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The increase in incidence was predominantly driven by increases in prostate (male) and breast (female) cancers. Without these two sites, all cancer trends in age standardised incidence rates were relatively stable. Trends for a small number of less common cancers showed concerning increases in incidence rates, for example, in melanoma skin, liver, oral, and kidney cancers. The number of cancer deaths decreased over the 25 year period, by 20% in men (from 32\u2009878 to 26\u2009322) and 17% in women (28\u2009516 to 23\u2009719); age standardised mortality rates reduced for all cancers combined by 37% in men (\u22122.0% per year) and 33% in women (\u22121.6% per year). The largest decreases in mortality were noted for stomach, mesothelioma, and bladder cancers in men and stomach and cervical cancers and non-Hodgkin lymphoma in women. Most incidence and mortality changes were statistically significant even when the size of change was relatively small.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Cancer mortality had a substantial reduction during the past 25 years in both men and women aged 35-69 years. This decline is likely a reflection of the successes in cancer prevention (eg, smoking prevention policies and cessation programmes), earlier detection (eg, screening programmes) and improved diagnostic tests, and more effective treatment. By contrast, increased prevalence of non-smoking risk factors are the likely cause of the observed increased incidence for a small number of specific cancers. This analysis also provides a benchmark for the following decade, which will include the impact of covid-19 on cancer incidence and outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmj-2023-076962","type":"journal-article","created":{"date-parts":[[2024,3,13]],"date-time":"2024-03-13T20:50:14Z","timestamp":1710363014000},"page":"e076962","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":78,"title":["25 year trends in cancer incidence and mortality among adults aged 35-69 years in the UK, 1993-2018: retrospective secondary analysis"],"prefix":"10.1136","volume":"384","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6290-8717","authenticated-orcid":false,"given":"Jon","family":"Shelton","sequence":"first","affiliation":[{"name":"Cancer Research UK, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ewa","family":"Zotow","sequence":"additional","affiliation":[{"name":"University College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lesley","family":"Smith","sequence":"additional","affiliation":[{"name":"Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shane A","family":"Johnson","sequence":"additional","affiliation":[{"name":"Cancer Research UK, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine S","family":"Thomson","sequence":"additional","affiliation":[{"name":"Public Health Scotland, Edinburgh, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amar","family":"Ahmad","sequence":"additional","affiliation":[{"name":"Cancer Research UK, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lars","family":"Murdock","sequence":"additional","affiliation":[{"name":"Cancer Research UK, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diana","family":"Nagarwalla","sequence":"additional","affiliation":[{"name":"Cancer Research UK, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Forman","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Health, University of Leeds, Leeds, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2024,3,13]]},"reference":[{"key":"2025110102314491000_384.mar13_8.e076962.1","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/66.6.1192"},{"key":"2025110102314491000_384.mar13_8.e076962.2","unstructured":"Queen\u2019s University Belfast, Northern Ireland Cancer Registry . 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