Colorectal cancer incidence, mortality and survival in South-east England between 1972 and 2001.

We report incidence, mortality and survival from colorectal cancer in South-east England using data from 162,022 incident cases and 97,697 deaths collected between 1972 and 2001 at the Thames Cancer Registry, which currently covers 14 million people. Overall, there was an increase in the incidence of colorectal cancer among men aged 50 years and over, and a decrease among the youngest age groups. In women, there was a clear decrease in incidence among those aged less than 60 years but a slight increase among those aged 60-79 years. Furthermore, there has been a steady decrease in mortality for all ages, larger in women than in men, and an increase in the 10-year relative survival for both sexes from just over 30% among those followed-up during 1981-1986 to just over 45% among those followed-up during 1997-2001.

Where do teenagers and young adults receive treatment for cancer?

BACKGROUND: Little is known about where teenagers and young adults receive their first cancer treatment. METHOD: We extracted data on 2260 residents of southeast England diagnosed with a malignant neoplasm aged 10-24 between 1998 and 2002 from the Thames Cancer Registry database. We identified 11 cancer network areas of residence, and the hospital and network where each patient received their first chemotherapy treatment. We classified hospitals as those including paediatric oncology centres, cancer centres with a teenage cancer unit or adult cancer centres or units. We examined how many patients in each of the age groups 10-14, 15-19 and 20-24 travelled outside their network of residence for chemotherapy. RESULTS: Overall 45% (1018) received chemotherapy. Three networks had paediatric oncology centres, and one also had a teenage cancer unit. Most 10-14-year-olds were referred from their network of residence to networks with these services. However, there was an increasing tendency for patients aged 15-19 and 20-24 to be treated within their network of residence and to be referred less commonly. CONCLUSIONS: Many young people with cancer are not referred to services providing care tailored to the needs of their age group. The absence of any pattern to referral, despite the presence of a teenage cancer unit in the area, suggests a lack of coordinated referral practice within and between cancer networks.