Cancer talk for HAZ

1. Cancer talk for HAZ • Basic descriptive epidemiology - concepts - information on patterns • Policy Context (inequalities) • Problems faced (determinants & solutions)

2. What is cancer? • Different types of malignant neoplasm (tumour, neoplasm, new growth) • Strictly speaking applies only to organs with an epithelial surface • Often understood to include luekaemia, melanoma, lymphoma, sarcoma of bone, brain tissue

3. Cancer in the UK • Major public health problem • Will afflict 1 in 3 before 75th birthday • 250,000 new cases each year • 140,000 deaths each year (25% of all deaths)

4. Cancer Survival • Reduce mortality by either • Preventing new cases from occurring • Increasing chances of survival once diagnosed • Contrary to popular belief survival is not a lottery • Inequalities in incidence, diagnosis and treatment and survival/outcome exist

5. National Policy - OHN • Improve health and reduce health gap • Reduce mortality from cancer in persons under 75 by at least 20% by year 2010 (saving 100,000 lives in total??) • will largely be achieved by the cumulative effect of a range of interventions, each targeting a specific cancer type (see later).

6. Cancer Epidemiology • What factors influence risk • Age (after childhood increase with age) • Sex • Affluence/deprivation -> wider determinants • Geography • Lifestyles • How do we measure impact • Incidence of cancer and death from cancer over time • Survival (usually at 5 years – Not ‘Cure Rate’)

7. Determinants of Health

15. All cancers All ages (1996-2000) Mortality by sex and level of deprivation

16. Breast Most common cancer in women (20%) 5yr Survival 20%-80% depending on stage, deprivation, age… Survival has improved but significant inequalities exist North Staffs 5yr survival worst in country Lung Most common cancer in men (25%), 3rd in women (11%) Poor survival at 5 years (6%) Smaller deprivation effect on survival Breast vs Lung Cancer

17. All cancers - All persons under 75

23. Lung cancer mortality in men & women 1989-1998

24. Lung Cancer – What is the problem? • 85%+ deaths from Ca Lung due to smoking • By 2011 as many women as men diagnosed with Ca lung (5-year survival 6%) • Cohort Effect – reduction in smoking rates have been slower in women • Need to target smoking cessation programmes particularly at women in deprived areas?

25. 75% of all deaths from cancer caused by top 10 Action should be focused on these causes A 20% overall reduction can be achieved by specific ‘interventions’ Two thirds of this reduction will come from primary prevention Cancer Epidemiology

26. How do we reduce the impact of Cancer

27. 1. Reduction in tobacco consumption 7.3% • 2. Improvement in provision of treatment services 4.0% • Increase in fruit and vegetable consumption 4% • Breast screening, with incremental improvement 2% • in quality • 5. Reduction in heavy alcohol consumption 1% • 6 Cervical screening, with incremental 1% • improvements in quality • 7 Colorectal screening, phased introduction of 0.5% • new modalities • 8. Reduction in domestic radon levels 0.2% • TOTAL 20.3% (Source: Nick Day) • For all the intervention targets listed above, the present • situation is less favourable for the more deprived sections of • the population

28. How do we reduce the impact of Cancer

29. How do we reduce the impact of Cancer

30. How do we reduce the impact of Cancer

31. Summary • Cancer is many different diseases grouped together • Different Causal/Risk factors • Different Treatments/Solutions • Requires a focus on prevention/screening • Inequalities are significant