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Cancer trends in England and Wales

This webpage provides information on cancer trends in England and Wales, including mortality rates, incidence, and survival rates. It also discusses the government's target to reduce cancer mortality by 2010 and the factors influencing cancer incidence and survival. The webpage is authored by Dr. Heather O. Dickinson from the Department of Child Health at the University of Newcastle.

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Cancer trends in England and Wales

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  1. Cancer trends in England and Wales Dr Heather O Dickinsonhttp://www.staff.ncl.ac.uk/heather.dickinson/Department of Child HealthUniversity of Newcastle

  2. Deaths by cause (all ages), England & Wales, 1998 other 18% cancer 25% diseases of respiratory system 16% diseases of circulatory system 41%

  3. Deaths by cause and age group, 1998 cancer circulatory system respiratory system Age 1-4 yrs Age 5-24 yrs accidents nervous system congenital anomalies other Age 25-74 yrs Over 75 yrs

  4. Adult cancer, diagnosed 1986-90 stomach bladder prostate Affluent rectum Deprived colon lung breast 0% 20% 40% 60% 80% 5-year survival

  5. Adult cancer, diagnosed 1986-90 stomach bladder prostate Affluent rectum Deprived colon lung breast ALL CANCERS 0% 20% 40% 60% 80% 5-year survival

  6. Target In July 1999, the UK government set a ‘tough but attainable’ target: to reduce the death rate from cancer in people under 75 by at least a fifth by 2010 (compared with 1997) - saving up to 100,000 lives

  7. Cancer mortality, under age 75 yrs 200 Annual mortality per 100,000 100 0 1950 1960 1970 1980 1990 1998 Year

  8. Male deaths from cancer, 1998 lung prostate colorectal stomach oesophagus bladder 0 5,000 10,000 15,000 20,000

  9. Female deaths from cancer, 1998 breast lung colorectal ovary pancreas stomach oesophagus 0 5,000 10,000 15,000 20,000

  10. Cancer mortality, males, age 45-74 yrs 400 200 0 1950 1960 1970 1980 1990 1998 colorectal prostate lung stomach   +  Annual mortality per 100,000 Year

  11. 150 100 50 0 1950 1960 1970 1980 1990 1998 Cancer mortality, females, age 45-74 yrs colorectal breast lung stomach   o + Annual mortality per 100,000 Year

  12. Death rates from cancer depend on: • incidence • several years ago • survival • over the past few years

  13. We can decrease the incidence through prevention. • We can improve survival through better treatment.

  14. Can starting prevention strategies now affect the incidence enough to reduce the death rate by 2010?

  15. Smoking accounts for • over one third of cancer deaths • lung, mouth, larynx, oesophagus and other cancers • about one fifth of other deaths • mainly from circulatory and respiratory disease

  16. Survival has improved. • If it continues to improve, roughly 24,000 deaths will be avoided by 2010 • If survival for everyone were as good as survival of the most affluent, about 41,500 deaths would be avoided.

  17. Eliminating social class differences - in both incidence and survival - would almost certainly save more lives in the next decade than innovative treatments.

  18. Cancer mortality, children 0-14 years 8 6 Annual mortality per 100,000 4 2 0 1950 1960 1970 1980 1990 2000 Year

  19. Affluent Deprived Children’s cancer, diagnosed 1986-90 Brain and spinal tumours Acute lymphoblastic leukaemia 0% 20% 40% 60% 80% 5-year survival

  20. Children’s cancer - a success story Why? • many childhood malignancies are chemosensitive - and among the first for which curative chemotherapy was developed • rare disease - so a manageable problem

  21. Children’s cancer - a success story Why? • treatment at regional centres • cross-speciality communication • evidence-based treatment • national collaboration in treatment protocols • most patients entered into clinical trials

  22. Can adult cancer be treated as successfully as children’s cancer? • Can we give everyone the best care, irrespective of their social status?

  23. Good statistics are the crucial underpinning of government policy.

  24. Statistics are needed for: • valid target setting • planning service delivery • audit of performance

  25. High quality statistics: • accurate • complete • timely

  26. What sort of statistics? • incidence } {age • mortality } by {sex • survival } {tumour type

  27. How do we use the statistics? • to analyse trends • to analyse factors affecting trends • to predict the effects of these factors as the age structure of the population changes

  28. Health care has taken the lead in calling for evidence based decisions; government policy likewise needs to be determined by a firm knowledge base.

  29. I work on the epidemiology of children’s cancer. I previously taught English to people from other countries - mainly Bangladesh and Pakistan - who had settled in England. I integrated health education into my English teaching. This work made me more aware of the inequalities in society, both within England and between different countries. Heather Dickinson

  30. Learning objectives - to understand: • factors influencing cancer incidence and survival • stratifying by age, sex, social class • national statistics on disease • Performance objectives - to assess: • national trends in disease rates • targets for reduction in mortality

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