Information Services Division

Cancer Incidence in
Scotland (2016)

Publication date
24 April 2018
YYYY

A National Statistics publication for Scotland

Information Services Division

This is a National Statistics Publication

National Statistics status means that the official statistics meet the highest standards of
trustworthiness, quality and public value. They are identified by the quality mark shown
above.
They comply with the Code of Practice for statistics and are awarded National Statistics
status following an assessment by the UK Statistics Authority’s regulatory arm. The Authority
considers whether the statistics meet the highest standards of Code compliance, including
the value they add to public decisions and debate.

Find out more about the Code of Practice at:

https://www.statisticsauthority.gov.uk/osr/code-of-practice/

Find out more about National Statistics at:

https://www.statisticsauthority.gov.uk/national-statistician/types-of-official-statistics/

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Contents

Contents................................................................................................................................... 2
Introduction .............................................................................................................................. 3
Main Points .............................................................................................................................. 4
Results and Commentary......................................................................................................... 5
Cancer incidence in Scotland ............................................................................................... 5
Cancer incidence by age ...................................................................................................... 6
Cancer incidence by socio-economic deprivation quintile .................................................... 6
Cancer incidence by site ...................................................................................................... 7
Glossary ................................................................................................................................. 13
List of Tables.......................................................................................................................... 14
Contact................................................................................................................................... 16
Further Information ................................................................................................................ 16
Rate this publication ............................................................................................................... 16
Appendices ............................................................................................................................ 17
Appendix 1 – Background information ................................................................................ 17
Appendix 2 – Publication Metadata .................................................................................... 19
Appendix 3 – Early access details ...................................................................................... 21
Appendix 4 – ISD and Official Statistics ............................................................................. 22

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Introduction
This publication provides information on cancer incidence in Scotland, covering the years
1992-2016 for each main type of cancer. The information presented here updates information
previously available on the Information Services Division (ISD) website.

Cancer registration in Scotland

The Scottish Cancer Registry has been collecting information on cancer since 1958. Data
collected by the Registry are published by ISD. This information is used for a wide variety of
purposes including: public health surveillance; health needs assessment, planning and
commissioning of cancer services; evaluation of the impact of interventions on incidence and
survival; clinical audit and health services research; epidemiological studies; and providing
information to support genetic counselling and health promotion. New developments in the
Scottish Cancer Registration and Intelligence Service will make cancer data more readily
available and will add new data on diagnosis and treatment to the Registry.

Using this publication

It may be misleading to focus too much attention on any apparent changes in incidence
between 2015 and 2016; it is more informative to examine trends in incidence observed over
a number of years. Striking changes from one year to the next may occur in the case of rare
cancers, but these are likely to reflect random fluctuation caused by small numbers of cases.
In such cases it is even more important to examine incidence rates for a number of years
aggregated together, rather than focussing on a single year of incidence.
Cancer registrations are believed to be essentially complete for the year 2016, but it is
important to note that the cancer registration database is dynamic. In common with cancer
registries in other countries, cancer incidence rates in Scotland can take up to five years after
the end of a given calendar year to reach 100% completeness and stability, due to the
continuing accrual of late registrations coming to light through death certification, for
example.

Data Visualisation
Data visualisation is included as part of this publication. This can be found on our website. If
you have any comments or suggestions about this visualisation, please contact us by email.

Acknowledgement
This publication uses data shared by patients and collected by the NHS as part of their care
and support.

