Overall cancer mortality decreases during the pandemic, but inequalities widen for some cancers
A new publication by the Welsh Cancer Intelligence and Surveillance Unit (WCISU) at Public Health Wales has shown that the long term decrease in the cancer death rate has accelerated over the past two years.
The publication, Cancer Mortality in Wales 2002-2021, shows that while the long term decrease in overall cancer mortality – the rate at which people are dying of cancer - had started to slow, in 2019 and 2020 that decrease intensified, with a further sharp decrease to 2021. Cancer remains one of the leading causes of death in Wales.
The gap in the overall cancer death rate between the most deprived and least deprived areas was wider during the latest decade than the previous one, rising from 40 per cent higher in 2002, to almost 55 per cent higher in 2021. However, overall, the gap didn’t change during the pandemic.
Professor Dyfed Wyn Huws, Director of WCISU, said: “While it is encouraging to see that the gap in overall cancer death rates between the most and least deprived areas didn’t increase in the most recent years – including during the pandemic – it is concerning that the gap hasn’t narrowed over the last decade.
“The rapidly decreasing cancer death rate we saw during the Covid-19 pandemic would normally be very welcome, but we need to interpret the impact of the pandemic with caution.
“Some possible explanations is that information on deaths during late 2021 may not yet be complete until later in 2022. Also, people with undetected cancer, or with cancer diagnosed during or before the pandemic, may have died from other health conditions during the pandemic, including from Covid-19, instead of from cancer.
“Further detailed research is underway in Wales, led by the Welsh Cancer Intelligence and Surveillance Unit with many partner organisations, in order to understand the recent trends in cancer mortality during the Covid-19 pandemic.”
Professor Huws added: “Widening inequalities in female breast cancer almost disappeared during the pandemic, after reaching a peak in 2019 - with the rate then being 50 per cent higher in the most deprived areas compared to the least. During the pandemic, the death rate from breast cancer in women initially increased in the least deprived areas and decreased in the most deprived.
“Of the four most common cancers, the widest mortality inequalities are from lung cancer. The deprivation gap widened up until 2017, before reducing in recent years, including during the pandemic. But the mortality rate was still 240 per cent higher in the most compared to the least deprived areas of Wales in 2021.
“In contrast, inequalities in colorectal (bowel) cancer mortality rapidly increased during the pandemic - from a 30 per cent difference between most and least deprived areas in 2019, to 80 per cent by 2021.
“Area deprivation differences in prostate cancer mortality were small and varied from year-to-year in the decade leading up to the pandemic, but by 2021, the rate was 40 per cent higher in the most deprived areas compared to the least.
“Overall cancer mortality has decreased by 19 per cent in Wales over the last two decades up to 2021. The decline is highest in males at over 20 per cent, with women seeing a slower decrease of around 14 per cent.
“We compared our statistics with cancer mortality across the UK from 2002 onwards, and found that the overall cancer death rate in Wales has been generally higher than in Northern Ireland, and consistently higher than in England. Scotland’s cancer mortality remained the highest throughout the same period.”
Other findings show that lung, prostate, female breast and colorectal cancers together account for more than half of the 8,795 cancer deaths in 2021. Lung cancer accounts for two in every 10 deaths from cancer, and age is a significant risk factor for cancer mortality with 70 per cent of all cancer deaths in recent years occurring in those over the age of 70.
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