Download Cancer in Waterloo region: the facts and reducing your risk

Cancer In Waterloo Region:
The facts and
reducing your risk
The picture of cancer across Canada
A relative survival
ratio compares
the observed
survival of people
with cancer to
the expected
survival of people
in the general
population.
Cancer affects almost everyone. The Canadian
Cancer Society estimates that nearly half of all
Canadians will develop cancer at some point in
their lifetime. It is the leading cause of death
in Canada, accounting for nearly 30 per cent of
deaths. Most people who develop cancer are
over 50. The number of new cancer cases in
Canada has been increasing over the last 30
years. Most of the increase is a result of the
aging population.
Cancer in Waterloo Region: The facts and reducing your risk
Four types of cancer— lung, breast, colorectal
and prostate cancer— account for over half of
all new cancer cases and half of all cancer
deaths in Canada. Prostate cancer is the most
common type diagnosed in Canadian men.
Breast cancer is the most common type
diagnosed in Canadian women. Most cancer
deaths occur in people over 50. Lung cancer is
the leading cause of cancer death in Canada.
Relative survival ratios for cancer in Canada
have improved by over 50 per cent compared to
two decades ago. This means that more people
live longer after a cancer diagnosis now than
ever before.
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The facts about cancer in Waterloo Region
From 1986 to 2009, the number of new cancer
cases steadily increased over time in Waterloo
Region, as the population increased. (Figure 1)
Overall, cancer incidence rates in Waterloo
Region were slightly lower than or on par with
those in all of Ontario.
The rate of cancer, which accounts for population
size, increased only slightly, however, in both
Waterloo Region and Ontario. Men had a higher
cancer incidence than women but the incidence
of cancer has increased more in women than in
men over this time period.
In Waterloo Region between 1986 and the early
1990’s, female breast cancer was the most
common type of cancer, followed by prostate,
colorectal and lung cancer. Since about 1990,
prostate cancer incidence rates overtook female
breast cancer rates to become the most common
type of cancer in Waterloo Region. Improved
detection of prostate cancer cases has played a
role in the increase.
An incidence rate
measures the
number of new
cancer cases
that occur per
year, out of every
100,000 people in a
geographic region.
2,500
500
2,000
400
1,500
300
1,000
200
500
100
0
1986
1990
Waterloo Region Cases
1995
2000
2005
Waterloo Region Rate
2009
Rate per 100,000 people
Number of cases
Figure 1. Cancer incidence in Waterloo Region and Ontario, 1986 to 2009*
0
Ontario Rate
Figure 2. Incidence of the four most common types of cancer in Waterloo Region, 1986 to 2009*
Rate per 100,000 people
200
160
120
80
40
0
1986
1990
Female breast
2
1995
Prostate
2000
Colorectal
2005
2009
Lung
Cancer in Waterloo Region: The facts and reducing your risk
Cancer mortality in Waterloo Region
From 1986 to 2009, the number of cancer deaths steadily increased over time in both Waterloo
Region and Ontario as the population increased. The rate of cancer mortality, which accounts for
population size, has steadily decreased over time. Overall, men had higher cancer mortality compared
to women.
The drop in mortality rates over time can be attributed to improvements in earlier detection and
screening of cancer, as well as more effective cancer treatments. In addition, smoking rates have
significantly declined since the 1950s and 1960s, especially among men, a trend that also contributed
to the overall decrease in cancer mortality rates from 1986 to 2009.
1000
250
800
200
600
150
400
100
200
50
0
1986
1990
Waterloo Region deaths
1995
2000
2005
Waterloo Region rate
2009
Rate per 100,000 people
Figure 3. Cancer mortality in Waterloo Region and Ontario, 1986 to 2009*
Number of deaths
A mortality rate
measures the
number of cancer
deaths that occur
per year, out of
every 100,000
people in a
geographic region.
0
Ontario rate
Between 1986 and 2009, lung cancer was the leading cause of cancer death in Waterloo Region,
followed by colorectal, female breast and prostate cancer. These four types of cancer were similarly
the leading causes of cancer death in Ontario.
Figure 4. The four leading causes of cancer mortality in Waterloo Region, 1986 to 2009*
Rate per 100,000 people
100
80
60
40
20
0
1986
1990
Female breast
Cancer in Waterloo Region: The facts and reducing your risk
1995
Prostate
2000
Colorectal
2005
2009
Lung
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Finding it Early:
Screening for cancer
In Ontario, there are province-wide screening programs for three types of cancer: breast, colorectal and
cervical. These programs offer screening tests free of charge to anyone in Ontario who is eligible.
