Download `Hear me now` workshop

Prostate cancer and ethnicity
Luke Hounsome
Public Health England
‘Hear me now’ workshop - Newham
Summary
• What is the picture on prostate cancer in Newham?
• How does this compare to the whole of England?
• Does your ethnicity affect your risk and outcomes?
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Prostate cancer and ethnicity – ‘Hear me now’ workshops
Where do the data come from?
• All newly diagnosed cases of cancer are registered by a regional office of the
national Cancer Registration Service.
• Deaths records are sent to Public Health England from the Office for National
Statistics.
• Ethnicity comes from hospital records which are linked to ONS deaths data –
ethnicity is self reported.
• Data for the boroughs of Newham, Tower Hamlets, Waltham Forest, Haringey
and City of London plus Hackney.
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Prostate cancer and ethnicity – ‘Hear me now’ workshops
Prostate cancer in Newham
• In 2008-10 combined there were 232 new cases of prostate cancer – 77 per
year on average. Incidence in line with the England average.
•
81% had a recorded ethnicity – of these 49% were white, 31% black and 17%
asian.
• In 2008-10 combined there were 84 deaths from prostate cancer – 28 per
year on average. Mortality in line with the England average.
•
99% had a recorded ethnicity – of these 53% were white, 31% black and 14%
asian.
• The population (based on 2009 ONS data) is 45% white, 16% black and 31%
asian (Indian, Pakistani, Bangladeshi).
• One-year relative survival is 90% (lower than the England average) and fiveyear relative survival is 81%.
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Prostate cancer and ethnicity – ‘Hear me now’ workshops
Prostate cancer in Newham
• Prostate cancer accounts for 22% of new cases of cancer in men in Newham.
•
In black men it is 39% of new cases, higher than average.
•
1 in 3 of the cancers in Newham with no known ethnicity are prostate cancers.
• Prostate cancer accounts for 12% of cancer deaths and 4% of all deaths in
men in Newham.
•
In black men it is 24% of cancer deaths, which is higher than average.
• In deaths for those aged under 75 (premature mortality) the percentages are
7% and 2% respectively.
•
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In black men it is 20% of premature cancer deaths and 7% of all premature
deaths, both higher than average.
Prostate cancer and ethnicity – ‘Hear me now’ workshops
Prostate cancer in Tower Hamlets
• In 2008-10 combined there were 162 new cases of prostate cancer – 54 per
year on average. Incidence lower than the England average.
•
80% had a recorded ethnicity – of these 70% were white, 18% black and 9%
asian.
• In 2008-10 combined there were 48 deaths from prostate cancer – 16 per
year on average. Mortality lower than the England average.
•
96% had a recorded ethnicity – of these 76% were white, 13% black and 14%
asian.
• The population (based on 2009 ONS data) is 53% white, 6% black and 30%
asian (Indian, Pakistani, Bangladeshi).
• One-year relative survival is 93% and five-year relative survival is 82% (both
in line with the England average).
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Prostate cancer and ethnicity – ‘Hear me now’ workshops
Prostate cancer in Tower Hamlets
• Prostate cancer accounts for 18% of new cases of cancer in men in Tower
Hamlets.
•
In black men it is 35% of new cases, higher than average.
•
In asian men it is 8% of new cases, lower than average.
•
1 in 3 of the cancers in Tower Hamlets with no known ethnicity are prostate
cancers.
• Prostate cancer accounts for 8% of cancer deaths and 3% of all deaths in
men in Tower Hamlets.
•
In asian men these numbers are 1% and 0%, lower than average.
• In deaths for those aged under 75 (premature mortality) the percentages are
5% and 2% respectively.
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Prostate cancer and ethnicity – ‘Hear me now’ workshops
Prostate cancer in City of London & Hackney
• In 2008-10 combined there were 316 new cases of prostate cancer – 105 per
year on average. Incidence higher than the England average.
•
61% had a recorded ethnicity – of these 41% were white, 53% black and 2%
asian.
• In 2008-10 combined there were 64 deaths from prostate cancer – 21 per
year on average. Mortality lower than the England average.
•
100% had a recorded ethnicity – of these 45% were white, 50% black and 2%
asian.
• The population (based on 2009 ONS data) is 64% white, 17% black and 11%
asian (Indian, Pakistani, Bangladeshi).
• One-year relative survival is 95% and five-year relative survival is 84% (both
in line with the England average).
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Prostate cancer and ethnicity – ‘Hear me now’ workshops
Prostate cancer in City of London & Hackney
• Prostate cancer accounts for 28% of new cases of cancer in men in City &
Hackney.
•
In black men it is 44% of new cases, higher than average.
•
In asian men it is 10% of new cases, lower than average.
•
2 in 5 of the cancers in City & Hackney with no known ethnicity are prostate
cancers.