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Main Points
 In 2016, excluding non-melanoma skin cancer, there were 31,331 people diagnosed with
cancer in Scotland (16,084 women and 15,247 men).
 Over the last ten years, the risk of developing cancer in Scotland decreased by 6% for
men but increased by 2% for women. Overall, there was a decrease in the risk of
developing cancer of 3% in the past decade.
 The number of cancers being diagnosed continues to rise over time, as the size of the
older population – who are at greater risk of most malignancies – increases. In 2016,
75% of cancer diagnoses were in people aged 60 and over.
 People who live in more deprived areas of Scotland are 26% more likely to be diagnosed
with cancer than those living in the least deprived areas. This overall finding is not
consistent for all cancer types and cannot be wholly attributed to differences in
behavioural factors. For example, the risks of the commonest sex-specific cancers in
men and women, prostate and breast, respectively, are higher in the least deprived areas.
 Lung cancer remains the most common cancer in Scotland with 5,045 cases diagnosed in
2016. For the first time, more women than men were diagnosed with lung cancer. The
decrease in risk of 18% over the past decade in men reflects decreases in the prevalence
of smoking.
 Bowel cancers are the third most common cancer in men and women. The risk of
developing bowel cancer fell by 15% in the past decade in Scotland; it fell by 18% in men
and 9% in women.
 Rates of thyroid, liver, kidney and pancreatic cancers have increased over time in men
and women. Uterine cancers and malignant melanomas of the skin in men have
increased.
 There is considerable variation in incidence trends over time between different types of
cancer. While each cancer has its own particular risk factors, cigarette smoking and being
overweight contribute to many different types of cancer.
 Nearly 4 in 10 cancers can be attributed to potentially modifiable risk factors. Cigarette
smoking, being overweight and some occupational risk factors are among the largest
cancer risks to the Scottish population. The effects of sunburn, alcohol consumption and
a diet that is high in meat and low in fruit and vegetables are also apparent in these
cancer data.

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Results and Commentary

These statistics can be found by cancer site on the Information Services Division website
cancer topic area and in the Cancer in Scotland summary report. Other statistics available
there include cancer mortality, lifetime risk, prevalence and survival.

Cancer incidence in Scotland

In 2016, 31,331 people were diagnosed with cancer in Scotland (16,084 females and 15,247
males). The number of people diagnosed has increased over the last ten years from 28,899
in 2007 (Figure 1). These figures do not include non-melanoma skin cancers, of which over
11,600 were diagnosed in 2016. An explanation of why non-melanoma skin cancers are not
included can be found in Appendix 1.
The overall risk of cancer is higher in men than women (Figure 1). Over the ten years to
2016, the age-adjusted incidence rates of cancer have increased by 1.9% for females and
decreased by 6.2% for males. This has reduced the gap between cancer risk in men and
women. For both sexes combined, the age-adjusted incidence rate has decreased by 2.6 %.
In contrast, the numbers of women diagnosed with cancer is higher than the numbers of men
and both have increased over time. An increase in the number of older people is one of the
main explanations for these increasing numbers.

Figure 1. Cancer incidence in Scotland, 1992-2016. Number of cases and age-adjusted

incidence rate by sex.

Source: Scottish Cancer Registry

1. All cancers excluding non-melanoma skin cancers (ICD-10 C00-C97 excl C44)

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Cancer incidence by age

The rate, or risk, of cancer diagnoses increases with age in both sexes (Figure 2). Age-
specific numbers of cancers reflect both the risk and the number of people at risk. The
numbers of cancers increases with age to a peak at 65-69 years, and then declines
thereafter as the size of the older population decreases. In 2016, over 75% of cancer
diagnoses were in people aged 60 and over.

Figure 2. Number of cancer registrations and age-specific rates per 100,000 population
for all malignant neoplasms diagnosed in 2016 by 5-year age group and sex.

Source: Scottish Cancer Registry

1. All cancers excluding non-melanoma skin cancers (ICD-10 C00-C97 excl C44)

Cancer incidence by socio-economic deprivation quintile

People who live in more deprived areas of Scotland are more likely to be diagnosed with
cancer. For all cancers combined, the most deprived areas in Scotland have incidence rates
that are 26% higher than the least deprived areas (Figure 3). This overall finding is not
consistent for all cancer types nor can it be wholly attributed to differences in behavioural
factors. For example, the risks of the commonest sex-specific cancers in men and women,
prostate and breast, respectively, are higher in the least deprived areas. Socio-economic
deprivation may further increase the cancer risks of some behavioural factors.

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Figure 3. Age-adjusted cancer incidence rates for all cancers combined (excluding
non-melanoma skin cancer) by deprivation quintile1 in Scotland, 2012-2016.

