Atlas of health variation in head and neck cancer in England: report summary
Published 22 October 2024
Applies to England
© Crown copyright 2024
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Summary
Head and neck cancer incidence and mortality rates are increasing in England.
Prior to the COVID-19 pandemic annual cases had reached 10,735 in England in 2019. Data for 2021 suggests the trend continues to increase with over 11,000 new cases recorded.
This increase is largely driven by an increase in oropharyngeal cancer, with 3,834 new cases in 2019, a 47% increase since 2013.
The highest incidence rates were in people aged 70 years and over, with an incidence rate over three and a half times higher than for those aged under 70 years.
Males have more than double the incidence rate of head and neck cancers than females.
People living in the most deprived areas have almost double the incidence rate of head and neck cancer compared to those living in the least deprived areas.
In England 53% of head and neck cancers were diagnosed at a late stage. Diagnosis at a late stage is associated with greater treatment complexity and poorer outcomes.
Across integrated care board (ICB) areas the percentage of patients diagnosed at a late stage varied between 45.0% and 59.6%.
People living in the most deprived areas were more likely to be diagnosed with head and neck cancer at a late stage than those living in the least deprived areas. Reasons may include lower health literacy, poorer communication of healthcare needs and poorer access to dental services.
In 2020, 3,469 people died of head and neck cancers in England, an increase from 3,313 deaths in 2019. The mortality rate for head and neck cancer continued to increase in 2020 while most other cancer mortality rates fell.
There was significant geographic variation in mortality rates. The ICB with the highest mortality rate was double the rate of the ICB with the lowest rate and people living in the most deprived areas have more than double the mortality rate of those living in the least deprived areas.
Interpreting the data
The information contained within this atlas is a starting point for commissioners and providers of oncology and head and neck cancer services to examine the indicators presented for their area, to assess the quality of their services and to benchmark themselves against others and the national average.
To understand what the variation means and whether it is unwarranted variation, further local work is necessary. It is important not to rely solely on comparison with the national average, but to consider what the appropriate figure or position is, based on local need. Where there are concerns, further analysis of the data, supplemented by local intelligence and consultation with stakeholders will usually be required to determine if action is required.
The atlas is intended to be used in conjunction with other local data sources and it is important users consider both counts and trends when reviewing and interpreting their own data. Users of the atlas are advised to not base judgements entirely on the most recent data point but to consider patterns over the whole time period presented.
This atlas presents data from 2013 to 2020, the most recent trend data available. While more recent data is available, 2021 rates are not comparable to earlier years as they have been calculated using new population estimates based on the 2021 census. Throughout the atlas we have commented on trends up to 2019 as the 2020 data may have been impacted by the COVID-19 pandemic.
In some areas, case numbers are small, so there is some statistical variation in the numbers from one year to the next. Despite this volatility, patterns at sub-national geographies remain relatively consistent over time. Where appropriate several years of data have been pooled to improve the robustness of the statistical analysis.
Differences in the rates of disease can be strongly related to the population age structure. Populations with higher proportions of older people can be expected to have higher rates. The atlas presents directly age-standardised rates that adjust for differences in age distribution. This enables rates to be compared between populations with differing age structures.
Further information
The main atlas report, interactive atlas dashboard, data and methods document, metadata and data file have also been published on the Fingertips website.
If you have any queries about this report, email dentalphintelligence@dhsc.gov.uk.