Annual Publication No. SA13/01

Transcription

1 Welsh Cancer Intelligence & Surveillance Unit Annual Publication No. SA13/01 Cancer Incidence in Wales, th April 2013

2 TABLE OF CONTENTS 1. FOREWORD REGISTRATION OF CANCER IN WALES ONS SUBMISSION DATA QUALITY DEFINITIONS AND STATISTICAL METHODS CALCULATION OF INCIDENCE RATES AND AGE STANDARDISATION STANDARD POPULATIONS CANCER NETWORKS IN WALES INCIDENCE FIGURES IN WALES BY SEX AND FIVE YEAR AGE GROUP MALES FEMALES TRENDS IN WALES CRUDE RATES PER 100,000 POPULATION IN WALES EASR PER 100,000 POPULATION IN WALES TRENDS BY CANCER NETWORK IN WALES EASR PER 100,000 POPULATION BY CANCER NETWORK IN WALES

3 1. FOREWORD The Welsh Cancer Intelligence & Surveillance Unit (WCISU) has published the latest Annual Report on cancer incidence in Wales for the calendar year 2011 with incidence I would like to acknowledge all the hard work and diligence required to meet a challenging publication schedule. Other occasional reports and further information regarding incidence, mortality, prevalence and survival including the Triennial publication, Cancer in Wales : A Comprehensive Report can be found on our website Mrs Shelagh Reynolds, General Manager, Welsh Cancer Intelligence and Surveillance Unit 2

4 2. REGISTRATION OF CANCER IN WALES The Welsh Cancer Intelligence and Surveillance Unit (WCISU) is part of Public Health Wales as of October 2009 and is tasked under its Performance Level Agreement (PLA) with the Welsh Government to register all incidence of cancer for the resident population of Wales wherever they are treated. It is essential therefore to ensure completeness of registration that all possible sources of data collection are used. The use of multiple sources of data means that information relating to the same cancer incidence is received, and this also enhances the data quality as different data items are brought together to form a single record. WCISU benefits from a sophisticated computer package and a highly trained workforce to ensure that duplicate registrations are avoided. For the most recent year reported (2011) multiple notifications were received from:- PEDW 1 records : Trusts throughout Wales : NHS Clearing Service Pathology records : Data received from 12 of 12 laboratories Canisc Extra Regional Notification Office for National Statistics : Cancer Deaths and Non Cancer Deaths 1 Patient Episode Database Wales Canisc has been routinely used as a registration source for the first time for diagnoses in 2011 and is an additional source of information to enable WCISU captures all accurate registrations in a given diagnosis year. Table 1 illustrates the number of records processed for the calendar year Electronic processing and manual intervention by registration officers provide the resulting registrations for 2011 incidence. Table 1: Notification received by WCISU 2011 Source of Information PEDW - Wales data - English data Pathology Canisc Other Registries Death Certificates: Cancer Non Cancer Total Records Received Resulting in: Total Registrations All Malignancies ex. skin Number of records received (All C, D, O and Q codes) (All C codes exc C44) 3

5 2.1 ONS SUBMISSION During the first years after being established WCISU s emphasis was concentrated on timeliness. However since the inherited backlog of data has been cleared more time and resource has been given to ensuring the quality, not only of the data currently being registered, but also of previous registrations. Registrations are submitted to ONS to enable flagging on the National Health Service Central Register (NHSCR) which in turn enables cancer registries to receive Death Certificate Information. Cancer Registries are expected to have no more than 0.5% status 3 records (ie. records containing serious errors) for each year submitted. Good quality record submission enables a high percentage of records to be traced on NHSCR. Table 2 shows WCISU submission to ONS and also is an indicator of the work that has been undertaken to assure its quality. Note that since the ONS management report was published, the figure for status 3% in 2011 has reduced and the traced records are now over 99% for the diagnosis period (March 2013). Table 2: WCISU submissions to ONS Year of Diagnosis Registrations* Status 3% Traced records % % 99.9% % 99.8% % 99.7% % 99.0% % 92.2% * All malignancies excluding skin (C44) and all D codes Source: ONS Management Report, December DATA QUALITY The quality of the information produced by WCISU can only be maintained at the highest level if all staff are involved in ensuring data quality at every process undertaken. Validation rules are embedded into the software used for registration and these are reviewed in conjunction with the United Kingdom association of Cancer Registries and the Office for National Statistics and updated as necessary. Quality checks are run on incoming data to identify any quality issues. Multiple sources of data are used for registration and any discrepancies between data sources are investigated to ensure data quality. Regular data validation is undertaken by the Unit s staff who access original source documentation at hospitals by accessing medical records and verifying data received. 4