Source: Scottish Cancer Registry

1. Deprivation quintile based on SIMD2012.

Cancer incidence by site

Lung cancer remains the most common cancer overall in Scotland for both sexes combined,
with 5,045 cases diagnosed in 2016. This accounted for 16.1% of all cancers in Scotland.
There were 4,636 cases of breast cancer (14.8%) and 3,700 cases of colorectal cancer
(11.8%) (Figure 4, Table 1).
For females, the most common cancers are breast, lung and colorectal cancers, accounting
for 55.5% of all malignancies in women. Prostate, lung and colorectal cancers are the most
common for males, accounting for 49.9% of cancers in men.
There have been significant changes in the rates of cancer over the past decade. For
females, there has been little significant change in rates of breast and lung cancers while
there has been a significant fall of 9% in the rate of colorectal cancers (Figure 5, Table 1).
Rates of thyroid, liver, kidney, uterine, cervical, head and neck, and pancreatic cancers have
increased in women. For males, there has been little significant change in the rate of
prostate cancers but falls of 18% in both lung and colorectal cancers over the past decade.
Rates of thyroid, liver, kidney, malignant melanoma, and pancreatic cancers have increased
in men.
A recent publication in the British Journal of Cancer1 estimated that nearly four in ten cancers
can be attributed to potentially modifiable risk factors. Cigarette smoking, being overweight
and some occupational risk factors are among the largest cancer risks to the Scottish

1
Brown, K.F. et al. The fraction of cancer attributable to modifiable risk factors in England, Wales, Scotland,
Northern Ireland, and the United Kingdom in 2015. British Journal of Cancer 118, 1-12 (2018).

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population. The effects of sunburn, alcohol and a diet that is high in meat and low in fruit and
vegetables are also apparent in these cancer data.
When attempting to interpret trends in cancer incidence, it is important to remember that
recent patterns of cancer are, for the most part, likely to reflect trends in the prevalence of
risk and protective factors going back several decades. The commentary below relates to
changes in the incidence rates of different types of cancer over the last ten years.

Figure 4. Most common 20 cancers in Scotland in 2016 for females and males (ordered
by total for all persons)

Source: Scottish Cancer Registry

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Table 1: Most common cancers in Scotland in 2016: Rank, number, frequency and
change in incidence rate since 2006

10 year %
Rank Type of cancer Number Frequency 1 p-value
change

Males
1 Prostate (C61) 3,167 20.8% -3.5 0.2603
2 Trachea, bronchus and lung (C33-C34) 2,491 16.3% -17.5 <0.0001
3 Colorectal (C18-C20) 1,949 12.8% -18.3 <0.0001
4 Head and Neck (C00-C14, C30-C32) 852 5.6% +0.9 0.8136
5 Malignant melanoma of skin (C43) 688 4.5% +28.7 <0.0001
6 Kidney (C64-C65) 627 4.1% +24.7 <0.0001
7 Bladder (C67) 580 3.8% -5.6 0.1037
8 Oesophagus (C15) 576 3.8% -6.2 0.1399
9 Non-Hodgkin lymphoma (C82-C86) 573 3.8% +3.9 0.3000
10 Stomach (C16) 412 2.7% -34.6 <0.0001
Other malignant neoplasms 3,332 21.9% x x
All malignant neoplasms excluding
15,247 100.0% -6.2 <0.0001
non-melanoma skin cancer

Females
1 Breast (C50) 4,615 28.7% +2.9 0.1243
2 Trachea, bronchus and lung (C33-C34) 2,554 15.9% +2.4 0.3137
3 Colorectal (C18-C20) 1,751 10.9% -9.1 0.0003
4 Corpus uteri (C54) 783 4.9% +33.2 <0.0001
5 Malignant melanoma of skin (C43) 695 4.3% +1.9 0.6199
6 Ovary (C56) 582 3.6% -13.4 <0.0001
7 Non-Hodgkin lymphoma (C82-C86) 449 2.8% -7.5 0.0785
8 Head and Neck (C00-C14, C30-C32) 388 2.4% +17.6 0.0032
9 Pancreas (C25) 385 2.4% +10.9 0.0411
10 Kidney (C64-C65) 353 2.2% +9.0 0.1877
Other malignant neoplasms 3,529 21.9% x x
All malignant neoplasms excluding
16,084 100.0% +1.9 0.1284
non-melanoma skin cancer

