Cancer Intelligence

Cancer Intelligence • Cancer screening & early diagnosis • 24th July 2014 • Postgraduate Centre, RSCH

Current population profile • Relative to England (dark outlines), Guildford and Waverley CCG has: • Fewer children aged 0-4 • More young people aged 10-19 • Fewer young adults aged 25-34 • Slightly more older adults 45-64 • More adults 75+

Population projections (65yrs) • 19.7% of the population of Guildford and Waverley CCG is projected to be over the age of 65 by 2020 • 3.7% of the population of Guildford and Waverley CCG is projected to be over the age of 85 by 2020

Life expectancy at birth by ward

Specific groups in Guildford and Waverley CCG • Specific groups requiring a targeted approach in Guildford and Waverley CCG include: • Carers: more than 18,700 people of all ages provide unpaid care; more than 1,300 are over 65 providing >20 hours a week • Older people: the need to maintain healthy life expectancy as population ages and good management of long term conditions. • Gypsy, Roma and Traveller community: Surrey has the 4th largest GRT community in the country. Guildford and Waverley CCG has around 14 authorised GRT sites • Armed service personnel and veterans: large number of army personnel and family at Pirbright, Deepcut and Keogh barracks and veterans and reservists in the local area, with particular health needs • Offenders serving community sentences, those on probation and ex-offenders that remain in the community may remain hard to reach.

Most prevalent conditions – Guildford and Waverley CCG: QOF 2012-13

Cancer in context • 28% of all deaths in CCG caused by cancer • 46% of deaths in under 75s due to cancer

Cancer Prevalence by CCG Source: Quality and Outcomes Framework (QOF), 2012/13

Lung cancer Incidence: • 2010 data shows that Surrey has lower incidence than the South East and England. • Similar to the trend nationally lung cancer incidence is declining in Men and increasing in Women across Surrey • Both Guildford and Waverley are lower than Surrey average with higher incidence in men then women. Mortality: • Higher in men than in women but rates have risen by 73% in women over the last 40 years (cancer research UK) • Surrey is below both the England and South East average • Waverley has the lowest mortality rate within Surrey from lung cancer

Breast cancer Incidence: • Historically higher in Surrey than South East and England • Higher in Guildford than Waverley and Guildford higher than Surrey average. Mortality: • Surrey is similar to England and South East average • The mortality rate for women with breast cancer in Guildford and Waverley CCG is 22.62/100,000 population.(2009/11) • Guildford has a similar rate of death from breast cancer compared to the Surrey average.

Bowel cancer Incidence: • Surrey is similar to both the South East and England rates • No clear difference between Guildford and Waverley in terms of new bowel cancer cases. Mortality: • Surrey lower mortality rate for 2010/12 compared to the South East and England. • Mortality rate in Guildford and Waverley is lower or similar to the Surrey average and there is similar mortality rate from bowel cancer in men across the two boroughs.

Malignant Melanoma Incidence • Nationally skin cancer has been increasing from 1993 through to 2011 • Higher in Surrey than the England and the South East rates • In Surrey the rate of new cases is higher in women than men • Slightly higher rate in Waverley then Guildford. Mortality • Higher for men and women in Surrey compared to Nationally. • Similar picture at borough level where death from skin cancer is higher in men then women in both boroughs.

Liver cancer • Liver cancer incidence in England has increased by 70% for males and 60% for females from 2003 to 2012. • It has been estimated that 1.3% of all new cancer cases in Guildford and Waverley were for liver cancer. The rate of which is slightly higher in Waverley than Guildford. • Approximately 2.6% of all cancer deaths in Guildford and Waverley were due to liver cancer.

Awareness and early Diagnosis Source : Strategic Clinical Network cancer dashboard

Routes to diagnosis

Screening programmes

Lifestyle Choices It is estimated that half of all cancers could be prevented by positive lifestyle choices. These measures include • Not smoking • Reducing alcohol intake • Maintaining a healthy body weight • Eating a healthy and balanced diet high in fruit and vegetables • Keeping active • Safe sun exposure

APHR: Smoking in G&W

APHR: Alcohol in G&W

APHR: Healthy weight in G&W

What stands out for G&W • Nearly half of all deaths under 75 years of age are due to cancer • G&W has the highest proportion of cancer cases on register by list size • Higher incidence of skin cancer in Surrey, especially in Women. • Higher mortality from skin cancer in Surrey, for men and this is similar at the borough level. • Higher incidence of breast cancer in Guildford compared to Surrey • Similar incidence trend in lung cancer to that seen nationally with decrease in men and increase in women. • Lung cancer mortality is lowest in Waverley although has highest smoking prevalence • Lowest 2 week wait referral numbers out of all Surrey CCGs. • Nearly a fifth of adults are obese. • More than a third of adults are not physically active enough.

Be Clear on Cancer & other PH campaigns C4L – summer – physical activity Sept/Oct - Stoptober Nov – BCOC Oesophageal & gastric /Ovarian Cancer (TBC) New Year – C4L February 2015 – BCOC ovarian cancer

Cancer Intelligence