Abstract
Reliable modelling of the dynamics of cancer morbidity risk is important, not least due to its significant impact on healthcare and related policies. We identify morbidity trends and regional differences in England for all-cancer and type-specific incidence between 1981 and 2016. We use Bayesian modelling to estimate cancer morbidity incidence at various age, year, gender, and region levels. Our analysis shows increasing trends in most rates and marked regional variations that also appear to intensify through time in most cases. All-cancer rates have increased significantly, with the highest increase in East, North West and North East. The absolute difference between the rates in the highest- and lowest-incidence region, per 100,000 people, has widened from 39 (95% CI 33-45) to 86 (78-94) for females, and from 94 (85-104) to 116 (105-127) for males. Lung cancer incidence for females has shown the highest increase in Yorkshire and the Humber, while for males it has declined in all regions with the highest decrease in London. The gap between the highest- and lowest-incidence region for females has widened from 47 (42-51) to 94 (88-100). Temporal change in in bowel cancer risk is less manifested, with regional heterogeneity also declining. Prostate cancer incidence has increased with the highest increase in London, and the regional gap has expanded from 33 (30-36) to 76 (69-83). For breast cancer incidence the highest increase has occurred in North East, while the regional variation shows a less discernible increase. The analysis reveals that there are important regional differences in the incidence of all-type and type-specific cancers, and that most of these regional differences become more pronounced over time. A significant increase in regional variation has been demonstrated for most types of cancer examined here, except for bowel cancer where differences have narrowed.
Highlights
In this study we investigate trends and differences in population cancer morbidity risk in England stratified by age, year, gender and region between 1981 and 2016 using the data available from the Office for National Statistics (ONS) [1]
The analysis has found that age-specific cancer incidence has generally increased in all regions in the period from 1981 to 2016 for all cancer types, with the exception of lung cancer in males
The findings point towards significant regional differences in cancer incidence, with the inequalities increasing over the study period in absolute terms for all-cancer rates, lung cancer in females and prostate cancer
Summary
In this study we investigate trends and differences in population cancer morbidity risk in England stratified by age, year, gender and region between 1981 and 2016 using the data available from the Office for National Statistics (ONS) [1]. We systematically employ several generalised linear model (GLM) structures including change point analysis to capture major health policy interventions for cancer incidence data in a Bayesian setting to estimate age-specific. Cancer morbidity trends and regional differences longevity and morbidity risk" (project ID: ARC001). The funders did not play any role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. All the views presented in this paper are of the authors only
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