All persons
1 Trachea, bronchus and lung (C33-C34) 5,045 16.1% -9.6 0.0002
2
2 Breast (C50) 4,636 14.8% x x
3 Colorectal (C18-C20) 3,700 11.8% -14.8 <0.0001
2
4 Prostate (C61) 3,167 10.1% x x
5 Malignant melanoma of skin (C43) 1,383 4.4% +15.2 <0.0001
6 Head and Neck (C00-C14, C30-C32) 1,240 4.0% +5.2 0.0332
7 Non-Hodgkin lymphoma (C82-C86) 1,022 3.3% -1.2 0.6474
8 Kidney (C64-C65) 980 3.1% +18.9 <0.0001
9 Bladder (C67) 870 2.8% -2.5 0.6645
10 Oesophagus (C15) 858 2.7% -6.4 0.1209
Other malignant neoplasms 8,430 26.9% x x
All malignant neoplasms excluding
31,331 100.0% -2.6 0.2545
non-melanoma skin cancer
Source: Scottish Cancer Registry
'x' = not applicable.
1. Estimated 10-year change in age-adjusted incidence rates, calculated using Poisson regression
analyses.
2. Percentage change in incidence is not shown in the ‘All Persons’ table for cancers occurring
mainly or only in one sex.
3. p-value is the probability that the 10 year percentage change occurred by chance. A p-value of
less than 0.05 indicates that the change is statistically significant.

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Figure 5. 10 year percentage change in incidence rate for 20 most common cancers in
Scotland

Source: Scottish Cancer Registry

Breast cancer
Known risk factors for breast cancer include older mother’s age at the birth of her first child,
smaller number of children, post-menopausal obesity, and alcohol consumption. The
introduction or extension of existing screening programmes leads to increases in diagnoses
of breast cancer.

Prostate cancer
There are few modifiable risk factors for prostate cancer. The rate of prostate-specific
antigen testing has a significant effect on rates of diagnosis.

Lung cancer
The single largest risk factor for lung cancer is cigarette smoking and the large decrease in
lung cancer in men reflects decreases in smoking prevalence over several decades.
Occupational exposures and low fruit and vegetable consumption are also risk factors.

Colorectal cancer
Recent decreases in incidence might reflect the removal of pre-malignant polyps at
colonoscopies resulting from the Scottish Bowel Screening Programme, but the larger
decrease in men compared with women is not consistent with men’s lower uptake of
screening. Modifiable risk factors for colorectal cancer include red and processed meat,
overweight, alcohol consumption and smoking.

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Cancer of the body of the uterus (corpus uteri)

The majority of cancers at this anatomical site affect the endometrium or lining of the womb.
The increase in incidence may be due, at least in part, to longstanding changes in fertility
(since childbearing appears to protect against endometrial cancer) and increases in levels of
obesity (which increase risk). A further contributing factor may be a decrease in rates of
hysterectomy, which leaves a larger population at risk of developing uterine cancer.

Malignant melanoma of the skin

Malignant melanoma of the skin is the fifth most common cancer in both women and men.
Incidence rates increased over the last decade by 28.7% in males and while they did not
change significantly in females over the past decade, substantial increases have occurred
previously. The primary recognised risk factor for melanoma of the skin is exposure to natural
and artificial sunlight, especially but not exclusively at a young age.

Ovarian cancer
The 13.4% decrease observed in ovarian cancer incidence may be partly due to increased
use of the oral contraceptive pill from the 1960s onwards, since this appears to protect
against the development of ovarian cancer.

Oesophageal cancer
It is not possible to say whether observed reductions in oesophageal cancers are due to
chance alone. Established risk factors for oesophageal cancer include smoking, alcohol
misuse, obesity, and chronic gastro-oesophageal reflux disease. Oesophageal cancer does
not appear in Table 1 for females as it is not one of the ten most common cancers for
women.

Bladder cancer
It is not possible to say whether observed changes in bladder cancers are due to chance
alone. One of the main risk factors for bladder cancer is smoking. Bladder cancer does not
appear in Table 1 for females as it is not one of the ten most common cancers for women.

