From 1992 to 2006 there was a mean of 16 cycling fatalities per year (range 8-21). 146 deaths (60%) were in inner London and 96 in outer London.
There was no evidence for a decline over time (p=0.7) other than a pronounced dip in 2004 when there were 8 fatalities. Freight vehicles were involved in 103 of 242 (43%) of all incidents and the vehicle was making a left turn in over half of these (53%).
The fatality rate ranged from 20.5 deaths in 1992 to 11.1 deaths in 2006 per 100,000 estimated cyclists per kilometre (rate ratio 0.54, 95% confidence interval 0.28 to 1.03).
Conclusions: There is little evidence fatality rates have fallen. Freight vehicles over 3.5 tonnes continue to present a disproportionate threat; they should be removed from urban roads and more appropriate means of delivery of essential goods found.