Prostate cancer and ethnicity Luke Hounsome Public Health
Prostate cancer and ethnicity Luke Hounsome Public Health England ‘Hear me now’ workshop - Newham
Summary • What is the picture on prostate cancer in Newham? • How does this compare to the whole of England? • Does your ethnicity affect your risk and outcomes? 2 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 records are sent to Public Health England from the Office for National Statistics. • Ethnicity comes from hospital records which are linked to ONS deaths data – ethnicity is self reported. • Data for the boroughs of Newham, Tower Hamlets, Waltham Forest, Haringey and City of London plus Hackney. 3 Prostate cancer and ethnicity – ‘Hear me now’ workshops
Prostate cancer in Newham • In 2008 -10 combined there were 232 new cases of prostate cancer – 77 per year on average. Incidence in line with the England average. • 81% had a recorded ethnicity – of these 49% were white, 31% black and 17% asian. • In 2008 -10 combined there were 84 deaths from prostate cancer – 28 per year on average. Mortality in line with the England average. • 99% had a recorded ethnicity – of these 53% were white, 31% black and 14% asian. • The population (based on 2009 ONS data) is 45% white, 16% black and 31% asian (Indian, Pakistani, Bangladeshi). • One-year relative survival is 90% (lower than the England average) and fiveyear relative survival is 81%. 4 Prostate cancer and ethnicity – ‘Hear me now’ workshops
Prostate cancer in Newham • Prostate cancer accounts for 22% of new cases of cancer in men in Newham. • In black men it is 39% of new cases, higher than average. • 1 in 3 of the cancers in Newham with no known ethnicity are prostate cancers. • Prostate cancer accounts for 12% of cancer deaths and 4% of all deaths in men in Newham. • In black men it is 24% of cancer deaths, which is higher than average. • In deaths for those aged under 75 (premature mortality) the percentages are 7% and 2% respectively. • 5 In black men it is 20% of premature cancer deaths and 7% of all premature deaths, both higher than average. Prostate cancer and ethnicity – ‘Hear me now’ workshops
Prostate cancer in Tower Hamlets • In 2008 -10 combined there were 162 new cases of prostate cancer – 54 per year on average. Incidence lower than the England average. • 80% had a recorded ethnicity – of these 70% were white, 18% black and 9% asian. • In 2008 -10 combined there were 48 deaths from prostate cancer – 16 per year on average. Mortality lower than the England average. • 96% had a recorded ethnicity – of these 76% were white, 13% black and 14% asian. • The population (based on 2009 ONS data) is 53% white, 6% black and 30% asian (Indian, Pakistani, Bangladeshi). • One-year relative survival is 93% and five-year relative survival is 82% (both in line with the England average). 6 Prostate cancer and ethnicity – ‘Hear me now’ workshops
Prostate cancer in Tower Hamlets • Prostate cancer accounts for 18% of new cases of cancer in men in Tower Hamlets. • In black men it is 35% of new cases, higher than average. • In asian men it is 8% of new cases, lower than average. • 1 in 3 of the cancers in Tower Hamlets with no known ethnicity are prostate cancers. • Prostate cancer accounts for 8% of cancer deaths and 3% of all deaths in men in Tower Hamlets. • In asian men these numbers are 1% and 0%, lower than average. • In deaths for those aged under 75 (premature mortality) the percentages are 5% and 2% respectively. 7 Prostate cancer and ethnicity – ‘Hear me now’ workshops
Prostate cancer in City of London & Hackney • In 2008 -10 combined there were 316 new cases of prostate cancer – 105 per year on average. Incidence higher than the England average. • 61% had a recorded ethnicity – of these 41% were white, 53% black and 2% asian. • In 2008 -10 combined there were 64 deaths from prostate cancer – 21 per year on average. Mortality lower than the England average. • 100% had a recorded ethnicity – of these 45% were white, 50% black and 2% asian. • The population (based on 2009 ONS data) is 64% white, 17% black and 11% asian (Indian, Pakistani, Bangladeshi). • One-year relative survival is 95% and five-year relative survival is 84% (both in line with the England average). 8 Prostate cancer and ethnicity – ‘Hear me now’ workshops
Prostate cancer in City of London & Hackney • Prostate cancer accounts for 28% of new cases of cancer in men in City & Hackney. • In black men it is 44% of new cases, higher than average. • In asian men it is 10% of new cases, lower than average. • 2 in 5 of the cancers in City & Hackney with no known ethnicity are prostate cancers. • Prostate cancer accounts for 10% of cancer deaths and 3% of all deaths in men in City & Hackney. • In black men these numbers are 20% and 8%, higher than average. • In deaths for those aged under 75 (premature mortality) the percentages are 4% and 1% respectively. • 9 In black men these numbers are 9% and 4%, higher than average. Prostate cancer and ethnicity – ‘Hear me now’ workshops