Non-Hodgkin’s lymphoma
Non-Hodgkin’s lymphoma (NHL) has decreased in females by 7.5%, with an increase in
males of 3.9%, however neither of these changes are statistically significant. Although
immunosuppression has been associated with the development of NHL, much has still to be
understood about the causes of NHL.

Pancreatic cancer
There have been increases in the incidence of pancreatic cancer in both females (10.9%)
and males (4.5%). While the causes of pancreatic cancer are poorly understood, smoking,
smokeless tobacco and overweight are reasonably well-established risk factors.

Kidney cancer
Cancers of the kidney continue to show increases in incidence rates over the last ten years of
24.7% and 9.0% for males and females, respectively. The increase has occurred primarily in
cancers of the renal parenchyma rather than of the renal pelvis. The reason for this increase

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is not clear. Established risk factors include obesity and smoking, but advances in medical
imaging may also have led to an increase in incidental diagnosis of some tumours.

Cervical cancer (cervix uteri)

The incidence of cervical cancer has increased by 19.1% over the last ten years. It was the
eleventh most common cancer in females in Scotland in 2016 but it is the most common
cancer in women under the age of 35 (as it is in the rest of the UK). The main risk factor for
cervical cancer is infection with the human papilloma virus (HPV), which can cause the most
common forms of cervical cancer.

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Glossary

Age-adjusted rate See European Age Standardised Rate (EASR) below.

Benign tumour A tumour that does not invade and destroy local tissue or spread to other sites
in the body.

Cancer registry The Scottish Cancer Registry is responsible for the collection of information on
all new cases of cancer arising in residents of Scotland. More detailed
information is available on the ISD website here.

Carcinoma A cancer of the epithelial tissue that covers all the body’s organs. Most cancers
are carcinomas.

Confidence interval The interval or range of values that is likely to contain the true value of a
parameter.

Crude rate The number of cases divided by the population. The crude rate does not
attempt to adjust for differences in age and sex structures between different
populations (see European age-standardised rate below). Typically expressed
as the number of cases per 100,000 population.

Epithelial tissue Tissue that covers the body’s organs and other internal surfaces.

European Age The rate that would have been found if the population in Scotland had the same
Standardised Rate (EASR) age-composition as the hypothetical standard European population. The 2013
European Standard Population (ESP2013) has been used to calculate EASRs
within this publication.
th
ICD-10 The 10 revision of the International Classification of Diseases produced by the
World Health Organisation (WHO). It assigns codes to particular diseases and
conditions.

Incidence Incidence refers to the number of new cases of a condition in a defined

population during a defined period and is typically expressed as the number of
new cases per 100,000 population per year (or other suitable units).

Indolent tumour One that grows slowly or is considered to be low risk.

Lifetime risk A person’s chance of developing cancer during their life.

Malignant tumour Cancerous growth.

Mortality rate The number of deaths as a rate per 100,000 population.

Neoplasm Abnormal growth

Non-melanoma skin cancer A type of cancer that usually develops slowly in the upper layers of the skin.
(NMSC)

Percentage A rate, number or amount in each hundred.

Prevalence The number of people with a diagnosis of a particular condition who are alive at
a given point in time.

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List of Tables
Table No. Cancer Incidence by year Time Period File and size
0 Cancer in Scotland Summary 1992-2016 PDF [495 kb]
1 All Cancers 1992-2016 Excel [1013 kb]
2 Bladder 1992-2016 Excel [985 kb]
3 Bone and Connective Tissues 1992-2016 Excel [2065 kb]
4 Brain and CNS 1992-2016 Excel [2714 kb]
5 Breast 1992-2016 Excel [1493 kb]
6 Colorectal 1992-2016 Excel [2134 kb]
7 Female Genital Organs 1992-2016 Excel [1725 kb]
8 Head and Neck 1992-2016 Excel [5359 kb]
9 Hodgkin Lymphoma 1992-2016 Excel [979 kb]
10 Kidney 1992-2016 Excel [992 kb]
11 Leukaemias 1992-2016 Excel [3164 kb]
12 Liver 1992-2016 Excel [975 kb]
13 Lung and Mesothelioma 1992-2016 Excel [1518 kb]
14 Male Genital Organs 1992-2016 Excel [973 kb]
15 Multiple Myeloma 1992-2016 Excel [973 kb]
16 Non-Hodgkin Lymphoma 1992-2016 Excel [1001 kb]
17 Oesophagus 1992-2016 Excel [982 kb]
18 Pancreas 1992-2016 Excel [982 kb]
19 Skin 1992-2016 Excel [2717 kb]
20 Stomach 1992-2016 Excel [985 kb]

