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Prostate cancer and ethnicity
Luke Hounsome
Public Health England
‘Hear me now’ workshop - Leeds
Summary
• What is the picture on prostate cancer in Leeds?
• 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 from cancer from the Office for National Statistics.
• Ethnicity from hospital record – self reported.
• All information in this presentation has been supplied through Public Health
England.
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Prostate cancer and ethnicity – ‘Hear me now’ workshops
Prostate cancer in Leeds
• In 2008-10 combined there were 1,384 new cases of prostate cancer – 461
per year on average. Incidence is in line with the England average.
•
84% had a recorded ethnicity – of these 96% were white.
• In 2008-10 combined there were 414 deaths from prostate cancer – 138 per
year on average. Mortality in line with England average.
•
96% had a recorded ethnicity – of these 96% were white.
• The population (based on 2009 ONS estimate) is 86% white, 3% black and
7% asian (Indian, Pakistani, Bangladeshi).
• One-year relative survival is 97% and five-year relative survival is 90% (this
is better than the England average).
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Prostate cancer and ethnicity – ‘Hear me now’ workshops
Prostate cancer in Leeds
• Prostate cancer accounts for 25% of new cases of cancer in men in Leeds.
•
1 in 6 of the cancers in Leeds with no known ethnicity are prostate cancers.
•
Lower in Asian men, at 14%.
• Prostate cancer accounts for 12% of cancer deaths and 4% of all deaths in
men in Leeds.
•
In black men this is 24% of cancer deaths and 8% of all deaths – higher than
the average.
• In deaths for those aged under 75 (premature mortality) the percentages are
8% and 3% respectively.
•
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Numbers are too small to infer any differences by ethnicity.
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) 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
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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)
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
Age at diagnosis
Black
9
Asian
White
Prostate cancer and ethnicity – ‘Hear me now’ workshops
Other
Mixed
80-84
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
10
Asian
White
Ethnicity
Prostate cancer and ethnicity – ‘Hear me now’ workshops
Other
Mixed
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
11
Asian
White
Prostate cancer and ethnicity – ‘Hear me now’ workshops
Other
Mixed
80-84
85+
Prostate cancer mortality in England – age adjusted
60
Age-standardised rate per 100,000
50
40
30
20
10
0
Black
12
Asian
White
Ethnicity
Prostate cancer and ethnicity – ‘Hear me now’ workshops
Other
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)
14
White
5 Years (2003-06)
Prostate cancer and ethnicity – ‘Hear me now’ workshops
Other
Mixed
10 Years (2000-02)
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)
15
White
5 Years (2003-06)
Prostate cancer and ethnicity – ‘Hear me now’ workshops
Other
Mixed
10 Years (2000-02)
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)
16
White
5 Years (2003-06)
Prostate cancer and ethnicity – ‘Hear me now’ workshops
Other
Mixed
10 Years (2000-02)
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)
17
White
5 Years (2003-06)
Prostate cancer and ethnicity – ‘Hear me now’ workshops
Other
Mixed
10 Years (2000-02)
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