monmouthshire in 2009-2013.

20. Cancer in Wales Cancer geography in Wales Figure 13: The cancer mortality rate at Middle Super Output Area shows pockets of high and low mortality in Wales with great variation between some neighbouring areas. ©Crown Copyright and database right 2015. Ordnance Survey 100044810 Source: Welsh Cancer Intelligence and Surveillance Unit’s Cancer Registry www.wcisu.wales.nhs.uk

21. Cancer in Wales Cancer geography in Wales Figure 14: One year relative survival is similar across the seven health boards of Wales in 2008-2012. Figure 15: Cwm Taf University health board has the lowest five year relative survival of all health boards in Wales in 2004-2008. ©Crown Copyright and database right 2015. Ordnance Survey 100044810 Source: Welsh Cancer Intelligence and Surveillance Unit’s Cancer Registry www.wcisu.wales.nhs.uk

22. Cancer in Wales Incidence, mortality and survival by area deprivation Figure 16: The difference between the cancer incidence rate (EASR) per 100,000 population in the least deprived fifth compared to the most deprived fifth has increased over time. Source: Welsh Cancer Intelligence and Surveillance Unit’s Cancer Registry www.wcisu.wales.nhs.uk

23. Cancer in Wales Source: Welsh Cancer Intelligence and Surveillance Unit’s Cancer Registry www.wcisu.wales.nhs.uk Figure 17: The difference between the cancer mortality rate (EASR) per 100,000 population in the least deprived fifth compared to the most deprived fifth has slightly increased over time. Incidence, mortality and survival by area deprivation

24. Cancer in Wales Source: Welsh Cancer Intelligence and Surveillance Unit’s Cancer Registry www.wcisu.wales.nhs.uk Figure 18: One year relative survival (%) for all cancers combined has improved in all deprivation fifths over time but the increase is greater in the most deprived fifth than the least deprived fifth thus narrowing the gap. Incidence, mortality and survival by area deprivation

25. Cancer in Wales Source: Welsh Cancer Intelligence and Surveillance Unit’s Cancer Registry www.wcisu.wales.nhs.uk Figure 19: A greater increase in five year survival (%) is seen in the least deprived fifth compared to the most deprived fifth over time, widening the gap. Incidence, mortality and survival by area deprivation

26. Cancer in Wales Figure 20: The most common cancers in men and women in Wales in 2013 Source: Welsh Cancer Intelligence and Surveillance Unit’s Cancer Registry www.wcisu.wales.nhs.uk Incidence, mortality and survival by area deprivation

27. Cancer in Wales Incidence, mortality and survival of different cancer types Figure 21: Over a quarter of all cancers in men were prostate cancer in 2013. Source: Welsh Cancer Intelligence and Surveillance Unit’s Cancer Registry www.wcisu.wales.nhs.uk

28. Cancer in Wales Figure 22: Nearly a third of all cancers in women were breast cancer in 2013. Source: Welsh Cancer Intelligence and Surveillance Unit’s Cancer Registry www.wcisu.wales.nhs.uk Incidence, mortality and survival of different cancer types

29. Cancer in Wales Figure 23: The average change in the number of new cancer cases by cancer type in Wales shows large variation in 2011-2013 compared with 2001- 2003. *Bladder cancer not shown due to a coding change in 2007 Source: Welsh Cancer Intelligence and Surveillance Units Cancer Registry www.wcisu.wales.nhs.uk Incidence, mortality and survival of different cancer types

30. Cancer in Wales Figure 24: The percentage change of new cancer cases varies by cancer type in Wales, 2011-2013 compared with 2001-2003. *Bladder cancer not shown due to a coding change in 2007 Source: Welsh Cancer Intelligence and Surveillance Units Cancer Registry www.wcisu.wales.nhs.uk Incidence, mortality and survival of different cancer types

31. Cancer in Wales Figure 25: Age adjusted incidence rates of cancer types in Wales, 2013 compared with 2004. *Bladder cancer not shown due to a coding change in 2007 Source: Welsh Cancer Intelligence and Surveillance Units Cancer Registry www.wcisu.wales.nhs.uk Incidence, mortality and survival of different cancer types

32. Cancer in Wales Figure 26: The average change in the incidence rate (EASR) per 100,000 population shows a large increase in melanoma and a large decrease in lung cancer in men in Wales, 2011-2013 compared with 2001-2003. *Bladder cancer not shown due to a coding change in 2007 Source: Welsh Cancer Intelligence and Surveillance Units Cancer Registry www.wcisu.wales.nhs.uk Incidence, mortality and survival of different cancer types

33. Cancer in Wales Figure 27: The percentage change in the cancer incidence rate (EASR) per 100,000 population by cancer type for men in Wales shows an increase of nearly three quarters for melanoma and two thirds increase for liver cancer in 2011-2013 compared with 2001-2003. *Bladder cancer not shown due to a coding change in 2007 Source: Welsh Cancer Intelligence and Surveillance Units Cancer Registry www.wcisu.wales.nhs.uk Incidence, mortality and survival of different cancer types

34. Cancer in Wales Figure 28: The change in the incidence rate (EASR) per 100,000 population by cancer type for women in Wales shows a large increase in lung cancer in 2011-2013 compared with 2001-2003. *Bladder cancer not shown due to a coding change in 2007 Source: Welsh Cancer Intelligence and Surveillance Units Cancer Registry www.wcisu.wales.nhs.uk Incidence, mortality and survival of different cancer types

35. Cancer in Wales Figure 29: The percentage change in the cancer incidence rate (EASR) per 100,000 population by cancer type for women shows an increase of over a half for liver cancer in Wales in 2011-2013 compared with 2001-2003. *Bladder cancer not shown due to a coding change in 2007 Source: Welsh Cancer Intelligence and Surveillance Units Cancer Registry www.wcisu.wales.nhs.uk Incidence, mortality and survival of different cancer types

