Prostate cancer and ethnicity Luke Hounsome Public Health

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 7 Prostate cancer and ethnicity

Prostate cancer incidence in England – age adjusted 8 Prostate cancer and ethnicity

Prostate cancer mortality in England – by age 9 Prostate cancer and ethnicity

Prostate cancer mortality in England – age adjusted 10 Prostate cancer and ethnicity

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 12 Prostate cancer and ethnicity

Prostate cancer survival in England – localised 13 Prostate cancer and ethnicity

Prostate cancer survival in England – locally advanced 14 Prostate cancer and ethnicity

Prostate cancer survival in England – advanced 15 Prostate cancer and ethnicity

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