Survival by stage
To assess the impact of early diagnosis campaigns, screening programmes and improvements in healthcare it is important to have accurate and complete detail on the stage of a cancer at diagnosis. Stage is a measure of how much a cancer has grown and spread, with later stages having poorer outcomes. The quality of staging data has improved greatly in recent years, with completeness for all cancers combined (excl. NMSC) at 76% in 2013, exceeding the goal of 70% (figures from the NHS CCGOIS, stage completeness, 2014). Completeness varies by site, with figures for breast, colorectal, lung, ovarian and prostate cancers being relatively high. There also remains substantial variation by CCG.
Several pieces of analysis exist that have used the 2012, 2013 and 2014 English staging data, including breakdowns of completeness, early stage diagnosis and survival analysis that will help inform further international study, helping facilitate comparisons of greater validity.
Cancer breakdown by stage 2014
Stage breakdown by CCG 2014
Data were extracted from the English National Cancer Registration Service database CAS (Cancer Analysis System) which has a staging flag pre-calculated.
The completeness of staging data continues to improve, allowing clearer interpretation of the cancer survival by stage figures. The completeness and survival figures for 2012-2014 data (and overall trends in survival from 2005-2014) are summarised in the data-briefing below:
Cancer survival in England by stage 2014
A short report has been produced giving a brief summary of the main variation in one-year relative survival of the selected cancer types by stage, sex, age, and socio-economic deprivation. Unless broken down by age survival figures presented in this report have been age-standardised. The report also compared the 2012 survival figures to those from the reports of the International Cancer Benchmarking Partnership (ICBP) from 2004-2007.
Cancer survival in England by stage 2012
In addition to the figures in this report, relative survival estimates are available in the accompanying workbooks. One-year age-standardised and non-standardised relative survival estimates were calculated on imputed and non-imputed datasets segmented by cancer type, sex, age, and socio-economic deprivation. Survival is calculated in intervals of: diagnosis to 1 month, 1-3 months, 3-6 months and 6-12 months.
Imputed stage survival workbook:This workbook contains data where unknown stage has been assigned to a stage category using statistical imputation. This methodology is outlined in the main report. Age-standardised relative survival estimates are shown for persons, males, females and by deprivation quintile with non-age-standardised rates shown for three different age groupings.
Non-imputed stage survival workbook:This workbook contains data for all TNM stages and unknown stage. Age-standardised relative survival estimates are shown for persons, males, females and by deprivation quintile with non-age-standardised rates shown for three different age groupings.
Survival by stage related studies
This spread sheet provides the proportion of cancer cases by stage at diagnosis for patients presenting via each of the six presentation routes, for 2012, 2013 and 2012-2013 combined. Detailed information is provided for 10 cancer sites.
Data are stratified by sex, age, socio-economic deprivation quintile and ethnicity. For further information on the methods and caveats, please see the workbook.
Interpreting geographic variation in cancer stage: This report examines two measures, firstly the completeness of staging data and secondly the proportion of early staged (I or II) cancers at Clinical Commissioning Group (CCG) level and former cancer registry areas.
Stage at diagnosis and early mortality from cancer in England: this article in the British Journal of Cancer summarises the stage breakdown and impact on survival for 5 cancer types in 2012.
Geographic breakdowns of stage completeness and early diagnosis are available for 2012 and 2013 from the Cancer Commissioning Toolkit (CCT).