For more information about these Ontario cancer screening programs, visit the Cancer Care Ontario website:
www.cancercare.on.ca/pcs/screening.
Breast Cancer
What are the facts?
• In 2009, there were 310 new female breast
cancer cases and 81 deaths due to breast
cancer in females in Waterloo Region.
• Breast cancer accounts for 28 per cent of all
female cancer cases in Waterloo Region.
How do we screen for breast cancer in
Ontario? Breast cancer screening is the regular
examination of a woman’s breasts to find breast
cancer early. It involves doing a breast x-ray,
called a mammogram, in eligible women, usually
once every two years.
Why get screened? When breast cancer
is found early, there is a better chance of
treating the cancer successfully. It is less likely
to spread, and there may be more treatment
options.
How are we doing in screening? In
2010/2011, just over 60 per cent of eligible
women in Waterloo Region had up-to-date
breast screening. This rate was similar to that
for all of Ontario. Breast screening rates have
been increasing over time since 2004/2005.
Cancer screening
means doing
medical tests in
people without
any symptoms,
to detect cancer
earlier.
Cancer screening
sees what we
can’t.
Who should be screened? Currently, the
Ontario Breast Screening Program
offers free, high-quality breast
cancer screening for women aged
50 to 74 years. Women outside of
this age range who have been
confirmed to be at high risk
for breast cancer are also
eligible.
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Cancer in Waterloo Region: The facts and reducing your risk
Finding it early:
Screening for cancer
Colorectal Cancer
The Fecal Occult
Blood Test is
performed at home
and involves taking
three separate
stool samples on
three different
days over a ten
day period, and
mailing them free
of charge to a lab
for analysis.
A colonoscopy
is a medical test
done by a doctor
that examines
the lining of the
large intestine for
abnormal growths
that may indicate
cancer.
What are the facts?
• In 2009, there were 288 new colorectal
cancer cases and 124 deaths due to
colorectal cancer in Waterloo Region.
• Colorectal cancer accounts for 13 per cent of
all cancer cases in Waterloo Region.
How do we screen for colorectal
cancer in Ontario?
Colorectal cancer screening for most people
involves doing a free, simple at home test
– the Fecal Occult Blood Test (FOBT) – once
every two years. For those at increased
risk because of a family history of one or
more first-degree relatives (parent, sibling
or child) with a diagnosis of colorectal
cancer, a colonoscopy is recommended.
Why get screened?
Often there are no early warning symptoms of
colorectal cancer, but if caught early, a person
with colorectal cancer can have up to a 90 per
cent chance of being cured. Early detection also
avoids more invasive forms of treatment, like
the removal of portions of the colon.
How are we doing in screening?
In 2010/2011, just over one-third of eligible
adults aged 50 to 74 years had up-to-date
colorectal cancer screening. This rate was
slightly higher than that for all of Ontario.
Colorectal cancer screening rates have been
increasing over time since 2004/2005.
Who should be screened?
Currently, the ColonCancerCheck program
recommends that all Ontarians aged 50 and
over be screened for colorectal cancer, either
through the FOBT at-home test (for those at
average risk) or colonoscopy (for those at
increased risk). For some at increased risk,
screening may be recommended prior to age 50.
Cancer in Waterloo Region: The facts and reducing your risk
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Finding it early:
Screening for cancer
Cervical Cancer
What are the facts?
• In 2009, there were 15 new cervical cancer
cases in Waterloo Region. There was an
average of six cervical cancer deaths each
year in Waterloo Region from 1986 to 2009.
• Cervical cancer accounts for nearly two per
cent of female cancer cases in Waterloo
Region.
Why get screened?
Pap tests check for cervical cell changes that
are caused by a Human Papillomavirus (HPV)
infection. Cervical cancer may be prevented
entirely by following these cell changes closely
and treating them if necessary. Screening with
a Pap test is the only way to find these cell
changes in your cervix that may lead to cancer.
How do we screen for cervical
cancer in Ontario?
Cervical cancer screening involves doing free,
regular Pap tests, usually every three years.
A Pap test is a simple procedure which takes
some cells from the cervix using a swab. It only
takes a few minutes to do during a visit to a
health care provider.
How are we doing in screening?
In 2009 to 2011, two-thirds of eligible women
in Waterloo Region had up-to-date cervical
screening. This rate was slightly higher than
that for all of Ontario. Cervical screening rates
have been increasing slightly over time since
the early 2000s.
Cervical cancer
can also be
prevented by
being immunized
against Human
Papillomavirus
(HPV), the virus that
causes a majority
of cases.