Table No. Summarised Cancer Incidence Time Period File and size
21 All Cancers 2012-2016 Excel [208 kb]
22 Bladder 2012-2016 Excel [204 kb]
23 Bone and Connective Tissues 2012-2016 Excel [308 kb]
24 Brain and CNS 2012-2016 Excel [371 kb]
25 Breast 2012-2016 Excel [249 kb]
26 Colorectal 2012-2016 Excel [313 kb]
27 Female Genital Organs 2012-2016 Excel [272 kb]
28 Head and Neck 2012-2016 Excel [622 kb]
29 Hodgkin Lymphoma 2012-2016 Excel [205 kb]
30 Kidney 2012-2016 Excel [201 kb]
31 Leukaemias 2012-2016 Excel [413 kb]
32 Liver 2012-2016 Excel [200 kb]
33 Lung and Mesothelioma 2012-2016 Excel [254 kb]
34 Male Genital Organs 2012-2016 Excel [203 kb]

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35 Multiple Myeloma 2012-2016 Excel [199 kb]

36 Non-Hodgkin Lymphoma 2012-2016 Excel [202 kb]
37 Oesophagus 2012-2016 Excel [203 kb]
38 Pancreas 2012-2016 Excel [200 kb]
39 Skin 2012-2016 Excel [364 kb]
40 Stomach 2012-2016 Excel [204 kb]

Table No. Summarised Cancer Incidence Time Period File and size
41 Incidence and Mortality by ICD-10 code 2007-2016 Excel [273 kb]
42 Cervical cancer incidence timeline 1982-2016 Excel [115 kb]
43 Cancer Treatment summary 2012-2016 Excel [45 kb]
44 Changes in incidence rate over 10 years 2006-2016 Excel [49 kb]

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Contact
Andrew Deas
Principal Information Analyst
Phone: 0131 275 7030
Email: andrew.deas@nhs.net
Lesley Bhatti
Senior Information Analyst
Phone: 0131 275 6125
Email: lesley.bhatti@nhs.net
Cavan Gallagher
Information Analyst
Phone: 0141 282 2061
Email: cavan.gallagher@nhs.net
David Morrison
Consultant in Public Health Medicine
Phone: 0131 275 6087
Email: david.morrison@nhs.net

Further Information
ISD publish a wide range of cancer statistics. You can find all our cancer information on our
website including data visualisation.
The next release of this publication will be 29 January 2019.

Rate this publication

Please provide feedback on this publication to help us improve our services.

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Information Services Division

Appendices
Appendix 1 – Background information
Source of data
The Scottish Cancer Registry is the source of the cancer incidence data provided in this
publication. More information on the registry can be found on the Information Services
Division website.
Note that cancer registrations differ from recorded hospital admissions for cancer, the
statistics for which can be found on the Hospital Care pages on the ISD Website. An
individual diagnosed with a new primary cancer would have a single registration for that
cancer, whereas he/she might have multiple admissions to hospital for the cancer. Moreover,
the diagnosis and treatment of cancer does not inevitably lead to hospital admission in every
case.

Non-melanoma skin cancer

As noted within the main body of the publication, non-melanoma skin cancer is excluded from
analyses of all cancers combined for the following reasons:
 In the interests of comparison with other countries, because not all cancer registries
collect data on non-melanoma skin cancers.
 Only the first occurrence of a basal cell carcinoma (the most common type of non-
melanoma skin cancer) is collected in Scotland because they are so common.
The ISD data on non-melanoma skin cancer is available on our website.

Data completeness
Cancer registrations are believed to be essentially complete for the year 2016, but it is
important to note that the cancer registration database is dynamic. In common with other
cancer registries, cancer incidence rates in Scotland can take up to five years after the end of
a given calendar year to stabilise due to the continuing accrual of late registrations coming to
light, for example through death certification.

