Prostate Cancer - Newcastle University

Prostate Cancer - Newcastle University

Prostate Cancer Craig Blundred Overview Disease Definition Epidemiological Classification Symptoms Disease Burden Incidence Mortality Health Services Who?

Geographical Distribution Disease Definition Prostate cancer is a malignant tumour of the prostate ICD 10 Code C61 / ICD9 185 Most common cancer in men in Western countries Aetiology of the disease is not well known Symptoms The same as for BPH Difficulty urinating / Increased need to urinate Blood in the Urine Often no symptoms until metastatic disease occurs Incidence & Mortality

Age standardised (European) incidence and mortality rates, prostate cancer, males, GB, 1975-2005 Rate per 100000 population 120 incidence 100 mortality 80 60 40 20 Year of diagnosis/death Source: Cancer Research UK 2005 2003 2001

1999 1997 1995 1993 1991 1989 1987 1985 1983 1981 1979 1977 1975

0 Incidence Rates Source: Cancer Research UK Mortality Rates Source: Cancer Research UK Regional Variations Wales Northern Ireland 140 100.0 90.0 120 80.0 100

70.0 60.0 80 Rate 60 50.0 Rate 40.0 30.0 40 20.0 20 10.0 0 0.0 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005

1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 Scotland 1993 - 2004 Scotland England 1993 - 2005 England 100.0 120 120 90.0 90.0 100 80.0 100 80.0

70.0 80 70.0 60.0 80 60.0 50.0 Rate 60 Rate 40.0 50.0 Rate 60 40

Rate 30.0 40.0 20.0 20 40 30.0 10.0 0 20.0- 20 10.0 - 0 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004

1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 Sources: Welsh Cancer Intelligence & Surveillance Unit, IDS Scotland, National Statistics, Northern Ireland Cancer Registry Impact on Health Services All Male Genital Cancers 1998-99 to 2005-06 England 250000 200000 150000 100000 50000 0 1998-99 1999-00 2000-01 2001-02 2002-03 Finished Episodes

Source: http://www.hesonline.nhs.uk 2003-04 Bed Days 2004-05 2005-06 Impact on Health Services 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 8,000 7,000

1,000 Male cases Male rates 800 6,000 5,000 600 4,000 400 3,000 2,000 200 1,000 0 Age at diagnosis Source: Cancer Research UK

0 Rate per 100,000 pop ulatio n Numbers of new cases and age specific incidence rates UK 2004 0-4 5-9 10-14 15-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79 80-84

85+ Age Prostate Cancer is a disease of older people Some estimate that if you live until youre 90, 90% of men will have prostate cancer N um ber of cases Population Details Socioeconomic status Incidence rates higher in more affluent men Survival rates higher in more affluent men

Difficult to identify socioeconomic status from figures Population Details 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 Main Data Sources Cancer

Registries Office of National Statistics Hospital Episode Statistics Prescription Cost Analysis Data Quality 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 Office for National Statistics Gets data from Cancer Registries and Hospital

Episode Statistics Hospital Episode Statistics Combines cancers of the male genital organs and so includes testicular and penile cancers Prescription Cost Analysis Useful for costing the burden of disease No geographical variations References

Cancer Research UK http://info.cancerresearchuk.org/cancerstats/types/prostate/?a=5441 Acessed 14th 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 p581-592 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, pp60-70 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 pp695-699 Office for National Statistics Cancer Statistics Series MB1 No 36 (2007) Office for National Statistics Mortality Statistics Series DH2 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

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