Unhealthy lifestyles linked to UK cancer rates

“British women are more likely to develop breast cancer than females from some of the poorer countries in the world, shocking new figures show,” reports the_ Daily Express_ . The Express and several other newspapers suggest that the higher cancer numbers are due to “unhealthy lifestyles and binge drinking”.

This news story is based on a report from the World Cancer Research Fund (WCRF). The report found the UK to have the 22nd highest cancer rates in the world, with the 11th highest breast cancer rates. The difference in rates, between countries, is thought to be partly due to better detection of cancers in developed countries such as the UK. The headlines highlight the fact that unhealthy lifestyles are also likely to be contributing to the high cancer rates in the UK and the rest of the developed world. Professor Martin Wiseman, Medical and Scientific Adviser for WCRF, said:

“The high incidence rates in the UK, Denmark and other high-income countries are not inevitable and lifestyle changes can make a real difference to people’s risk. In fact, scientists estimate that about a third of the most common cancers in the UK and other high-income countries could be prevented by maintaining a healthy weight, being more physically active and eating more healthily.”

Our Live Well pages contain lots of information on how to reduce your chances of cancer through leading a healthier lifestyle.

What are the reports based on?

This news story is based on a press release from the World Cancer Research Fund (WCRF) using figures compiled by the World Health Organization (WHO). The figures were collected by the WHO’s International Agency for Research in Cancer (IARC) GLOBOCAN project. The aim of the GLOBOCAN project is to provide current estimates of the national incidence and death rate from major types of cancers for all countries of the world. These estimates have been made using data from 2008, the most recent available to the IARC, along with information publicly available on the internet.

Some of the figures on new cancer diagnoses are from cancer registries that record all diagnoses within the country’s population, while some are calculated using the available registries that record diagnoses for an area within the country. Data on causes of death are collected by the WHO, although the quality of the data varies from country to country. Estimates of national populations are based on figures from the UN.

The estimates on cancer incidence have been broken down for all ages and for gender. The figures are analysed in a way that takes into account differences in population age in different countries.

What do the figures show?

The figures show that high-income countries generally had higher cancer rates than low-income countries. Denmark, Ireland and Australia had the three highest rates of new cancer diagnoses with 326,317 and 314 people per 100,000 diagnosed each year. There was a marked contrast between the countries with the highest cancer diagnosis and death rates however. The countries with the highest rates of cancer deaths each year were Mongolia, Hungary and Armenia, with 185, 166 and 154 per 100,000 per year.

How does the UK perform?

• According to the figures, the UK has the 22nd highest cancer rates in the world out of the 184 countries or territories assessed, with about 267 people out of every 100,000 being diagnosed with cancer each year.
• When looking at the rates by sex, the UK has the 33rd highest cancer rates in the world for men, and the 12th highest rate of cancers for women.
• Cancer mortality rates in the UK were 116 per 100,000 people, the 38th highest.
• Breast cancer rates in the UK are the 11th highest in the world. This may be linked to the fact that breast cancer is particularly associated with higher body fat and alcohol consumption. Worldwide, breast cancer is the most common cancer in women, and Western Europe has the highest rates of any region in the world with an overall incidence of 89.7 per 100,000 women. For the UK, this figure is 89.1. In the developed world, incidence figures are typically above 80 per 100,000 women, compared to the developing world where they are typically below 40. The difference in mortality rates between different global regions is lower, at between 6 and 19 per 100,000 people per year. This is mainly due to the favourable chances of survival from disease in the developed world. In the UK the mortality figure is 18.6 per 100,000 women per year, making it 31st highest in the world.
• Following breast cancer, the second most common cancer for women in the UK is lung cancer (25.9 cases diagnosed per 100,000 women per year; annual mortality 20.8 per 100,000), closely followed by colorectal cancer (25.3 cases diagnosed per 100,000 women per year; annual mortality 9.1 per 100,000).
• For UK men, the most common cancer is prostate (64.0 cases diagnosed per 100,000 men per year; annual mortality 13.8 per 100,000), followed by lung cancer (38.2 cases diagnosed per 100,000 men per year; annual mortality 32.2 per 100,000) and colorectal (37.3 cases diagnosed per 100,000 men per year; annual mortality 13.9 per 100,000).
• For both men and women in the UK there are 266.9 cancers diagnosed per 100,000 of the population, annually, with a mortality of 115.8 per 100,000 of the population, annually. A UK man has a 13.3% chance of dying from cancer before the age of 75; a woman has a 10.6% chance.

Why do some countries have higher cancer rates?

The WHO figures were not analysed to look at why cancer rates are higher in some countries than others. However, the WCRF press release does make some suggestions of likely reasons. It suggests that high-income countries such as Denmark and the UK are better at diagnosing and recording cases of cancer than lower income countries.

However, it also suggests that to a large extent the differences are likely to be linked to lifestyle, with people in high income countries being less physically active, more likely to be obese and drinking more alcohol. Denmark, for example, is reported to have high rates of smoking and drinking among women.

Can we say whether cancer rates have improved?

It is difficult to say from these figures. These most recent GLOBOCAN figures pertain to 2008 only, and although the project has produced figures for previous years the IARC cautions that because the methods used to obtain data on cancer rates are being improved and changed over time, estimates from different years are not directly comparable. They say that changes in rates should therefore not be interpreted as showing a trend in cancer rates over time.

However, a clearer picture on cancer survival in the UK and several other developed countries may be seen from a study published in December by Cancer Research UK and the Department of Health. Published in The Lancet , the study compared cancer survival rates with comparable Western countries. Those figures showed that survival improved in the UK between 1995 and 2007 for all cancers.

What can I do to reduce my risk of cancer?

Make healthier lifestyle choices. Professor Martin Wiseman, Medical and Scientific Adviser for WCRF, said:

“We know that people in high-income countries are more likely to be overweight, drink a lot of alcohol and be inactive.

“There is strong scientific evidence that these factors increase the risk of several common cancers and the figures show the effect of this. When you look at the list, the countries that do worse for these factors tend to be nearer the top.

“The high incidence rates in the UK, Denmark and other high-income countries are not inevitable and lifestyle changes can make a real difference to people’s risk. In fact, scientists estimate that about a third of the most common cancers in the UK and other high-income countries could be prevented by maintaining a healthy weight, being more physically active and eating more healthily.

“Of course, not smoking will have an important effect beyond that, as will avoiding sunburn. So when you put all these factors together it is clear that many cases are being diagnosed every year that could have been prevented.”

Are these differences in cancer rates between countries reliable?

These results can show patterns across different regions, but as there are differences in how the data is collected and the completeness of data between countries, some figures may be more accurate than others, and the figures may not all be directly comparable. However, these are probably the best worldwide figures currently available.

Sarah Woolnough from Cancer Research UK said: “Comparing cancer incidence rates between different countries can be misleading due to differences in how the data is collected. In some countries, such as the UK, the whole population is accounted for in the data. But in others the coverage is much smaller, so the overall figures may not actually be representative of the whole country.”