Pharmacoepidemiologist Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, United Kingdom
Background: There are currently 3 million people living with cancer in the United Kingdom (UK) with cancer being one of the leading causes of death. Studies of the epidemiology of cancer in the general population provide valuable insights that inform assessments of disease burden, public health policy, and effectiveness of health system care delivery.
Objectives: To determine the incidence and prevalence of 8 cancers (breast, colorectal, head and neck, liver, lung, pancreas, prostate, and stomach) in the UK using primary care records.
Methods: We included patients aged ≥18 years between January 2000 and December 2019 registered in the Clinical Practice Research Datalink (CPRD) GOLD and AURUM databases. We used a population cohort study design to calculate the annual incidence rates (IR) and annual period prevalence of 8 cancers among the adult population. Annual IR (per 100 000 person-years at risk) and prevalence (%) were estimated for each database as well as stratified by gender and age (10-year age bands).
Results: Across both databases, the IR and prevalence of all cancers increased from 2000 to 2019 apart from stomach cancer where IR peaked in 2006 and prevalence peaked in 2011-2012. The highest IR were for breast (141.0 to 187.9), prostate (104.4 to 181.5), colorectal (43.5 to 65.2), and lung cancers (22.4 to 61.1). Prevalence in 2019 for these cancers was 2.10-2.31% (breast), 1.42-1.56% (prostate), 0.43-0.44% (colorectal), and 0.13-0.14% (lung). IR and prevalence were higher in males apart from breast cancer. For pancreatic cancer there were no gender differences; for lung cancer from 2015, prevalence was higher in females (2019 prevalence: 0.14-0.15%) than males (2019 prevalence: 0.12-0.13%). IR and prevalence were higher in older age groups for all cancers. For colorectal cancer, IR remained stable after 2005 in 50-89-year-olds whilst increasing in 30–49-year-olds and those older than 90, with prevalence increasing across all age groups. For breast cancer, IR increased in those aged 40-49 but with stable prevalence after 2014, however IR was stable from 2005 in those aged 50-89 years with increasing prevalence. For prostate cancer, IR and prevalence increased in 40–79-year-olds but showed stability in incidence and increasing prevalence in 80-89-year-olds. Across all cancers, for males, the increase in prevalence was the greatest in those aged 80-89 from 3.17 in 2000 to 9.99% in 2019 and for females, in those aged 70-79 for breast cancer (2.03-6.04%).
Conclusions: Cancer incidence and prevalence continue to rise in the UK. For breast, colorectal, and prostate cancers, incidence and prevalence are increasing in younger age groups and the oldest populations, indicating a higher burden of disease and healthcare resources required.
