Annual incidence of cancer will rise by a third by 2040, taking the number of newly-diagnosed cases to a record half a million each year, according to a new analysis by Cancer Research UK (CRUK), published to coincide with the close of its 20th anniversary year and World Cancer Day on Saturday.
The report, Cancer in the UK: Overview 2023, published today, predicted that based on current trends, the number of cancer cases diagnosed annually will increase from 384,000 now to 506,000 in 2040 – passing the half million mark for the first time, and meaning a total of up to 8.4 million new cases of cancer between now and 2040.
The rise in incidence, driven by a growing and ageing population, was forecasted to lead to an additional 41,000 cancer deaths annually – up almost a quarter from 167,000 now to an estimated 208,000 by 2040 – meaning 3.5 million cancer deaths in the UK between 2023 and 2040.
Cumulative numbers of deaths and cases between 2023 and 2040 included approximately:
- 1.3 million cases and 277,000 deaths for prostate cancer
- 1.2 million cases and 199,000 deaths for breast cancer
- 1.1 million cases and 707,000 deaths for lung cancer
- 811,000 cases and 320,000 deaths for bowel cancer
Even though rates of diagnosis were projected to fall for some cancer types, such as bowel cancer and non-Hodgkin lymphoma, the absolute numbers would increase due to population growth, CRUK said. Similarly, while it is anticipated that mortality rates may fall for many cancer types, absolute numbers of deaths are likely to increase.
The researchers said that the majority of both cases and deaths were anticipated to be in people aged 70 and over (60% of cases and 76% of deaths – up from 42% and around 50%, respectively, in the late 1970s).
In her foreword to the report, CRUK's Chief Executive, Michelle Mitchell, said that in the two decades since the charity was founded, "cancer outcomes have continued to improve", with survival doubling since the 1970s. However, more cancers diagnosed in older people, who are more likely to be living with other long-term health conditions, means more cancer patients will also have more complex needs, which must be met.
NHS 'Not on Track' With Earlier Diagnosis
The charity said that whilst cancer survival has improved for many cancer types, the UK lags behind comparable countries, and "needs to take bold action to prevent more cancers", as well as ensuring faster diagnosis and treatment. It called for immediate action by the Government "to address the chronic staff and equipment shortages within the NHS", as well as increased investment in cancer research and innovation, with a 10-year fully funded plan to "transform cancer survival from world-lagging to world leading".
Too many patients are diagnosed at a late stage and via emergency presentations; diagnostic services are struggling to keep up with demand, and cancer waiting times are currently the worst on record, the report noted.
"The NHS is not on track to achieve its ambition of diagnosing 75% of cancers at stage 1 or 2 by 2028," CRUK warned. A recent poll it commissioned from YouGov revealed that 79% of 2387 adults surveyed didn't think the NHS had enough staff or equipment to tackle cancer.
According to a recent report from NHS Digital, at the end of September last year almost one in 10 (9.7%) posts in the NHS in England were contemporaneously vacant - 133,446 full time equivalent vacancies in total and a record high.
Ms Mitchell, said: "Today’s analysis provides a stark reminder of the challenges the NHS in England is set to face in years to come. Cancer patients are already facing unacceptably long waits for diagnosis and treatment, and staff in cancer services are working very hard.
"On World Cancer Day, we are demanding that the Prime Minister, Rishi Sunak, provide long-term, lasting solutions to ensure cancer survival dramatically improves in England. A 10-year cancer plan that will prepare cancer services for the future, give people affected by cancer the care they deserve and the resources – people and equipment – the NHS needs, is essential."
Many Cancers Potentially Preventable
CRUK highlighted research showing that the proportion of cancer cases in the UK attributable to modifiable risk factors was 37.7% in 2015, meaning that almost 4 in 10 cancer cases ( or more than 135,000 annually) were preventable. The two biggest preventable causes of cancer are smoking and overweight/obesity.
"If recent trends continue, smoking could cause around one million cancer cases in the UK between now and 2040," according to calculations by CRUK’s Cancer Intelligence Team. Yet the Government is currently on track to miss its target of creating a Smokefree England by 2030, the charity warned.
Its recent analysis of cancer and smoking trends noted that, while smoking is known to be the main cause of preventable cancer and death, accounting for around 15% of all cancer cases in England overall, it was responsible for a majority of cancers linked with deprivation. More than twice as many cancer cases in the most deprived quintile of the population compared with the least deprived could be attributed to smoking (21.1% versus 9.7%).
CRUK called on the Government to implement the recommendations of the independent Khan Review to make smoking obsolete by 2030. The Khan review urged the Government to increase the age of sale of tobacco products from 18, by one year, every year "until no one can buy a tobacco product", as well as additional funding for smoke free policies, if necessary from a tobacco industry levy. It also called for the NHS to offer stop smoking advice and support at every interaction with patients, as well as promoting vaping as an alternative.
A Department of Health and Social Care spokesperson told us that the Government "remained committed to its smokefree ambition" and would continue to enforce strong regulations on the sale of cigarettes to help "protect future generations from starting this lethal addiction". However it was "still considering" the recommendations made in the Khan review - "further information will be available in due course".
The Cancer Intelligence Team also calculated that by 2040 there will be more than 21 million obese adults in the UK, well over a third of the population (36%), and overtaking the proportion (30%) of people of a healthy weight. It would also mean that obesity overtakes smoking as the largest cause of cancer. CRUK said that despite this, "junk food marketing restrictions have been pushed back even further", and called on the Government to implement "stronger prevention strategies", not least to alleviate pressures on the NHS.
NHS Could be 'Overwhelmed' by Number of New Cancer Cases
Cancer Research UK’s chief clinician, Professor Charles Swanton, said: "Right now, the NHS is just about treading water. By the end of the next decade, if left unaided, the NHS risks being overwhelmed by the sheer volume of new cancer diagnoses. It takes 15 years to train an oncologist, pathologist, radiologist, or surgeon. The Government must start planning now to give patients the support they will so desperately need.
"I'm hopeful that, through investment and reform in the health service, and advancements in research, future numbers of cancer cases might not be as high as these projections warn. But if the Government doesn’t act now to prepare for this demand, there's a risk that our hard-fought progress in cancer survival could go into reverse."
Asked to comment on the report by Medscape News UK, a Department of Health and Social Care spokesperson said: "We are laser focused on fighting cancer on all fronts – prevention, diagnosis, treatment, research and funding – so we can deliver the best possible outcomes for patients.
"More patients are being diagnosed and starting treatment earlier, with 92 community diagnostic centres open since 2021 delivering over 2.8 million tests, scans and checks including to detect cancer. We also recently announced a £10million investment in more breast cancer screening units as well as software and service upgrades.
"We have partnered up with among the best and brightest minds who created the COVID Pfizer vaccine to try to develop new cancer vaccines and put record amounts in exciting trials to look at ways of better treating cancer."
Ms Mitchell said: "There are real challenges ahead, but unprecedented opportunities for progress too. We must rise to both of them so that we can bring about a world where everybody can live longer, better lives, free from the fear of cancer."