Reports

Cancer survival in Wales

Main points

For people diagnosed with cancer in Wales during 2018 to 2022, 75% survived one year from diagnosis and 60% survived five years from diagnosis, after accounting for other causes of death.

Cancer survival improved steadily from the early 2000s to the mid 2010s. Between the 2002-2006 and 2014-2018 diagnosis periods, one year survival rose by 8 percentage points and five year survival by 9 percentage points (Figure 1).

Figure 1: Trends in one- and five-year survival of cancer in Wales

One- and five-year age-standardised net survival (%), all cancers excluding NMSC, persons aged 15-99, Wales, 2002-2006 to 2018-2022

Produced by Public Health Wales, using cancer registration data (WCISU), public health mortality (PHM) and mid-year population estimates (MYE) (ONS) and Welsh Index of Multiple Deprivation (WIMD) (WG)

However, improvements have since stalled, with trends remaining broadly flat up to 2018-2022. This levelling off began before the pandemic, from the 2015-2019 period.

One-year cancer survival has recovered significantly following the COVID-19 pandemic.

Looking at single years of diagnosis, one-year cancer survival fell by 4 percentage points between 2019 and 2020, around the onset of the COVID-19 pandemic. By 2022, it had recovered to pre-pandemic levels (Figure 2).

Figure 2: Trends in one-year survival of cancer in Wales

One-year age-standardised net survival (%), all cancers excluding NMSC, persons aged 15-99, Wales, 2002-2022

Produced by Public Health Wales, using cancer registration data (WCISU), PHM and MYE (ONS) and WIMD (WG)

Cancers typically diagnosed at a later stage – such as colorectal and lung – experienced the largest temporary declines in one-year survival but have since recovered well. In contrast, cancers more often diagnosed earlier – including prostate and breast – were less affected.

Cancer survival worsens with increasing area deprivation. In 2018-2022, five-year survival was significantly higher in the least deprived areas than in the most deprived areas.

Despite broad improvements in cancer survival, the area deprivation gap has remained stable, with estimates around 10-13 percentage points higher in the least deprived areas (Figure 3).

Figure 3: Trends in five-year survival of cancer in Wales by area deprivation fifth

Five-year unstandardised net-survival (%) by deprivation fifth, all caners excluding NMSC, persons aged 15-99, Wales, 2002-2006 to 2018-2022

Produced by Public Health Wales, using cancer registration data (WCISU), PHM and MYE (ONS) and WIMD (WG)

Colorectal cancer has consistently had the widest deprivation gap amongst the most common cancers. This difference narrowed up to the 2017–2021 diagnosis period but has since widened again, driven by improving five-year survival in the least deprived areas alongside little change in the most deprived (Figure 4).

Figure 4: Trends in five-year survival of colorectal (bowel) cancer in Wales by area deprivation fifth

Five-year unstandardised net survival (%) by deprivation fifth, colorectal cancer, persons aged 15-99, Wales, 2002-2006 to 2018-2022

Produced by Public Health Wales, using cancer registration data (WCISU), PHM and MYE (ONS) and WIMD (WG)

The area deprivation gap in five-year unstandardised net survival is almost twice as large for late-stage diagnosis than for early-stage.

For all stageable cancers, deprivation inequalities are significant for both stage groupings, though markedly wider for late-stage diagnosis (Figure 5).

Figure 5: Five-year survival of early- and late-stage diagnoses of stageable cancers in Wales by area deprivation fifth during the diagnosis period 2018-2022

Five-year unstandardised net survival (%) by stage at diagnosis and deprivation fifth, all stageable cancers, persons aged 15-99, Wales, 2018-2022

Produced by Public Health Wales, using cancer registration data (WCISU), PHM and MYE (ONS) and WIMD (WG)

Site-specific relationships are less consistent. For colorectal five-year survival and lung cancer one-year survival, deprivation gaps are significant for late-stage, but not early-stage diagnosis. In contrast, prostate and female breast cancers show smaller differences overall, with no clear or consistent relationship with deprivation across stage groupings.

Interpretation should consider that COVID-19 disrupted access to screening, GP referral and diagnostics, and this may have affected stage at diagnosis differently across deprivation groups.

Data tables

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Technical information

Pre-release list

Dr Tracey Cooper, NHS Wales Cancer Board Chair and Chief Executive of Public Health Wales

Professor Tom Crosby, National Cancer Clinical Director for Wales

Anthony Davies, Senior Policy Manager, Value Based Healthcare Policy Team, Welsh Government

Public Health Scotland: Thomas Godfrey, Greig Stanners, Callum Rintoul, Gemma Turner