• Prostate cancer accounts for 10% of cancer deaths and 3% of all deaths in
men in City & Hackney.
•
In black men these numbers are 20% and 8%, higher than average.
• In deaths for those aged under 75 (premature mortality) the percentages are
4% and 1% respectively.
•
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In black men these numbers are 9% and 4%, higher than average.
Prostate cancer and ethnicity – ‘Hear me now’ workshops
Prostate cancer in Waltham Forest
• In 2008-10 combined there were 420 new cases of prostate cancer – 140 per
year on average. Incidence higher than the England average.
•
80% had a recorded ethnicity – of these 68% were white, 22% black and 7%
asian.
• In 2008-10 combined there were 96 deaths from prostate cancer – 32 per
year on average. Mortality in line with the England average.
•
100% had a recorded ethnicity – of these 75% were white, 21% black and 3%
asian.
• The population (based on 2009 ONS data) is 62% white, 14% black and 16%
asian (Indian, Pakistani, Bangladeshi).
• One-year relative survival is 96% (in line with the England average) and fiveyear relative survival is 77% (lower than England average).
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Prostate cancer and ethnicity – ‘Hear me now’ workshops
Prostate cancer in Waltham Forest
• Prostate cancer accounts for 32% of new cases of cancer in men in Waltham
Forest.
•
In black men it is 50% of new cases, higher than average.
•
2 in 5 of the cancers in Waltham Forest with no known ethnicity are prostate
cancers.
• Prostate cancer accounts for 15% of cancer deaths and 4% of all deaths in
men in Waltham Forest.
•
In black men 10% of all deaths are prostate cancer, higher than average.
•
In asian men 2% of all deaths are prostate cancer, lower than average.
• In deaths for those aged under 75 (premature mortality) the percentages are
7% and 3% respectively.
•
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In black men 9% of all deaths in under 75s are from prostate cancer, higher
than average.
Prostate cancer and ethnicity – ‘Hear me now’ workshops
Prostate cancer in Haringey
• In 2008-10 combined there were 357 new cases of prostate cancer – 119 per
year on average. Incidence higher than the England average.
•
71% had a recorded ethnicity – of these 57% were white, 27% black and 6%
asian.
• In 2008-10 combined there were 95 deaths from prostate cancer – 32 per
year on average. Mortality in line with the England average.
•
99% had a recorded ethnicity – of these 60% were white, 29% black and 2%
asian.
• The population (based on 2009 ONS data) is 67% white, 15% black and 10%
asian (Indian, Pakistani, Bangladeshi).
• One-year relative survival is 97% and five-year relative survival is 86% (both
in line with the England average).
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Prostate cancer and ethnicity – ‘Hear me now’ workshops
Prostate cancer in Haringey
• Prostate cancer accounts for 29% of new cases of cancer in men in Haringey.
•
No differences between ethnic groups.
•
2 in 5 of the cancers in Haringey with no known ethnicity are prostate cancers.
• Prostate cancer accounts for 13% of cancer deaths and 5% of all deaths in
men in Haringey.
•
In black men 22% of cancer deaths and 8% of all deaths are prostate cancer,
higher than average.
•
In asian men 2% of all deaths are prostate cancer, lower than average.
• In deaths for those aged under 75 (premature mortality) the percentages are
7% and 3% respectively.
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Prostate cancer and ethnicity – ‘Hear me now’ workshops
Prostate cancer in England
• In 2008-10 combined there were 102,252 new cases of prostate cancer –
34,084 per year on average.
•
74% had a recorded ethnicity – of these 94% were white.
• In 2008-10 combined there were 24.363 deaths from prostate cancer – per
year on average.
•
98% had a recorded ethnicity – of these 99% were white.
• The population (based on 2009 ONS data) is 87% white, 3% black and 6%
asian (Indian, Pakistani, Bangladeshi).
• One-year relative survival is 95% and five-year relative survival is 84%.
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Prostate cancer and ethnicity – ‘Hear me now’ workshops
Prostate cancer in England
• Prostate cancer accounts for 26% of new cases of cancer in men in England.
•
3 in 5 of the cancers in England with no known ethnicity are prostate cancers.
•
42% of cancers known to be in black men are prostate cancer
•
18% of cancers known to be in asian men are prostate cancer
• Prostate cancer accounts for 12% of cancer deaths and 4% of all deaths in
men in England.
•
22% of cancer deaths in black men and 8% of all deaths
•
8% of cancer deaths in asian men, and 2% of all deaths
• In deaths for those aged under 75 (premature mortality) the percentages are
7% and 3% respectively.
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•
15% of cancer deaths in black men and 6% of all deaths
•
5% of cancer deaths in asian men, and 1% of all deaths
Prostate cancer and ethnicity – ‘Hear me now’ workshops
Prostate cancer in England - stage
• Stage data is only available for 26% of newly diagnosed prostate cancers.