This seems to be a particular issue for chronic lymphocytic leukaemia (CLL) – if the disease
is progressing slowly and diagnosed incidentally on the basis of a blood test, hospital contact
(and therefore opportunities for ascertainment) may be limited for some months or even
years after diagnosis.

Note on trends
It may be misleading to focus too much attention on any apparent changes in incidence
between 2015 and 2016; it is more informative to examine trends in incidence observed over
a number of years. Striking changes from one year to the next may occur in the case of rare
cancers, but these are likely to reflect random fluctuation caused by small numbers of cases -
in such cases, it is even more important to examine incidence rates for a number of years
aggregated together, rather than focusing on a single year of incidence.

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Comparisons – UK and international

Cancer incidence publications for the rest of the UK can be found at the links below:

England
Wales
Northern Ireland

Comparisons are also produced by Cancer Research UK, and the most recent incidence
data can be found on their CancerStats page.

Comparison of Scottish and UK cancer data to that of other countries is a complex process
because of the wide variation amongst data collection and coding practices, as well as
variation in the quality and completeness of data. The International Agency for Research on
Cancer maintain an online database, Global Cancer Observatory, that is searchable for
comparative data.

Age-adjusted incidence rates

Based on the number of cancer registrations in each of the calendar years, the following
rates were calculated for this publication:
Crude Rate
The crude rate is the total number of people with an illness (or who die) in a
country or region, divided by the total population of that country or region,
and is normally expressed 'per 1,000’, ‘per 10,000’ or ‘per 100,000’.

Making comparisons on the crude rate can be misleading if the age structures of the
populations of the countries or regions are quite different. Areas with larger percentages of
younger people are unlikely to have as high levels of incidence as areas with larger
percentages of older people – and therefore if we don’t adjust for these differences we may
draw the wrong conclusion about the health of an area simply because of the age-structure of
the population. European Age-Sex Standardised Rates (EASRs) allow us to make
comparisons between different geographical areas as they allow the effects of having
different age structures in either the same population over time or different geographies to be
removed.

European Age-Sex Standardised Rate (EASR) using ESP2013

For each 5 year age group, the crude rate is calculated and then the
weighted average of all age groups is taken based on the weightings of the
2013 European Standard Population, to give the overall EASR.

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Appendix 2 – Publication Metadata

Metadata Indicator Description

Publication title Cancer Incidence in Scotland (2016)
Description Annual and 5 year summaries of new incidence cases of cancer in Scotland,
by Cancer Network Region and Health Board. Within Scotland and Network
levels of reporting, the incidence figures are broken down by age group and
sex.
Theme Health and Social Care
Topic Conditions and Diseases
Format Excel workbooks
Data source(s) Scottish Cancer Registry (SMR06)
Date that data are acquired 05 March 2018
Release date 24 April 2018
Frequency Annual
Timeframe of data and Data up to 31 December 2016. No delays between data availability and
timeliness processing of data for publication.
Continuity of data Reports include data from 1992 to 2016. Coding of cancer registrations
moved from ICD-9 to ICD-10 and from ICD-O to ICD-O2 in incidence year
1997, then to ICD-O3 in incidence year 2006. ICD codes have been back-
mapped to 1989 for continuity of reporting. The range of statistics provided
does mean that the continuity will vary, and while considered to be very high,
any notable discontinuities (eg for specific conditions) will be highlighted within
the published data.
Revisions statement As with other population-based cancer registries, the Scottish Cancer Registry
is dynamic, with ongoing updating of records. Each year's release includes a
refresh of the previous years, and as new registrations from previous years
come to light, or changes in the coding are taken into account, the numbers
may change. The timing of the release is intended to balance the likelihood of
significant revision with timeliness of data.
Revisions relevant to this The definition of Non Hodgkin Lymphoma has changed to include ICD-10
publication code C86, which was introduced in 2014. Incidence figures for 2014 and 2015
have been recalculated. There is minimal impact on the overall incidence
figures for Non Hodgkin Lymphoma.
Concepts and definitions See the Cancer Information FAQs
Relevance and key uses of The number and type of cancer registrations, by sex and geography, allow
the statistics planning for provision of cancer treatment services and palliative care
planning. Permits indirect measure of success of public health measures and
interventions over the longer term. Key uses include: public health
surveillance; health needs assessment, planning and commissioning of
cancer services; evaluation of the impact of interventions on incidence and
survival; clinical audit and health services research; epidemiological studies;
and providing information to support genetic counselling and health
promotion.
Accuracy Registry data are subject to validation at data entry and quality assurance
procedures. See the Cancer Information FAQs.
Reported data are compared to previous years' figures and to expected
trends.
Completeness At time of extraction, data for the most recent year are estimated to be at least
98% complete. See above note on Revisions. Routine indicators of data
quality are compared to the rest of the UK and to other countries, and are