Being screened for
cervical cancer and
being immunized
against HPV are
both recommended.
Who should be screened?
Currently, the Ontario Cervical Screening
Program recommends that screening should
begin at age 21 for women who have ever
been sexually active (that is, who have ever
had any sexual skin-to-skin contact, including
intercourse, intimate touching or oral sexual
contact). Women who are not sexually active by
age 21 should delay cervical cancer screening
until they are sexually active. Cervical cancer
screening may be discontinued at age 70.
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Cancer in Waterloo Region: The facts and reducing your risk
Reducing your risk:
Lifestyle factors that affect cancer risk
There are many factors that affect our risk for developing cancer. Some we cannot change, such
as our age, whether we are male or female, and our genetic make-up. There are many factors that
affect our risk of developing cancer that we can change, however.
Some of the most important modifiable risk factors for cancer are discussed here.
A modifiable risk
factor is something
that we can control
which affects our
risk of developing
cancer. Examples
include smoking,
healthy eating, and
physical activity.
Tobacco and second-hand smoke
Healthy eating
How does it affect cancer risk?
It increases risk for lung cancer and many other
types of cancer. Tobacco use and exposure is
the leading preventable cause of disease and
death in Ontario.
How does it affect cancer risk? High
consumption of red meat, processed meat
and salt increases cancer risk, while high
consumption of vegetables, fruit, fibre and
whole grains reduces cancer risk.
What are the facts?
• About 20 per cent of the population in
Waterloo Region currently smoke, similar to
Ontario.
• Nearly 17 per cent of non-smokers are
regularly exposed to second-hand smoke.
What are the facts?
Over a third of those in Waterloo Region
consume vegetables and fruit at least five times
per day, similar to Ontario. Just over 40 per
cent of Waterloo Region adults are at a healthy
weight, similar to Ontario.
What can you do?
Avoid exposure to tobacco. If you
don’t smoke, remain smoke-free. If
you smoke, reduce the amount
you smoke, or quit altogether.
Cancer in Waterloo Region: The facts and reducing your risk
What can you do?
Make healthier eating choices more
often. Reduce your salt and red meat
intake. Increase your vegetable and
fruit intake. Maintain a healthy
body weight. Aim for a Body Mass
Index (BMI) between 20 to 25.
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Physical activity
Drinking alcohol
How does it affect cancer risk?
Inadequate levels of physical activity increase
the risk of colorectal and breast cancer. Long
periods of sedentary activity, even within
a lifestyle that includes adequate physical
activity, can also increase the risk of cancer.
How does it affect cancer risk?
Drinking alcohol, especially high amounts
regularly over time, has been associated with
oral, throat, esophageal, colorectal, breast and
liver cancer.
What are the facts?
• A lower proportion of the population is
active during their leisure time in Waterloo
Region than in Ontario.
• Nearly two-thirds of people are sedentary
during their leisure time, doing things such as
watching TV or using computers, for 15 hours
or more every week.
What can you do?
Stay active. Move often. Break up long periods
of sedentary activity with short bouts of
movement.
What are the facts?
Almost two-thirds of the population regularly
drinks in Waterloo Region and 17 per cent have
had at least one episode of drinking heavily in
the past year, similar to Ontario. Men used to
be more likely to regularly drink, but alcohol
consumption in women has
increased and now women and
men are equally likely to regularly
drink.
About half of cancers
can be prevented
through healthy
eating, active living,
avoiding tobacco
and getting screened
regularly.
What can you do?
Follow Canada’s Low-Risk Alcohol
Drinking Guidelines to lower your overall
risk from drinking alcohol.*
The guidelines are available
from the Canadian Centre
on Substance Abuse at:
www.ccsa.ca/Eng/
topics/alcohol/drinkingguidelines
*Cancer Care Ontario and the Canadian Centre on Substance Abuse have recently reported on more stringent alcohol drinking guidelines
which specifically aim to reduce cancer risk. Region of Waterloo Public Health will be reviewing these cancer-specific alcohol drinking
guidelines and the Low-Risk Alcohol Drinking Guidelines and may update recommendations in the future. For more information on these
alcohol drinking guidelines, see: http://www.ccsa.ca/Resource%20Library/CCSA-Cancer-and-Alcohol-Summary-2014-en.pdf.
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Cancer in Waterloo Region: The facts and reducing your risk
Reducing your risk:
Lifestyle factors that affect cancer risk
HPV vaccination
How does it affect cancer risk?