The following are expressed as percentage of cases where the stage is known.
Black
Asian
White
Other
Mixed
Not
known
Localised
53%
(243)
47%
(92)
52%
(10,075)
40%
(36)
46%
(21)
61%
(3,800)
Locally
advanced
17%
(79)
24%
(46)
15%
(2,961)
20%
(18)
11%
(5)
17%
(1,066)
Advanced
30%
(140)
29%
(56)
32%
(6,182)
39%
(445)
43%
(20)
22%
(1,384)
Source: National Cancer Data Repository; Hospital Episode Statistics
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Prostate cancer and ethnicity – ‘Hear me now’ workshops
Prostate cancer incidence in England – by age
2000
1800
Age-specific rate per 100,000
1600
1400
1200
1000
800
600
400
200
0
40-44
45-49
50-54
55-59
60-64
65-69
70-74
75-79
80-84
Age at diagnosis
Black
Asian
White
Other
Mixed
Source: National Cancer Data Repository; Hospital Episode Statistics
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Prostate cancer and ethnicity – ‘Hear me now’ workshops
85+
Prostate cancer incidence in England – age adjusted
200
180
Age-standardised rate per 100,000
160
140
120
100
80
60
40
20
0
Black
Asian
White
Ethnicity
Other
Mixed
Source: National Cancer Data Repository; Hospital Episode Statistics
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Prostate cancer and ethnicity – ‘Hear me now’ workshops
Prostate cancer mortality in England – by age
2000
1800
Age-specific rate per 100,000
1600
1400
1200
1000
800
600
400
200
0
40-44
45-49
50-54
55-59
60-64
65-69
70-74
75-79
Age at death
Black
Asian
White
Other
Mixed
Source: Office for National Statistics; Hospital Episode Statistics
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Prostate cancer and ethnicity – ‘Hear me now’ workshops
80-84
85+
Prostate cancer mortality in England – age adjusted
60
Age-standardised rate per 100,000
50
40
30
20
10
0
Black
Asian
White
Ethnicity
Other
Source: Office for National Statistics; Hospital Episode Statistics
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Prostate cancer and ethnicity – ‘Hear me now’ workshops
Mixed
Prostate cancer in England
• What do all these numbers/graphs mean?
• The risk of getting prostate cancer is over double (RR 2.3) for black men, but
nearly half (RR 0.54) for asian men, compared to white men.
• The risk of dying from prostate cancer is about double (RR 2.06) for black
men, and under half (RR 0.46) for asian men, compared to white men.
• What about the individual?
• The lifetime risk of getting prostate cancer is 27% for a black man, 7% for an
asian man, and 12% for a white man.
• The lifetime risk of dying from prostate cancer is 8% for a black man, 2% for
an asian man, and 4% for a white man.
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Prostate cancer and ethnicity – ‘Hear me now’ workshops
Prostate cancer survival in England – all stages
100
90
80
Relative survival
70
60
50
40
30
20
10
0
Black
Asian
1 Year (2007-10)
White
5 Years (2003-06)
Other
Mixed
10 Years (2000-02)
Source: National Cancer Data Repository; Hospital Episode Statistics
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Prostate cancer and ethnicity – ‘Hear me now’ workshops
Not known
Prostate cancer survival in England – localised
100
90
80
Relative survival
70
60
50
40
30
20
10
0
Black
Asian
1 Year (2007-10)
White
5 Years (2003-06)
Other
Mixed
10 Years (2000-02)
Source: National Cancer Data Repository; Hospital Episode Statistics
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Prostate cancer and ethnicity – ‘Hear me now’ workshops
Not known
Prostate cancer survival in England – locally advanced
100
90
80
Relative survival
70
60
50
40
30
20
10
0
Black
Asian
1 Year (2007-10)
White
5 Years (2003-06)
Other
Mixed
10 Years (2000-02)
Source: National Cancer Data Repository; Hospital Episode Statistics
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Prostate cancer and ethnicity – ‘Hear me now’ workshops
Not known
Prostate cancer survival in England – advanced
100
90
80
Relative survival
70
60
50
40
30
20
10
0
Black
Asian
1 Year (2007-10)
White
5 Years (2003-06)
Other
Mixed
10 Years (2000-02)
Source: National Cancer Data Repository; Hospital Episode Statistics
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Prostate cancer and ethnicity – ‘Hear me now’ workshops
Not known
Prostate cancer in England
• Survival from prostate cancer is high, and (given the amount of data we have)
does not appear to vary by ethnicity.
• Survival is primarily driven by how advanced the cancer is at diagnosis.
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•
Difference between localised and advanced at one year is about 20%
•
Difference at five years is about 55%
•
Difference at ten years is nearly 80%
Prostate cancer and ethnicity – ‘Hear me now’ workshops