Prostate cancer in Waltham Forest • In 2008 -10 combined there were 420 new cases of prostate cancer – 140 per year on average. Incidence higher than the England average. • 80% had a recorded ethnicity – of these 68% were white, 22% black and 7% asian. • In 2008 -10 combined there were 96 deaths from prostate cancer – 32 per year on average. Mortality in line with the England average. • 100% had a recorded ethnicity – of these 75% were white, 21% black and 3% asian. • The population (based on 2009 ONS data) is 62% white, 14% black and 16% asian (Indian, Pakistani, Bangladeshi). • One-year relative survival is 96% (in line with the England average) and fiveyear relative survival is 77% (lower than England average). 10 Prostate cancer and ethnicity – ‘Hear me now’ workshops
Prostate cancer in Waltham Forest • Prostate cancer accounts for 32% of new cases of cancer in men in Waltham Forest. • In black men it is 50% of new cases, higher than average. • 2 in 5 of the cancers in Waltham Forest with no known ethnicity are prostate cancers. • Prostate cancer accounts for 15% of cancer deaths and 4% of all deaths in men in Waltham Forest. • In black men 10% of all deaths are prostate cancer, higher than average. • In asian men 2% of all deaths are prostate cancer, lower than average. • In deaths for those aged under 75 (premature mortality) the percentages are 7% and 3% respectively. • 11 In black men 9% of all deaths in under 75 s are from prostate cancer, higher than average. Prostate cancer and ethnicity – ‘Hear me now’ workshops
Prostate cancer in Haringey • In 2008 -10 combined there were 357 new cases of prostate cancer – 119 per year on average. Incidence higher than the England average. • 71% had a recorded ethnicity – of these 57% were white, 27% black and 6% asian. • In 2008 -10 combined there were 95 deaths from prostate cancer – 32 per year on average. Mortality in line with the England average. • 99% had a recorded ethnicity – of these 60% were white, 29% black and 2% asian. • The population (based on 2009 ONS data) is 67% white, 15% black and 10% asian (Indian, Pakistani, Bangladeshi). • One-year relative survival is 97% and five-year relative survival is 86% (both in line with the England average). 12 Prostate cancer and ethnicity – ‘Hear me now’ workshops
Prostate cancer in Haringey • Prostate cancer accounts for 29% of new cases of cancer in men in Haringey. • No differences between ethnic groups. • 2 in 5 of the cancers in Haringey with no known ethnicity are prostate cancers. • Prostate cancer accounts for 13% of cancer deaths and 5% of all deaths in men in Haringey. • In black men 22% of cancer deaths and 8% of all deaths are prostate cancer, higher than average. • In asian men 2% of all deaths are prostate cancer, lower than average. • In deaths for those aged under 75 (premature mortality) the percentages are 7% and 3% respectively. 13 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 ONS data) is 87% white, 3% black and 6% asian (Indian, Pakistani, Bangladeshi). • One-year relative survival is 95% and five-year relative survival is 84%. 14 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. 15 • 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 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) Advanced 30% (140) 29% (56) 32% (6, 182) 39% (445) Source: National Cancer Data Repository; Hospital Episode Statistics 16 Prostate cancer and ethnicity – ‘Hear me now’ workshops 17% (1, 066) 43% (20) 22% (1, 384)
Prostate cancer incidence in England – by age Source: National Cancer Data Repository; Hospital Episode Statistics 17 Prostate cancer and ethnicity – ‘Hear me now’ workshops
Prostate cancer incidence in England – age adjusted Source: National Cancer Data Repository; Hospital Episode Statistics 18 Prostate cancer and ethnicity – ‘Hear me now’ workshops
Prostate cancer mortality in England – by age Source: Office for National Statistics; Hospital Episode Statistics 19 Prostate cancer and ethnicity – ‘Hear me now’ workshops
Prostate cancer mortality in England – age adjusted Source: Office for National Statistics; Hospital Episode Statistics 20 Prostate cancer and ethnicity – ‘Hear me now’ workshops
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. 21 Prostate cancer and ethnicity – ‘Hear me now’ workshops
Prostate cancer survival in England – all stages Source: National Cancer Data Repository; Hospital Episode Statistics 22 Prostate cancer and ethnicity – ‘Hear me now’ workshops
Prostate cancer survival in England – localised Source: National Cancer Data Repository; Hospital Episode Statistics 23 Prostate cancer and ethnicity – ‘Hear me now’ workshops
Prostate cancer survival in England – locally advanced Source: National Cancer Data Repository; Hospital Episode Statistics 24 Prostate cancer and ethnicity – ‘Hear me now’ workshops
Prostate cancer survival in England – advanced Source: National Cancer Data Repository; Hospital Episode Statistics 25 Prostate cancer and ethnicity – ‘Hear me now’ workshops
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. 26 • 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
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