Download Cancer - National Cancer Registry Ireland

Cancer: global & Irish
perspectives
Mairead O’Connor
National Cancer Registry
Outline of presentation
• Global burden
• How does Ireland compare?
• Background on the National Cancer
Registry
• Cancer in Ireland
Cancer terminology
• Incidence is the number of new cases arising in a given period
in a specified population. This information is collected routinely
by cancer registries-expressed as an absolute number of cases
per year or as a rate per 100,000 persons per year
• Mortality is the number of deaths occurring in a given period in a
specified population. It can be expressed as an absolute
number of deaths per year or as a rate per 100,000 persons per
year.
• The prevalence of a particular cancer can be defined as the
number of persons in a defined population who have been
diagnosed with that type of cancer, and who are still alive at the
end of a given year, the survivors.
Age-standardised
Cancer terminology
• An age-standardised rate (ASR) is a summary measure of the
rate that a population would have if it had a standard age
structure. Standardization is necessary when comparing several
populations that differ with respect to age because age has a
powerful influence on the risk of cancer.
• A relative risk of greater than one or of less than one usually
means that being exposed to a certain substance or factor either
increases (relative risk greater than one) or decreases (relative
risk less than one) the risk of cancer,
http://globocan.iarc.fr/Pages/glossary.aspx
Cancer Prevention
What causes cancer?
Many things!
- mostly exposure to one or more carcinogens
- genetics -play a role in how likely we are to develop cancer if we
are exposed to one or more carcinogens.
Cancer prevention
- Apx. half of all cancers could be prevented
- Smoking, obesity, alcohol, physical activity, sun and UV
- Infections and HPV
- Screening and vaccination
- ’12 ways to reduce your risk of cancer’
https://www.cancer.ie/sites/default/files/contentattachments/ics_12_
ways_a3_web.pdf
GLOBOCAN
http://globocan.iarc.fr
Global burden of cancer 1
Cancer incidence ASR (per 100,000) for both sexes 2012 (excluding NMSC)
Global burden of cancer 2
• 14.1 million new cancer cases, 8.2 million cancer deaths and
32.6 million people living with cancer in 2012 worldwide.
• 57% (8 million) of new cancer cases, 65% (5.3 million) of the
cancer deaths and 48% (15.6 million) of the 5-year prevalent
cancer cases occurred in the less developed regions.
• The overall age standardized cancer incidence rate is almost
25% higher in men than in women,
• Lung cancer was the most common cancer worldwide
contributing 13% of the total number of new cases diagnosed in
2012.
• Breast cancer (women only) was the second most common
cancer with nearly 1.7 million new cases in 2012.
• Colorectal cancer was the third most common cancer with
nearly 1.4 million new cases in 2012.
Global burden of cancer 3
Women
Top three, breast,
colorectal and
lung cancers,
contributed more
than 43% of all
cancers (excluding
NMSC).
http://globocan.iarc.fr
Global burden of cancer 4
men
•Lung cancer was the
most common cancer
worldwide in men
contributing nearly 17% of
the total number of new
cases diagnosed in 2012.
Estimated number of new
cancer cases: Ireland v USA
Ireland (total 20,808)
USA (total 1603,586)
Estimated number of new cancer cases*:
Ireland vs Zimbabwe
Ireland (total 20,808)
Zimbabwe (total 15,520)
For 2012, 20,808 new cases of cancer but many more living with
cancer (survivors)
How does Ireland compare with
Europe?
Cancer rates comparison
Ireland vs. EU-27* in 2012
• The cancer incidence rate in Irish males (excluding NMSC) was
10% higher than the EU average (453/100,000), partly due to
increased diagnosis of prostate cancer in Ireland
• The mortality rate estimate from cancer in males was slightly
lower (9%) than the EU27 average partly due to a lower than
average mortality rate from lung cancer (19% lower).
• The incidence rate in females was 16% higher than the EU
average reflecting higher incidence of lung (55% higher),
ovarian (24% higher), breast (13% higher) and colorectal cancer
(14% higher) among Irish females. The mortality rate in females
was 13% higher than the EU27 average.
• *estimates for 27 members of the EU
Cancer in Ireland 1994-2014: Annual Report of the National Cancer
Registry
Estimated number of new cancer
cases*: Ireland vs Croatia
Ireland (total 20,808)
Croatia (total 22,890)
Cancer in Ireland and the
role of the National
Cancer Registry
National Cancer Registry of Ireland
• Began registration in 1994
• Statutory body, funded by Department of Health
• Records and reports on all new cases of cancer
• Reports on all cancer deaths
• Active research programme
• Staff of >50
Statutory duties
• to identify, collect, classify, record, store and analyse
information on cancers and cancer patients;
• to use the data in research and…in the planning and
management of services;
• to advise, inform and assist the Minister with regard
to cancer services.
Registration is voluntary—covers public and private
sectors.
The uses of cancer information
To understand
1. factors which increase cancer risk
2. factors which affect the outcome of cancer
and to use this information in:

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

Disease prevention
Early detection
Improving survival
Enhancing quality of life
How we collect data
• Staff based in hospitals
(96%)
Pathology reports
(85%)
Discharge summaries (HIPE) (10%)
Cancer and radiotherapy clinics (5%)
• Death certificates
(3-4%)
• GPs
(<1%)
• Registration is 96-97% complete
Data collected by the Registry
• Over 100 separate pieces of information
on
Patient
Cancer
Treatment
Outcome
Changing caseloads (>570,000 tumours 1994-2014)
All registered tumours – by diagnosis year:
• 19,455 diagnosed 1994 (annual average 19,591 1994-1996)
• 38,162 diagnosed 2014 (average 37,591 2012-2014)
All invasive cancers:
• 17,437 diagnosed 1994 (average 17,465 1994-1996)
• 31,262 diagnosed 2014 (average 30,649 2012-2014)
All invasive cancers excluding non-melanoma skin:
• 12,287 diagnosed 1994 (average 12,263 1994-1996)
• 20,958 diagnosed 2014 (average 20,782 2012-2014)
All treatments / consultations – by treatment year:
• 31,364 1994 (average 35,441 1994-1996)
• 100,443 2014 (average 100,286 2012-2014)
What we produce
•
•
•
•
•
Annual reports
Frequent short reports
Periodic reports (e.g. all-Ireland cancer statistics)
Web site
Responses to requests for information




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Department of Health
HSE, NCCP
Public, public representatives
Commercial
Students, researchers etc
• Research publications
Scientific papers published per year
(with NCR authors / co-authors)
Reports
25
All-Ireland cancer atlas 1994-2007
Colorectal cancer
Melanoma of skin
Information on website; www.ncri.ie
Website: geographic information:
Focus on two recent reports
Annual report: most common cancers 2012-2014
Cancer Trends 1994-2014
** ↑ significant increase, ↓ significant decrease, ↔ no change
The top three most common cancers in each sex are shown in
bold
Cancer prevalence (survivors)
139,526 patients were still
alive at the end of 2014
Cancer survival by site
Cancer inequalities in Ireland
• Report published June 2016.
• Inequalities by deprivation;
urban/rural status; age.
• Inequalities in incidence;
survival; stage; treatment; noncancer comorbidity.
• Period 2008-2012.
• All cancers (ex. NMSC);
stomach; colorectal; lung;
melanoma; breast; cervix;
prostate; lymphoma; leukaemia
Cancer incidence, Ireland, 2008-2012:
rural v. urban populations
Cancer rates in urban areas 10-11% higher overall
Arrows indicate significant
differences
Cancer incidence, Ireland, 2008-2012:
least v most deprived 20% of population
cancer incidence was slightly but significantly higher in the
most deprived 20% of the population
Arrows indicate significant
differences
Cancer stage IV %, Ireland, 2008-2012:
least v most deprived 20% of population
Arrows indicate significant
differences
Cancer survival, Ireland, 2008-2012:
least v most deprived 20% of population
Arrows indicate significant
differences
Cancer inequalities in Ireland:
Key points
• Higher cancer incidence in urban than in rural populations,
overall and for six of the nine specific cancer types examined.
• Higher incidence of cancer in more deprived populations,
overall and for three of nine major cancer types, but the opposite
trend (lower incidence in more deprived populations) for breast
cancer and melanoma.
• Lower proportions of early stage and higher proportions of later
stage cancers among more deprived populations for four of the
nine major cancers.
• Lower survival of cancer patients from more deprived
populations, overall and for six of the nine major cancers.
Cancer research projects
• Using data collected at the Registry
• Population-based surveys of cancer patients, carers,
cancer health professionals
• Interviews with cancer patients, carers, cancer
professionals
http://www.ncri.ie/research/projects
Cancer infographics
http://www.ncri.ie/publications/infographics
Thanks to:
• National Cancer Registry staff – data
collection and quality assurance
• Hospitals, clinics and their staff – access to
patient records, pathology notes etc
• Central Statistics Office and General Register
Office – population and mortality data
Further information: [email protected]
@MaireadOConnor8 & @IrishCancerReg
www.ncri.ie