Human Papillomavirus (HPV) is the most
common sexually transmitted infection, and
it causes 70 per cent of all cases of cervical
cancer.
What are the facts?
• Two-thirds of the population aged 15 to 49
years in Waterloo Region report a sexual
debut under 20 years of age.
• The proportion of the population with two
or more sexual partners in the past year is
lower in Waterloo Region compared to all of
Ontario.
• Men are more likely to have had multiple
partners in the past year than women.
Cancer in Waterloo Region: The facts and reducing your risk
What can you do?
Females in grades 8 through 12 should get
vaccinated against HPV. Use physical barrier
methods such as a condom during sexual
activity to further help prevent transmission of
HPV and other sexually transmitted infections.
For more information on what
you can do to reduce your risk
of cancer, visit the Region of
Waterloo Public Health website:
http://chd.region.waterloo.on.ca/
en/healthylivinghealthprotection/
cancerprevention.asp.
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What is Public Health doing about
cancer in Waterloo Region?
Within our mandate set out by the Ontario Public Health Standards, Region of Waterloo Public Health aims to reduce the
burden of chronic diseases, including cancer, in the population of Waterloo Region.
We work towards this goal with a number of cancer prevention strategies, including those that focus on tobaccofree living, improving eating habits, increasing physical activity, reducing alcohol consumption, and increasing cancer
screening and early detection.
Below are some examples of specific Region of Waterloo Public Health initiatives which
aim to help prevent and reduce the incidence of cancer in Waterloo Region:
• Comprehensive tobacco use reduction activities – We provide brief smoking cessation counselling over the phone
and smoking cessation workshops with free nicotine replacement therapy for eligible smokers. We work with workplaces,
health care organizations and other interested community partners to create comprehensive smoke-free policies. We also
work with local youth volunteers to promote tobacco-free living and healthy lifestyles among Waterloo Region youth.
• Reducing exposure to second-hand smoke – We partner with Waterloo Region Housing (WRH) and the Propel
Centre for Population Health Impact at the University of Waterloo to implement and monitor the Waterloo Region Housing
smoke-free policy which came into effect on April 1, 2010.
• Promoting healthy lifestyle to reduce breast cancer risk – We support the Hook Up to Breast Cancer Prevention
program aimed at young women in secondary and post-secondary schools which encourages reduced alcohol and tobacco
consumption, increased physical activity, and healthy eating to reduce the risk of breast cancer.
• Promoting provincial cancer screening programs for early cancer detection – We partner with Waterloo Region
Housing and the Waterloo Wellington Regional Cancer Program to increase awareness and participation in screening for
breast, cervical, and colorectal cancers among neighbourhoods where there are low screening rates.
• Supporting community projects that encourage healthy eating – We support several community garden
development projects in Waterloo Region, which provide health benefits including increased vegetable and fruit
consumption, improved mental health and increased opportunities for physical activity.
• Comprehensively promoting healthy living – We established and coordinate the Waterloo Region Healthy
Communities Partnership to oversee health promotion activities carried out by local partners to promote healthy eating,
physical activity and mental health in a comprehensive way. Since its inception, the Partnership has accomplished a
number of initiatives that have encouraged community participation in the promotion and implementation of healthy public
policies.
• Promoting and directly providing access to HPV vaccination – We provide the HPV vaccine Gardasil® to females
from grades 8 through 12 at no cost through a school-based immunization program and promote the benefits of HPV
vaccination to health care providers and the public.
*Source: Cancer Care Ontario – SEER*Stat – OCRIS (May 2012) October 2012 release.
Note: Rates illustrated in this report have been age-standardized to the 1991 Canadian population.
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Cancer in Waterloo Region: The facts and reducing your risk
Cancer In Waterloo Region:
The facts and
reducing your risk
For more detailed, technical information and statistics, see
Cancer in Waterloo Region: a Population Health Status
Report available at: http://chd.region.waterloo.on.ca/en/
researchResourcesPublications/resources/WR_CancerReport.pdf
Region of Waterloo Public Health (2014). Cancer in Waterloo Region:
The facts and reducing your risk. Waterloo, ON.
For more information, please contact:
Epidemiology and Health Analytics
Region of Waterloo Public Health
99 Regina Street South, 3rd floor
Waterloo, Ontario N2J 4V3
Phone: 519-575-4400
Email: [email protected]
www.regionofwaterloo.ca/ph
Accessible formats of this document are available upon request.
Please call the Coordinator, Marketing and Communications at
519-575-4400 ext. 2244 (TTY 519-575-4608) to request an
accessible format.
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Cancer in Waterloo Region: The facts and reducing your risk