Six take home messages about cancer statistics in Wales

Cancer is one of the biggest public health challenges that Wales faces, profoundly impacting people and health and care systems. And diagnoses continue to rise. Between 2002 and 2019, cancer cases in Wales increased by 27% from 16,055 to 20,392.

Fully understanding the statistics and trends behind cancer in Wales means we can improve evidence-based decision making, strategic decision making and improve early detection and treatment.

As part of our series of reports on cancer care in Wales, I’ve worked as part of our Sector Intelligence team to give an in-depth analysis of cancer trends in Wales. This blog sums up some of this work and gives you a look at some of the statistics and summarises six of my take home thoughts on factors such as cancer type, mortality, early detection, advanced in treatment and NHS capacity.

1. Our ageing population is driving the rise in cancer cases

As mentioned at the start of the blog, the number of cancer cases has increased by 27% in just under 20 years. However, if you adjust these figures for population ageing, there’s a relatively modest 2.2% rise. This suggests that the true cancer risk isn’t exponentially rocketing but instead Wales’ demographic profile is shifting towards older age groups.

Cancer and ageing are closely linked, due to mutations in our genes occurring over time and prolonged exposure to carcinogens. Changes in our body as we get older such as hormonal shifts, cellular senescence and immune system alterations can also influence cancer development.

Without significant intervention, our ageing population will place growing pressure on healthcare services in Wales.

2. We’re seeing the rates of different types of cancer rise and fall

Changing lifestyle, behavioural and demographic factors, as well as better early detection and prevention, are leading to a shift in the prevalence of specific cancers.

The data shows that melanoma and liver cancer are two types which have seen big rises in incidence. Lifestyle factors for both have had a huge influence.

Melanoma of the skin saw a jump from 466 cases in 2002 to 1,020 by 2019. Inadequate sun protection practises in older generations with less awareness of UV risks in their youth has been suggested a significant contributor to increased melanoma rates. However, there’s also been stabilising rates in younger people, which suggests public health campaigns are working.

With liver cancer, there was a rise from 151 cases in 2002 to 335 in 2019. Factors such as excessive alcohol consumption, obesity and smoking all have a big impact, with almost half of liver cancer cases being preventable. 

We’ve seen a drop in some cancers including stomach, which fell 30% from 549 cases to 387. This can be put down to economic development and improved food preservation, with using refrigeration for food storage and transport playing a big role. Declining rates of Helicobacter pylori infection have also driven this downward trend.

3. There’s a big link between deprivation and cancer risk

Cancer rates are 25% higher in the most deprived areas, with factors such as smoking rates, diet, environmental exposure and healthcare access being highly influential.

The Covid-19 pandemic exacerbated these disparities. People in less deprived areas experienced a quicker recovery in cancer diagnoses, which suggests those in disadvantaged areas faced bigger barriers to accessing healthcare in the pandemic such as GP visits and routine screening. What’s more, disparities in education and health awareness may contribute to delayed symptom recognition and medical help-seeking behaviour.

4. There’s some progress in cancer mortality rates

The statistics show an overall decline in cancer mortality of 16.3% since 2002. This demonstrates how cancer care has advanced over the past two decades. Early diagnosis through screening and public awareness and prevention through initiatives like the HPV vaccine have been vital in this.

However, we’re seeing a widening mortality gap between socioeconomic groups. Cancer mortality in the most deprived areas is now 53.8% higher than the least deprived, highlighting the urgent need for targeted intervention.

Some cancers also have persistent mortality rates. Lung cancer is the most fatal, highlighting the need for improved screening and earlier intervention. We are seeing some progress in this regard, such as the implementation of the National Lung Screening Programme for Wales.

5. There’s a growing challenge for what comes after cancer survival

Overall cancer survival rates are going up. Five-year survival has increased from 51.7% in 2002 to 63% in 2019. However, this does depend on the cancer type and stage at diagnosis, which drives home the importance of enhanced screening programmes and quicker referral pathways.

The jump in survival rates also means we should consider the growing population of cancer survivors in Wales, who can face a range of healthcare challenges. Ongoing health issues including recurrence, secondary cancers, long-term treatment side effects and mental health challenges can have a huge impact on people’s quality of life and NHS resource. It’s therefore important to improve post-treatment support to factor this in.

6. Waiting times and NHS capacity remain a huge issue and priority to solve

There is a 62-day treatment target for cancer for which the Welsh Government aims to meet 75% compliance, however this target is currently not being met. The failure to meet this target highlights the rising demand for cancer services and strain on the healthcare system in Wales.

Investment in our diagnostics and treatment capacity is essential. Otherwise waiting time targets will keep being missed and outcomes will worsen. Leaders can address this challenge by streamlining referral processes and increasing the cancer-related workforce, which has been highlighted by Senedd Research.

All these statistics from the report give a strong insight into what the cancer landscape is like in Wales. We can take heart from some of the figures, which indicate overall progress in survival and mortality. However, some of these numbers highlight the colossal system pressures our NHS in Wales is currently facing.

For more insights into the Welsh cancer landscape, read the report’s executive summary.