1. better information --> better decisions --> better health1 Projections of cancer incidence in Scotland to 2020 Roger Black, Samuel Oduro, David Brewster Information Services Division

2. better information --> better decisions --> better health2 Background First projections used for Cancer Scenarios report and Cancer in Scotland: Action for Change (2001) Updated for Cancer in Scotland: Sustaining Change and radiotherapy planning (2004) Further updated to account for revised population projections and used in Better Cancer Care (2008) Current exercise exploits availability of more historical baseline incidence data, more recent population projections and new statistical methodology

3. Data and methods Historical incidence data 1978-2007 GRO population estimates 1978-2007 GRO population projections 2008-2022 Age-Period-Cohort models using software developed by the Norwegian Cancer Registry (NORDPRED)

4. Lung cancer risk varies by birth cohort Source: Swerdlow et al, 1998

5. Age-Period-Cohort models Model works by estimating the simultaneous influence of age, period and birth cohort on individual risk Cohort effects highly predictable Future period effects not so, e.g. new screening programme, diagnostic test

6. Source: GRO(S) We have consistently underestimated population growth in Scotland …

7. Source: GRO(S) … and most of the growth is in people aged 75+

8. Results (average number of new cases per annum)

10. Validation

11. Comment on results Results reasonably reliable for most of the common cancers and the total Concern about prostate cancer (period effect) We usually adopted the most conservative results from the range of model predictions Model choice is always to some extent subjective

12. Conclusion New cancer cases expected to increase by approximately 8% every five years up to 2020 This is mainly due to our aging population Results for Scotland compatible with those for England (33% increase from 2001 to 2020).