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available on the UKIACR website. There have been adhoc studies of data
completeness in the past. See the Cancer Information FAQs.
Comparability Cancer incidence data are regularly compared with the UK and other
countries, for example in the publication Cancer Incidence in Five
Continents. Cancer incidence data is also published separately for
England, Wales and Northern Ireland.
Accessibility It is the policy of ISD Scotland to make its web sites and products accessible
according to published guidelines.
Coherence and clarity All Cancer tables are accessible via the Cancer pages on the ISD website.
Cancer sites are presented within Excel spreadsheets of cancer groupings,
where appropriate. This should minimise the number of spreadsheets a user
has to go through to find data, as well as ensure that they are selecting the
correct data. Geographical hierarchies are also presented using drop down
menus. Spreadsheets may require the user to manipulate drop-down menus,
to avoid a frequent problem of confounding data on males and females, and
geographical designations.
Value type and unit of Number of new cases of cancer as count; rates of cancer as crude, European
measurement age standardised, World Age standardised, and as Standardised incidence
ratios. Number, eg 1.1
Disclosure The ISD protocol on Statistical Disclosure Protocol is followed.
Official Statistics National Statistics
designation
UK Statistics Authority May 2010
Assessment
Last published 25 April 2017
Next published 29 January 2019
Date of first publication
Help email nss.isdcancerstats@nhs.net
Date form completed 29 March 2018

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Appendix 3 – Early access details

Pre-Release Access
Under terms of the "Pre-Release Access to Official Statistics (Scotland) Order 2008", ISD is
obliged to publish information on those receiving Pre-Release Access ("Pre-Release Access"
refers to statistics in their final form prior to publication). The standard maximum Pre-Release
Access is five working days. Shown below are details of those receiving standard Pre-
Release Access.

Standard Pre-Release Access:

Scottish Government Health Department
NHS Board Chief Executives
NHS Board Communication leads

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Appendix 4 – ISD and Official Statistics

About ISD
Scotland has some of the best health service data in the world combining high quality, consistency,
national coverage and the ability to link data to allow patient based analysis and follow up.
Information Services Division (ISD) is a business operating unit of NHS National Services
Scotland and has been in existence for over 40 years. We are an essential support service to
NHSScotland and the Scottish Government and others, responsive to the needs of
NHSScotland as the delivery of health and social care evolves.
Purpose: To deliver effective national and specialist intelligence services to improve the
health and wellbeing of people in Scotland.
Mission: Better Information, Better Decisions, Better Health
Vision: To be a valued partner in improving health and wellbeing in Scotland by providing a
world class intelligence service.

Official Statistics
Information Services Division (ISD) is the principal and authoritative source of statistics on
health and care services in Scotland. ISD is designated by legislation as a producer of
‘Official Statistics’. Our official statistics publications are produced to a high professional
standard and comply with the Code of Practice for Official Statistics. The Code of Practice is
produced and monitored by the UK Statistics Authority which is independent of Government.
Under the Code of Practice, the format, content and timing of statistics publications are the
responsibility of professional staff working within ISD.
ISD’s statistical publications are currently classified as one of the following:
 National Statistics (ie assessed by the UK Statistics Authority as complying with the Code
of Practice)
 National Statistics (ie legacy, still to be assessed by the UK Statistics Authority)
 Official Statistics (ie still to be assessed by the UK Statistics Authority)
 other (not Official Statistics)
Further information on ISD’s statistics, including compliance with the Code of Practice for
Official Statistics, and on the UK Statistics Authority, is available on the ISD website.

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