1. ¹Cancer Research UK Cancer Survival Group, Non-Communicable Disease Epidemiology Unit, Department of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK
2. ²Département d'Hépatogastroentérologie et Oncologie Digestive, Centre Hospitalo-Universitaire Ambroise-Paré, 9 avenue Charles de Gaulle, F-92100 Boulogne, France
3. ³Social and Health Analysis and Reporting Division, Office for National Statistics (Room FG/114), 1 Myddelton Street, London EC1R 1UW, UK
4. ⁴Wales Cancer Intelligence and Surveillance Unit, 13th Floor, Brunel House, 2 Fitzalan Road, Cardiff CF24 0HA, Wales
5. ⁵Division of Clinical Epidemiology and Ageing Research, German Cancer Research Center, Bergheimer Strasse 20, D-69115 Heidelberg, Germany
6. ⁶Biostatistics Division, Hospices Civils de Lyon, Université Claude Bernard, 162 avenue Lacassagne, F-69424 Lyon Cédex 3, France
7. ⁷Department of Social Policy, London School of Economics and Political Science, Houghton Street, London WC2A 2AE, UK

Correspondence: Dr B Rachet, E-mail: bernard.rachet@lshtm.ac.uk

Abstract

Survival has risen steadily since the 1970s for most cancers in adults in England and Wales, but persistent inequalities exist between those living in affluent and deprived areas. These differences are not seen for children. For many of the common adult cancers, these inequalities in survival (the 'deprivation gap') became more marked in the 1990s. This volume presents extended analyses of survival for adults diagnosed during the 14 years 1986–1999 and followed up to 2001, including trends in overall survival in England and Wales and trends in the deprivation gap in survival. The analyses include individual tumour data for 2.2 million cancer patients. This article outlines the structure of the supplement – an article for each of the 20 most common cancers in adults, followed by an expert commentary from one of the leading UK clinicians specialising in malignancies of that organ or system. The available data, quality control and methods of analysis are described here, rather than repeated in each of the 20 articles. We open the discussion between clinicians and epidemiologists on how to interpret the observed trends and inequalities in cancer survival, and we highlight some of the most important contrasts in these very different points of view. Survival improved substantially for adult cancer patients in England and Wales up to the end of the 20th century. Although socioeconomic inequalities in survival are remarkably persistent, the overall patterns suggest that these inequalities are largely avoidable.