6 Analysis of data in response to requests for information and in preparation of publications includes analysis staff in the quality program by highlighting any anomalies in the data that are then passed for further validation. In an effort to maintain good standards of incoming data, WCISU has developed and delivered training packages to cancer information staff across Wales. Staff from the Unit who have been trained as Clinical Coding Tutors also participate in the delivery of basic clinical coding to staff across Wales and jointly develop, with the All Wales Coding Tutor, neoplasm workshops as further training for coding staff. 3. DEFINITIONS AND STATISTICAL METHODS 3.1 CALCULATION OF INCIDENCE RATES AND AGE STANDARDISATION Crude Rate: This is the total number of cases registered per year as a proportion of the total population. It is usually quoted per 100,000 population. Rates for older age groups are in general, much higher than those for younger people, so that the crude rate for an area is very much influenced by the age structure of the population of that area. This means that comparisons of the crude rates between populations with different age structures can be misleading. For this reason, methods have been developed to age-standardise cancer incidence rates. Direct Standardisation: Age specific incidence rates from the population under study are applied to a standard reference population to obtain the number of cases that would arise in the standard population in each group. These are summed to obtain the overall directly standardised incidence rate expressed per 100,000 population. The standard hypothetical population used in this report the "European Standard Population" is shown in Table STANDARD POPULATIONS The European Age Standardised Rate (EASR) for Wales per 100,000 population is calculated by applying age specific rates for Wales to the relevant standard European population shown above. These are then summed across all age groups to obtain the overall EASR. Because the age structure of the Welsh population differs from that of the European standard population, the standardised rate for Wales, for any particular type of cancer will differ from the crude rate. In general, because the Welsh population is slightly older than the European standard, the effect will be to lower the crude rate. 5

7 Table 3: European Standard Population Age Group Standard Population Age Group Standard Population Under and over All ages 100, CANCER NETWORKS IN WALES Cancer Statistics are presented by Cancer Network in Wales for the most common cancers in Wales for both males and females. Figure 1 shows the Cancer Networks in Wales. NORTH WALES CANCER NETWORK Code 00NA 00NC 00NE 00NG 00NJ 00NL Local Authority Anglesey Gwynedd Conwy Denbighshire Flintshire Wrexham NA NC NE NG NJ NL SOUTH WALES CANCER NETWORK Code 00NN 00NQ 00NS 00NU 00NX 00NZ 00PB 00PD 00PF 00PH 00PK 00PL 00PM 00PP 00PR 00PT Local Authority Powys Ceredigion Pembrokeshire Carmarthenshire Swansea Neath and Port Talbot Bridgend Vale of Glamorgan Rhondda Cynon Taff Merthyr Tydfil Caerphilly Blaenau Gwent Torfaen Monmouthshire Newport Cardiff NS NU NX NQ NZ Crown Copyright License Number Produced by Welsh Cancer Intelligence and Surveillance Unit PB PF PH PD NN PL PK PT PM PR PP Figure 1: Cancer Networks in Wales. 6

8 4. INCIDENCE FIGURES IN WALES BY SEX AND FIVE YEAR AGE GROUP MALES ICD10 Code Site TOTAL C00-C14 Total lip, oral cavity and pharynx C00 Lip C01-C02 Tongue C03-C06 Mouth C07-C08 Salivary glands C09-C10 Oropharynx C11 Nasopharynx C12-C13 Hypopharynx C14 Pharynx, unspecified C15 Oesophagus C16 Stomach C17 Small intestine C18-C20 Colorectal C18 Colon C19-C20 Rectum C21 Anus and anal canal C22 Liver and intrahepatic bile ducts C23-C24 Gallbladder C25 Pancreas C26 Digestive organs, unspecified C30-C31 Nasal cavities C32 Larynx C33-C34 Lung C37-C39,C45 Respiratory system C40-C41 Bone C43 Malignant melanoma of skin C46 Kaposi's sarcoma C48 Retroperitoneum and peritoneum C47, C49 Connective tissue C50 Breast C60, C63 Penis C61 Prostate C62 Testis C67 Bladder C64-C66, C68 Kidney C69 Eye and adnexa C71 Brain C70, C72 Other nervous system C73 Thyroid gland C74-C75 Other endocrine glands C76-C80 Other and unspecified C81 Hodgkin's disease C82-C85 Non-Hodgkins Lymphoma C88, C90 Multiple myeloma C91-C95 Total Leukaemia C910 Acute lymphoblastic leukaemia C911 Chronic lymphocytic leukaemia C920 Acute myeloid leukaemia C921 Chronic myeloid leukaemia C96 Other and unspecified C (exc C44) Total of all neoplasms (excluding NMSC) NMSC Non-melanoma skin cancer 7

