Prostate Cancer Craig Blundred Overview n Disease Definition

Prostate Cancer Craig Blundred

Overview n Disease Definition ¨ Epidemiological ¨ Symptoms n Classification Disease Burden ¨ Incidence ¨ Mortality ¨ Health Services n n Who? Geographical Distribution

Disease Definition Prostate cancer is a malignant tumour of the prostate n ICD 10 Code C 61 / ICD 9 185 n Most common cancer in men in Western countries n Aetiology of the disease is not well known n

Symptoms n The same as for BPH ¨ Difficulty urinating / Increased need to urinate ¨ Blood in the Urine n Often no symptoms until metastatic disease occurs

Rate per 100000 population Incidence & Mortality Source: Cancer Research UK

Incidence Rates Source: Cancer Research UK

Mortality Rates Source: Cancer Research UK

Regional Variations Sources: Welsh Cancer Intelligence & Surveillance Unit, IDS Scotland, National Statistics, Northern Ireland Cancer Registry

Impact on Health Services Source: http: //www. hesonline. nhs. uk

Impact on Health Services n Prescription Costs for England 2005 ¨ Prostate Cancer and Gonadorelin Analogues ¨ 625100 prescription items dispensed ¨ £ 126, 375, 600 Source: Health and Social Care Information Centre

Population Details n n n Age Prostate Cancer is a disease of older people Some estimate that if you live until you’re 90, 90% of men will have prostate cancer Source: Cancer Research UK

Population Details n Socioeconomic status ¨ Incidence ¨ Survival rates higher in more affluent men ¨ Difficult to identify socioeconomic status from figures

Population Details n Ethnicity ¨ Difficult to ascertain but some ethnic groups appear to be more susceptible ¨ Within the USA, African-Americans have a higher rate than Caucasian Americans ¨ Migrants moving from low risk to high risk areas acquire the local incidence rate

International Comparisons Eurostat Atlas of Mortality in the European Union 2002

Data Quality n Main Data Sources ¨ Cancer Registries ¨ Office of National Statistics ¨ Hospital Episode Statistics ¨ Prescription Cost Analysis

Data Quality n Cancer Registries ¨ Systematic collection of data to assist in the management of disease ¨ Core data collected with optional categories ¨ Core data does not include ethnicity and has markers of socioeconomic status which could be contentious ¨ Death certification

Data Quality n Office for National Statistics ¨ Gets data from Cancer Registries and Hospital Episode Statistics n Hospital Episode Statistics ¨ Combines cancers of the male genital organs and so includes testicular and penile cancers n Prescription Cost Analysis ¨ Useful for costing the burden of disease ¨ No geographical variations

References n n n Cancer Research UK http: //info. cancerresearchuk. org/cancerstats/types/prostate/? a=5441 Acessed 14 th April 2008 Eurostat Atlas of Mortality in the European Union 2002 Luxembourg Ferlay, J. Autier, P. Boniol, M. Heanue, M. and Boyle, P. Estimates of the cancer incidence and mortality in Europe in 2006 Annals of Oncology (2007) 18 p 581 -592 Health and Social Care Information Centre Prescription Cost Analysis England 2006 London 2007 Hsing, A. Tsao, L and Devesa, S. International Trends and Patterns of Prostate Cancer Incidence and Mortality International Journal of Cancer (2000) 85, pp 60 -70 Jarup, L. Best, N. Toledano, M. Wakelfield, J. and Elliot, P. Geographical Epidemiology of Prostate Cancer in Great Britain International Journal of Cancer (2002) 97 pp 695 -699 Office for National Statistics Cancer Statistics Series MB 1 No 36 (2007) Office for National Statistics Mortality Statistics Series DH 2 No 32 (2005) Quinn, M. Moller, H. Cancer Atlas of the UK and Ireland (200 Selley S, Donovan J, Faulkner A, Coast J, Gillatt D. Diagnosis, management and screening of early localised prostate cancer. Health Technol Assess 1997; 1 (2). The Information Centre Hospital Episode Statistics http: //hesonline. nhs. uk 1999 to 2007