Cancer cases rise across Northern Ireland as new 30‑year data reveals stark inequalities
Cancer touches every community in Northern Ireland, and new figures released today by Queen’s University’s Northern Ireland Cancer Registry (NICR) offer the clearest picture yet of how the disease has shaped lives over the past three decades.
overing diagnoses from 1993 to 2023, the report charts incidence, survival, prevalence and the stark inequalities that continue to define cancer outcomes across the region.
The headline finding is sobering: an average of 10,549 people were diagnosed with cancer each year between 2019 and 2023, excluding non‑melanoma skin cancer (NMSC), which remains common but generally less serious. Add those cases in, and the annual total rises by almost 4,000 more.
Behind the numbers sit familiar patterns. For women, breast cancer remains the most frequently diagnosed, accounting for nearly a third of all female cancers. Lung cancer follows, then colorectal cancer.
For men, prostate cancer dominates, representing more than one in four male diagnoses, with colorectal and lung cancer close behind.
Age remains the strongest predictor of cancer risk. More than a third of all cases occur in people aged 75 and over, and incidence peaks among those in their late eighties.
Yet the report stresses that cancer is not solely a disease of older age. Each year, an average of 51 children aged 0–14 are diagnosed - a reminder that cancer’s reach is wide and indiscriminate.
The overall number of cases continues to rise. Compared with 2014-2018, the average annual number of cancers (excluding NMSC) increased by 8.8% in 2019–2023.
The jump was sharper among men (+11.9%) than women (+5.6%). Some cancer types saw particularly steep increases: thyroid cancer rose by more than 48% in men and 51% in women, while liver cancer, malignant melanoma and prostate cancer also climbed significantly.
Where you live matters too. After adjusting for population size and age, cancer incidence rates were 8.4% higher than the Northern Ireland average in Belfast, and 3.3% higher in the Western Trust.
Rates were lower in the south‑eastern, southern and northern trusts. Socio‑economic deprivation also plays a powerful role: the most deprived areas recorded incidence rates 13.5% higher than the NI average, while the least deprived areas saw rates 6% lower.
The type of cancer often reflects this inequality. Cervical, head and neck, kidney, liver, lung, oesophageal, stomach and cancers of unknown primary were all more common in deprived communities.
Meanwhile, malignant melanoma and prostate cancer were more frequently diagnosed in the least deprived areas - a pattern linked to lifestyle, occupational exposure and healthcare access.
Stage at diagnosis remains one of the most critical factors in survival. During 2019-2023, the proportion of patients diagnosed at stage IV ranged from just 3.3% for malignant melanoma to 51.3% for pancreatic cancer. Among the four most common cancers, late‑stage diagnosis was lowest for breast cancer (5.5%) and highest for lung cancer (44.6%).
Survival figures underline the importance of early detection. Among patients diagnosed between 2014 and 2018, one‑year net survival stood at 74.5%, while five‑year survival reached 58.1%. Yet almost one in five patients died within six months of diagnosis - a stark reminder of how aggressive some cancers can be.
Five‑year survival varies dramatically by cancer type. Breast cancer patients had an 83.2% survival rate, and prostate cancer patients fared even better at 87.1%. Colorectal cancer survival hovered around 60%. Lung cancer, however, remained the most lethal of the common cancers, with five‑year survival at just 19.4% for women and 14.4% for men.
Some cancers show encouraging progress. Between 2009-2013 and 2014–2018, overall five‑year survival rose from 55.9% to 58.1%. Lung cancer survival improved significantly, as did survival for male pancreatic cancer. No cancer type recorded a significant decline in survival over that period.
Age at diagnosis also shapes outcomes. Younger patients consistently fare better: five‑year survival for colorectal cancer is 66.4% among those aged 15–54, compared with 48.5% for those aged 75–99. The pattern is similar for breast, lung and prostate cancers. But stage at diagnosis remains the biggest determinant of all.
The gulf between early and late‑stage survival is stark: early‑stage colorectal cancer has a five‑year survival rate of 92.7%, compared with 7.1% for late‑stage disease. For lung cancer, the difference is even more dramatic — 55.6% versus 2%.
The report also highlights how many people are now living with cancer. At the end of 2023, 76,455 people in Northern Ireland had been diagnosed with cancer at some point between 1999 and 2023.
More than two‑thirds had been diagnosed within the past decade, and over a third were aged 75 or older. Breast cancer remains the most prevalent, with 18,586 women living with the disease, followed by prostate cancer, with 14,258 men.
Taken together, the NICR figures paint a picture of a population ageing, surviving longer, but also facing rising incidence and persistent inequalities. They show progress - improved survival, better detection, more people living beyond diagnosis - but also the scale of the challenge ahead. Cancer remains one of NI’s most pressing public health issues, shaped by age, geography, deprivation and the critical importance of early diagnosis.