9 4.2 FEMALES ICD10 Code Site TOTAL C00-C14 Total lip, oral cavity and pharynx C00 Lip C01-C02 Tongue C03-C06 Mouth C07-C08 Salivary glands C09-C10 Oropharynx C11 Nasopharynx C12-C13 Hypopharynx C14 Pharynx, unspecified C15 Oesophagus C16 Stomach C17 Small intestine C18-C20 Colorectal C18 Colon C19-C20 Rectum C21 Anus and anal canal C22 Liver and intrahepatic bile ducts C23-C24 Gallbladder C25 Pancreas C26 Digestive organs, unspecified C30-C31 Nasal cavities C32 Larynx C33-C34 Lung C37-C39,C45 Respiratory system C40-C41 Bone C43 Malignant melanoma of skin C46 Kaposi's sarcoma C48 Retroperitoneum and peritoneum C47, C49 Connective tissue C50 Breast C51-C52 Other female genital C53 Cervix Uteri C54 Corpus uteri C55 Uterus, part unspecified C56 Ovary C57 Other and unspecified female genital organs C58 Placenta C67 Bladder C64-C66, C68 Kidney C69 Eye and adnexa C71 Brain C70, C72 Other nervous system C73 Thyroid gland C74-C75 Other endocrine glands C76-C80 Other and unspecified C81 Hodgkin's disease C82-C85 Non-Hodgkins Lymphoma C88, C90 Multiple myeloma C91-C95 Total Leukaemia C910 Acute lymphoblastic leukaemia C911 Chronic lymphocytic leukaemia C920 Acute myeloid leukaemia C921 Chronic myeloid leukaemia C96 Other and unspecified C (exc C44) Total of all neoplasms (excluding NMSC) NMSC Non-melanoma skin cancer 8

10 5. TRENDS IN WALES Incidence figures (all ages) MALES FEMALES ICD10 Code Site C00-C14 Total lip, oral cavity and pharynx C00 Lip C01-C02 Tongue C03-C06 Mouth C07-C08 Salivary glands C09-C10 Oropharynx C11 Nasopharynx C12-C13 Hypopharynx C14 Pharynx, unspecified C15 Oesophagus C16 Stomach C17 Small intestine C18-C20 Colorectal C18 Colon C19-C20 Rectum C21 Anus and anal canal C22 Liver and intrahepatic bile ducts C23-C24 Gallbladder C25 Pancreas C26 Digestive organs, unspecified C30-C31 Nasal cavities C32 Larynx C33-C34 Lung C37-C39,C45 Respiratory system C40-C41 Bone C43 Malignant melanoma of skin C46 Kaposi's sarcoma C48 Retroperitoneum and peritoneum C47, C49 Connective tissue C50 Breast C51-C52 Other female genital C53 Cervix Uteri C54 Corpus uteri C55 Uterus, part unspecified C56 Ovary C57 Other and unspecified female genital organs C58 Placenta C60, C63 Penis C61 Prostate C62 Testis C67 Bladder C64-C66, C68 Kidney C69 Eye and adnexa C71 Brain C70, C72 Other nervous system C73 Thyroid gland C74-C75 Other endocrine glands C76-C80 Other and unspecified C81 Hodgkin's disease C82-C85 Non-Hodgkins Lymphoma C88, C90 Multiple myeloma C91-C95 Total leukaemia C910 Acute lymphoblastic leukaemia C911 Chronic lymphocytic leukaemia C920 Acute myeloid leukaemia C921 Chronic myeloid leukaemia C96 Other and unspecified C (exc C44) Total of all neoplasms (excluding NMSC) NMSC Non-melanoma skin cancer 9

11 6. CRUDE RATES PER 100,000 POPULATION IN WALES MALES FEMALES ICD10 Code Site C00-C14 Total lip, oral cavity and pharynx C00 Lip C01-C02 Tongue C03-C06 Mouth C07-C08 Salivary glands C09-C10 Oropharynx C11 Nasopharynx C12-C13 Hypopharynx C14 Pharynx, unspecified C15 Oesophagus C16 Stomach C17 Small intestine C18-C20 Colorectal C18 Colon C19-C20 Rectum C21 Anus and anal canal C22 Liver and intrahepatic bile ducts C23-C24 Gallbladder C25 Pancreas C26 Digestive organs, unspecified C30-C31 Nasal cavities C32 Larynx C33-C34 Lung C37-C39,C45 Respiratory system C40-C41 Bone C43 Malignant melanoma of skin C46 Kaposi's sarcoma C48 Retroperitoneum and peritoneum C47, C49 Connective tissue C50 Breast C51-C52 Other female genital C53 Cervix Uteri C54 Corpus uteri C55 Uterus, part unspecified C56 Ovary C57 Other and unspecified female genital organs C58 Placenta C60, C63 Penis C61 Prostate C62 Testis C67 Bladder C64-C66, C68 Kidney C69 Eye and adnexa C71 Brain C70, C72 Other nervous system C73 Thyroid gland C74-C75 Other endocrine glands C76-C80 Other and unspecified C81 Hodgkin's disease C82-C85 Non-Hodgkins Lymphoma C88, C90 Multiple myeloma C91-C95 Total Leukaemia C910 Acute lymphoblastic leukaemia C911 Chronic lymphocytic leukaemia C920 Acute myeloid leukaemia C921 Chronic myeloid leukaemia C96 Other and unspecified C (exc C44) Total of all neoplasms (excluding NMSC) NMSC Non-melanoma skin cancer 10

