The facts of life and death: cancer and your chances of surviving

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AROUND 26,000 Scots are diagnosed with cancer each year and around 15,000 die of the disease annually.

One in three of us will contract cancer in our lifetime; one in four of us will die of it.

Cancer accounts for 27 per cent of all UK male deaths and 23 per cent of female deaths.

The World Health Organisation recently predicted a 50 per cent increase worldwide to 15 million new cases by 2020.

Over the past 50 years, the incidence of cancer in Britain has risen steadily. From 1989 to 1998 in Scotland, cancer in men grew by 6.7 per cent and in women by 11.7 per cent.

Your chance of getting cancer increases with age. Two-thirds of all cases are diagnosed in people aged 65 and over.

Compared with the rest of Western Europe and the US, Scotland does not fare well when it comes to surviving cancer. The most recent statistics show that, of the Scots diagnosed with cancer between 1985 and 1989, only 33.7 per cent were still alive five years later.

The chance of surviving cancer in Sweden is more than 50 per cent greater then it is in Scotland. Although men in Germany and France have a much higher incidence of cancer than those in Scotland, 45.2 per cent of French cancer patients and 44.7 per cent of German cancer patients were alive five years after diagnosis. In England, the five-year survival rate is 37 per cent and in Sweden, 52.1 per cent.

For the big three cancers - colorectal, breast and lung - Scotland has poor survival rates compared with its European neighbours. Along with prostate cancer, these diseases account for more than half of all Scotland’s cancer deaths.

Scotland also performs poorly on breast cancer compared with other European countries. It has about 3,000 new cases a year, a smaller incidence per head of population than Sweden or France but a higher mortality rate. Recent statistics show 65 per cent of Scots women were still alive five years after diagnosis; in France, the figure is 80.3 per cent and Sweden 80.5 per cent.

Experts hope strides made in treatment mean that the next set of published statistics will show Scottish breast cancer survival rates at around 75 per cent.

Lung cancer is responsible for around 3,750 deaths in Scotland annually, about a quarter of all Scotland’s cancer deaths. Although 90 per cent of lung cancer would be eradicated if smoking stopped, there has been little improvement in survival rates in the last 20 years and Scots top the international league when it comes to lung cancer.

It is one of the most difficult cancers to treat successfully and of the 4,500 Scots diagnosed with lung cancer each year, only 6.2 per cent will live for more than five years. In France, the survival rate is 11.9 per cent and in Germany 9.4 per cent. In Sweden it is 9 per cent and in England 7 per cent.

Bowel cancer, or colorectal cancer, is Scotland’s second most lethal cancer, with around 3,500 new cases diagnosed annually and around 1,750 deaths each year. For cancer of the colon, a disease more prevalent among men in France and Germany than in Scotland, the five-year survival rate for Scots is 41.1 per cent. For Germany it is 49.8 per cent, France 52.9 per cent and Sweden, 53.6 per cent.

Overall cancer levels in Scotland are almost a fifth higher than in England, a statistic attributed in the main to unhealthy lifestyle. The Scottish incidence of lung cancer is around 50 per cent higher than the UK average. Bowel cancer in men is around 25 per cent higher.

However, survival rates in Scotland have increased for the majority of cancers over the last 25 years. Skin cancer has seen a 31 per cent increase in survival rates for men and 20 per cent for women.

Testicular cancer has a five-year survival rate of 90 per cent in Scotland. Pancreatic cancer, by comparison, has a five-year survival rate of less than 4 per cent.

If you are still alive five years after cancer has first been diagnosed, your prospects are considered to be good.

Statistically, women have a better chance of survival than men. Overall, the younger you are when you are diagnosed, the better your chance of survival, even allowing for a higher level of mortality generally in older age groups.

Your sex can make a difference to how well you fare. In general, women with thyroid, oral and skin cancer do significantly better than men with the same diseases. Men with bone marrow cancer and bladder cancer have better prospects than female patients.

Dr Anna Gregor, lead cancer clinician for Scotland, says of the statistics: "Scotland is one of the top European countries for reducing mortality from cancer. We might have started from a high base but we are over the hump. While France, Italy, the eastern European countries and some Scandinavian countries have mortality statistics which are still rising, ours are falling."