Cancer incidence in Scotland
To December 2020

A supporting statement for this statistical release is available from the news section of our website.

About this release

This release by Public Health Scotland (PHS) provides an annual update of cancer incidence statistics in Scotland from January 1996 to December 2020. All cancer types are included. Generally, cancer incidence statistics should be interpreted within the context of long-term trends, these statistics demonstrate the impacts of the COVID-19 pandemic on cancer services.

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Cancer incidence in Scotland, age-adjusted rates* and Poisson Model 95% Confidence Intervals, 2010 to 2020

*Note truncated y-axis.

Main points

• Overall, the rate (-9%) and number (-8%) of new cancers fell by between 2019 and 2020. There were 30,395 cases in 2020, down from 33,156 in 2019. Most of the decrease is likely due to under-diagnosis caused by the pandemic. The reduction in cancer registrations is much larger than would have been expected had the pandemic not happened.
• Many cancers showed much bigger falls in incidence in 2020 compared with 2019:
• the top four cancers in Scotland showed falls of: lung (7%), female breast (11%), prostate (10%) and colorectal (19%); while cervical cancer incidence fell by a quarter (24%).
• It also appears that pausing screening services led to an under-diagnosis of the early-stage breast (-20%), colorectal (-33%) and cervical (-45%) cancers compared with the number of early detected cancers in 2019.
• Overall, the pandemic appears not to have increased socio-economic inequalities in cancer incidence (33% higher in more deprived areas pre-pandemic compared with 30% in 2020). These short-term reductions in differences between most and least deprived are more likely to indicate a greater level of under-diagnosis rather than greater falls in cancer occurrence in more deprived areas. Lung cancer diagnoses fell by 12% in people from the most deprived areas and by 5% in the least deprived areas. However, some cancer types fell to a greater extent in people from less deprived areas. Cervical cancer diagnoses almost halved (46% reduction) in the least deprived areas but fell 16% in the most deprived areas.

Background

The Scottish Cancer Registry (external website) collects information on every cancer in Scotland and uses the data to inform cancer control. Cancer registrations are believed to be essentially complete for the year 2020, but it is important to note that the cancer registration database is dynamic. "All cancers" by convention exclude non-melanoma skin cancers.

COVID-19 had a huge impact on all aspects of cancer control in Scotland, causing widespread disruption from the end of March 2020. All cancer screening programmes were paused for several months and urgent referrals for suspected cancer fell substantially as patients followed the 'Stay at home; protect the NHS' message. Patients being less likely to seek help, and delays in investigations may have led to patients not being diagnosed in 2020 when they could have been. Also, some will have died of COVID-19 before they were diagnosed with cancer in 2020.

Further information

The next release of this publication will be 18 April 2023.