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Joint Strategic Needs Assessment
Briefing: Analysis of Cancer Mortality in Oldham
May 2014
Joint Strategic Needs Assessment
Key Findings and Implications
The study was carried out because cancer mortality in Oldham is higher than that for
England. Although mortality has declined, the rate of decline for Oldham has been
much slower.
Key Findings
The prospects for future reduction in
cancer mortality are mixed. Our
incidence rates remain higher than
England. Lung cancer incidence is of
particular concern. However, we have
lower rates for colorectal and cervical
cancer incidence.
The biggest causes of cancer deaths
are Digestive, Respiratory, Breast,
Lymphoid, Haematopoietic and
related, Male genital including
prostate, Urinary Tract and Female
genital including cervical.
Although this is broadly similar
compared to England there are some
marked differences. Lymphoid and
related cancers are much higher in
Oldham.
The biggest inequality gap between
England and Oldham is that for lung
cancer. Stomach cancer in men and
Upper Gastrointestinal cancers are
also comparatively high.
In addition to respiratory and digestive
cancers, breast cancer is a significant
contributor to female mortality.
There were marked ethnic differences
in mortality with the South Asian group
having a much lower mean age of
death. They also had much higher
mortality from Lymphoid,
haematopoietic and related cancers.
There were large differences in
mortality at the ward level. Although
this was associated with deprivation,
deprivation alone, does not fully
account for the observed differences.
Medlock Vale, Shaw and Hollinwood
wards had much higher mortality
compared to wards such a
Saddleworth South, St Mary’s and
Saddleworth North.
Some of the more deprived wards
such as St Mary’s, Coldhurst, Werneth
and Chadderton South had relatively
much lower rates.
At the District Partnership level,
Failsworth and Hollinwood and
Oldham District had the highest rates.
There were some significant
differences at the primary care cluster
level. The highest number of deaths,
were in Royton, Shaw & Compton
cluster and the lowest in Werneth.
When the number of cancer deaths,
were adjusted for the size of the
registered population, the cluster with
a significantly high proportion was
East Oldham.
Royton, Shaw and Crompton and the
Integrated Care Centre were also
much higher. Saddleworth, Glodwick
and Werneth clusters had the lowest
proportion.
The findings need to be explored to
understand the underlying differences
in outcomes between person
characteristics such as age, sex and
Joint Strategic Needs Assessment
Introduction
ethnicity, where people live (e.g. ward)
and variations in primary care
outcomes. This will enable better
targeting of interventions to help
reduce future mortality.
Key Implications
Reducing the number of people
developing cancer (incidence) is the
most effective way of reducing cancer
mortality in the future. The main risk
factors for cancer are related to
lifestyle: smoking, unhealthy diets,
overweight and obesity, physical
inactivity and alcohol.
Smoking is by far the biggest
contributor to cancer mortality and our
smoking prevalence is comparatively
high. The other risk factors are also
important particularly when they are
grouped together.
For people who develop cancer, early
presentation to the GP, timely referral
of suspected cancer and access to
high quality diagnostic and treatment
services, will improve the survival of
cancer patients.
Good quality palliative care can make
a big difference in improving the
quality of life for patients and their
families and carers.
Introduction: Why is cancer mortality an important issue to consider?
Cancer mortality in Oldham is higher
than that for England and compared to
statistical neighbours. Although cancer
mortality has declined in Oldham, the
rate of decline has been much slower
in Oldham. Oldham had the lowest
decline of all areas in the North West.
Cancer is a major burden on the
health and wellbeing of individuals and
communities. There are estimated to
be 5600 people in Oldham with
cancer.
Over 1000 people diagnosed with
cancer in Oldham every year.
Over 300 people in Oldham die
prematurely from cancer every year
and cancer is the most common cause
of death in Oldham.
Cancer has major economic impacts
and increases demand for health and
social care services. In England, the
economic cost of cancer in 2008 was
estimated at £18.3 billion. This is
projected to increase to 24.7 billion by
2020.
The impact of increasing costs to the
health and social care economy will
make it harder to allocate resources
for prevention and for improving the
health and wellbeing of people in
Oldham.
Joint Strategic Needs Assessment
Methods and Implications
What has been done
for the JSNA?
This study is an exploratory analysis,
to provide a starting point for
understanding the reasons for our high
cancer mortality. To provide the
context for the mortality study the main
trends in incidence were summarised
based on existing information.
The main focus was on analysing
cancer deaths. This involved analysing
nearly 5000 deaths between 2004 and
small numbers where subsets of the
data set were analysed.
The strength of the study is the size of
the sample and the techniques used to
minimise bias.
However, the study was limited in
scope, and further work needs to be
done not just on cancer mortality but to
explore the full cancer pathway
2012. Various statistical techniques
were used to minimise the impact of
What
use
can
stakeholders make of
the findings?
Stakeholders such as Oldham Council,
CCG, Secondary Care providers and
the third sector should consider what
role they can play in reducing cancer
mortality in Oldham.
Oldham council has a key role in
primary prevention. It is responsible for
commissioning services that help to
reduce exposure to cancer risks.
These include Health Improvement
Services that help people to give up
smoking, and improving the uptake of
healthier lifestyles such as improving
access to fruit and veg and
opportunities for physical activity.

Nearly half of all cancers are potentially
preventable

Oldham had the lowest decline in cancer
mortality in the North West

There are estimated to be 5600 people in
Oldham with cancer.

Over 1000 people are diagnosed with
cancer in Oldham every year

Over 300 people in Oldham die
prematurely from cancer every year

Cancer is the most common cause of
death in Oldham

The economic cost of cancer in 2008
was estimated at £18.3 billion. This is
projected to increase to 24.7 billion by
2020
Joint Strategic Needs Assessment
Implications
Deprivation is associated with
increased risk for certain cancers and
reduced survival from cancer.
Improving the overall wellbeing of
Oldham residents and reducing
deprivation has a key role in improving
future cancer outcomes.
NHS England and Public Health
England have the lead role in
promoting awareness of cancer and
providing and promoting the uptake of
screening services. This includes
making services accessible to
deprived communities and people from
BME communities.
Oldham CCG and primary care
services in Oldham have a vital role in
early diagnosis and referral to
secondary care diagnostic and
treatment services. They can also play
in important part in primary prevention
by providing brief interventions on
lifestyle and referral to services such
as smoking cessation.
Pennine Acute Hospitals Trust and
other secondary care providers such
as Christie’s, have a big role to play in
diagnosing and treating patients and
improving survival from cancer. This
involves timely and equitable access
to their services, and using evidenced
based and effective treatment.
Around half of all cancer is
preventable so stakeholders working
with each other and their clients can
make a major contribution in reducing
cancer mortality in Oldham.
A full copy of the JSNA is available from the public health department.