36. Cancer in Wales Figure 30: The cancer incidence rate (EASR) per 100,000 population for areas with increasing deprivation (fifths) by cancer type Source: Welsh Cancer Intelligence and Surveillance Units Cancer Registry www.wcisu.wales.nhs.uk Incidence, mortality and survival of different cancer types

37. Cancer in Wales Figure 31: Lung cancer is the most common cancer death in Wales in 2013. Source: Welsh Cancer Intelligence and Surveillance Units Cancer Registry www.wcisu.wales.nhs.uk Incidence, mortality and survival of different cancer types

38. Cancer in Wales Figure 32: Over a fifth of all cancer deaths in men in Wales were from lung cancer in 2013. Source: Welsh Cancer Intelligence and Surveillance Units Cancer Registry www.wcisu.wales.nhs.uk Incidence, mortality and survival of different cancer types

39. Cancer in Wales Figure 33: Over a fifth of all cancer deaths in women in Wales were from lung cancer in 2013. Source: Welsh Cancer Intelligence and Surveillance Units Cancer Registry www.wcisu.wales.nhs.uk Incidence, mortality and survival of different cancer types

40. Cancer in Wales Figure 34: The largest change in the average number of cancer deaths is for lung cancer in women in 2011-2013 compared with 2001-2003. Source: Welsh Cancer Intelligence and Surveillance Units Cancer Registry www.wcisu.wales.nhs.uk Incidence, mortality and survival of different cancer types

41. Cancer in Wales Figure 35: The largest percentage change in the average number of cancer deaths is for liver cancer for both men and women in Wales in 2011-2013 compared with 2001-2003. Source: Welsh Cancer Intelligence and Surveillance Units Cancer Registry www.wcisu.wales.nhs.uk Incidence, mortality and survival of different cancer types

42. Cancer in Wales Figure 36: The cancer mortality rate (EASR) per 100,000 population is highest for lung cancer in Wales in 2013 and 2004 compared to other cancer types. Source: Welsh Cancer Intelligence and Surveillance Units Cancer Registry www.wcisu.wales.nhs.uk Incidence, mortality and survival of different cancer types

43. Cancer in Wales Figure 37: Prostate and lung cancers show the largest absolute decreases in cancer mortality (EASR) rate per 100,000 men in Wales from 2001-2003 to 2011-2013 Source: Welsh Cancer Intelligence and Surveillance Units Cancer Registry www.wcisu.wales.nhs.uk Incidence, mortality and survival of different cancer types

44. Cancer in Wales Figure 38: The largest percentage increase in the cancer mortality rate (EASR) per 100,000 men is for liver cancer from 2001-2003 to 2011-2013. Source: Welsh Cancer Intelligence and Surveillance Units Cancer Registry www.wcisu.wales.nhs.uk Incidence, mortality and survival of different cancer types

45. Cancer in Wales Figure 39: Breast cancer has the largest absolute decrease in cancer mortality (EASR) rate per 100,000 women in Wales from 2001-2003 to 2011-2013 Source: Welsh Cancer Intelligence and Surveillance Units Cancer Registry www.wcisu.wales.nhs.uk Incidence, mortality and survival of different cancer types

46. Cancer in Wales Figure 40: The largest percentage increase in the cancer mortality rate (EASR) per 100,000 women is for liver cancer from 2001-2003 to 2011- 2013 Source: Welsh Cancer Intelligence and Surveillance Units Cancer Registry www.wcisu.wales.nhs.uk Incidence, mortality and survival of different cancer types

47. Cancer in Wales Figure 41: The cancer mortality rate (EASR) per 100,000 shows the difference between the least deprived and most deprived fifth for lung cancer is increasing in Wales. Source: Welsh Cancer Intelligence and Surveillance Units Cancer Registry www.wcisu.wales.nhs.uk Incidence, mortality and survival of different cancer types

48. Cancer in Wales Figure 42: Improvements in one year survival (%) are seen for the majority of cancer types *There was a bladder coding change in 2007, hence the large change in survival. Source: Welsh Cancer Intelligence and Surveillance Unit’s Cancer Registry www.wcisu.wales.nhs.uk Incidence, mortality and survival of different cancer types

49. Lung Cancer in Wales Figure 43: Improvements in five year survival (%) are seen for the majority of cancer types Incidence, mortality and survival of different cancer types *There was a bladder coding change in 2007, hence the large change in survival. Source: Welsh Cancer Intelligence and Surveillance Unit’s Cancer Registry www.wcisu.wales.nhs.uk

50. Cancer in Wales Figure 44: Large variation is seen for one year relative survival from oesophageal cancer by health board Source: Welsh Cancer Intelligence and Surveillance Units Cancer Registry www.wcisu.wales.nhs.uk Incidence, mortality and survival of different cancer types

51. Cancer in Wales Figure 45: There is a large variation in five year survival by health board population for prostate cancer. Source: Welsh Cancer Intelligence and Surveillance Units Cancer Registry www.wcisu.wales.nhs.uk Incidence, mortality and survival of different cancer types

52. Cancer in Wales Figure 46: Lung, female breast and prostate cancer show decreases in the deprivation gap for one year relative survival over time in Wales. Source: Welsh Cancer Intelligence and Surveillance Units Cancer Registry www.wcisu.wales.nhs.uk Incidence, mortality and survival of different cancer types

53. Cancer in Wales Figure 47: Wide variation exists between the least and most deprived fifths for five year relative survival (%) in Wales for female breast, prostate and bowel cancer. Source: Welsh Cancer Intelligence and Surveillance Units Cancer Registry www.wcisu.wales.nhs.uk Incidence, mortality and survival of different cancer types