12 7. EASR PER 100,000 POPULATION IN WALES MALES FEMALES ICD10 Code Site C00-C14 Total lip, oral cavity and pharynx C00 Lip C01-C02 Tongue C03-C06 Mouth C07-C08 Salivary glands C09-C10 Oropharynx C11 Nasopharynx C12-C13 Hypopharynx C14 Pharynx, unspecified C15 Oesophagus C16 Stomach C17 Small intestine C18-C20 Colorectal C18 Colon C19-C20 Rectum C21 Anus and anal canal C22 Liver and intrahepatic bile ducts C23-C24 Gallbladder C25 Pancreas C26 Digestive organs, unspecified C30-C31 Nasal cavities C32 Larynx C33-C34 Lung C37-C39,C45 Respiratory system C40-C41 Bone C43 Malignant melanoma of skin C46 Kaposi's sarcoma C48 Retroperitoneum and peritoneum C47, C49 Connective tissue C50 Breast C51-C52 Other female genital C53 Cervix Uteri C54 Corpus uteri C55 Uterus, part unspecified C56 Ovary C57 Other and unspecified female genital organs C58 Placenta C60, C63 Penis C61 Prostate C62 Testis C67 Bladder C64-C66, C68 Kidney C69 Eye and adnexa C71 Brain C70, C72 Other nervous system C73 Thyroid gland C74-C75 Other endocrine glands C76-C80 Other and unspecified C81 Hodgkin's disease C82-C85 Non-Hodgkins Lymphoma C88, C90 Multiple myeloma C91-C95 Total Leukaemia C910 Acute lymphoblastic leukaemia C911 Chronic lymphocytic leukaemia C920 Acute myeloid leukaemia C921 Chronic myeloid leukaemia C96 Other and unspecified C (exc C44) Total of all neoplasms (excluding NMSC) EASR European Age Standardised Rate per 100,000 population NMSC Non-melanoma skin cancer 11

13 8. TRENDS BY CANCER NETWORK IN WALES Incidence figures (all ages) Males NORTH WALES CANCER NETWORK SOUTH WALES CANCER NETWORK ICD 10 codes Cancer Site C15 Oesophagus C18-C20 Colorectal C25 Pancreas C33-C34 Trachea, Bronchus and Lung C43 Malignant Melanoma of Skin C61 Prostate C64-C66,C68 Urinary Tract excluding Bladder C67 Bladder C82-C85 Non-Hodgkin's Lymphoma C91-C95 Leukaemia All C exc C44 All excluding NMSC Females NORTH WALES CANCER NETWORK SOUTH WALES CANCER NETWORK ICD 10 codes Cancer Site C15 Oesophagus C18-C20 Colorectal C25 Pancreas C33-C34 Trachea, Bronchus and Lung C43 Malignant Melanoma of Skin C50 Breast C54 Corpus Uteri C56 Ovary C64-C66,C68 Urinary Tract excluding Bladder C67 Bladder C82-C85 Non-Hodgkin's Lymphoma C91-C95 Leukaemia All C exc C44 All excluding NMSC NMSC Non-melanoma skin cancer 12

14 9. EASR PER 100,000 POPULATION BY CANCER NETWORK IN WALES Males NORTH WALES CANCER NETWORK SOUTH WALES CANCER NETWORK ICD 10 codes Cancer Site C15 Oesophagus C18-C20 Colorectal C25 Pancreas C33-C34 Trachea, Bronchus and Lung C43 Malignant Melanoma of Skin C61 Prostate C64-C66,C68 Urinary Tract excluding Bladder C67 Bladder C82-C85 Non-Hodgkin's Lymphoma C91-C95 Leukaemia All C exc C44 All excluding NMSC Females NORTH WALES CANCER NETWORK SOUTH WALES CANCER NETWORK ICD 10 codes Cancer Site C15 Oesophagus C18-C20 Colorectal C25 Pancreas C33-C34 Trachea, Bronchus and Lung C43 Malignant Melanoma of Skin C50 Breast C54 Corpus Uteri C56 Ovary C64-C66,C68 Urinary Tract excluding Bladder C67 Bladder C82-C85 Non-Hodgkin's Lymphoma C91-C95 Leukaemia All C exc C44 All excluding NMSC NMSC Non-melanoma skin cancer EASR European Age Standardised Rate per 100,000 population 13