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Prostate cancer and ethnicity
Luke Hounsome
Public Health England
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.
2
Prostate cancer and ethnicity
About the results
• The stage of prostate cancer has been broken into three parts:
•
Localised (TNM stage I/II) – the cancer is within the prostate gland
•
Locally advanced (TNM stage III) – the cancer has spread to lymph nodes near
the prostate
•
Advanced (TNM stage IV) – the cancer has spread to other parts of the body
(metastasised)
• Survival figures are relative survival taking into account background mortality
rates by age, deprivation and region. This allows the percentages to be fairly
compared.
• Age-standardised incidence/mortality rates take into account different age
structures in different populations, to allow fair comparisons to be made. The
1976 European Standard Population is used.
3
Prostate cancer and ethnicity
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 estimates) is 87% White, 3% Black and 6%
Asian (Indian, Pakistani, Bangladeshi).
• One-year relative survival (based on 2006-10 diagnoses) is 95% and fiveyear relative survival (based on 2002-06 diagnoses) is 84%.
4
Prostate cancer and ethnicity
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.
5
•
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
Prostate cancer in England - stage
• Stage data is only available for 26% of newly diagnosed prostate cancers in
2008-10. The following are expressed as percentage of cases where the stage
is known.
Black
Asian
White
Other
Mixed
Not
known
All men
Localised
53%
(243)
47%
(92)
52%
(10,075)
40%
(36)
46%
(21)
61%
(3,800)
54%
(14,267)
Locally
advanced
17%
(79)
24%
(46)
15%
(2,961)
20%
(18)
11%
(5)
17%
(1,066)
16%
(4,175)
Advanced
30%
(140)
29%
(56)
32%
(6,182)
39%
(445)
43%
(20)
22%
(1,384)
30%
(7,817)
6
Prostate cancer and ethnicity
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
7
Prostate cancer and ethnicity
Asian
White
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
8
Prostate cancer and ethnicity
Asian
White
Ethnicity
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
9
Prostate cancer and ethnicity
Asian
White
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
10
Prostate cancer and ethnicity
Asian
White
Ethnicity
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.
11
Prostate cancer and ethnicity
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)
12
Prostate cancer and ethnicity
White
5 Years (2003-06)
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)
13
Prostate cancer and ethnicity
White
5 Years (2003-06)
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)
14
Prostate cancer and ethnicity
White
5 Years (2003-06)
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)
15
Prostate cancer and ethnicity
White
5 Years (2003-06)
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.
16
•
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