Cancer

Last updated: 2019-10-15 12:24:55
[+] Expand all

1. Summary

Last updated: 15/10/19

2. Introduction

There are 2.5 million people living with cancer in the UK.

There are more than 360,000 new cancer cases in the UK every year, that's nearly 990 every day.

Every two minutes someone in the UK is diagnosed with cancer.

The earlier a cancer can be diagnosed the greater the prospect of survival. Evidence suggests that later diagnosis of cancer has been a major factor in the poorer survival rates in the UK compared with some other countries in Europe.

There are around 164,000 cancer deaths in the UK every year, that's around 450 every day.

Every four minutes someone in the UK dies from cancer.

Cancer accounts for more than a quarter of all deaths in the UK.

Lives can be saved from cancer, primarily through better awareness of the signs and symptoms and earlier diagnosis of cancer.

The number of people living with cancer is going up partly because more people are surviving cancer for longer.

However, more people are getting cancer in the first place, and many are left with serious long-term side-effects.

There are more than 1 million admissions to hospital for cancer in England.

The annual cost of all cancers to the UK economy is £15.8 billion.

The cost of lung cancer at £2.4 billion each year is far higher than that for any other cancer.

Source: Oxford University, Cancer research UK and Macmillan cancer support

Other JSNA topics this topic closely linked to:

Smoking

Obesity

Diet and nutrition

Alcohol misuse

Sexual health

Oral health

Physical inactivity

End of life care

 

Last updated: 15/10/19

3. Data and Intelligence

Cancer incidence and mortality

Source: National Cancer Registration Service Cancer Analysis System, snapshot CAS1712

In 2015, the top three most common tumour sites for males in Hartlepool and Stockton (HAST) were Prostate, Lung and Colon. These accounted for over 45% of all cases.

Source: National Cancer Registration Service Cancer Analysis System, snapshot CAS1712

In 2015, the top three most common tumour sites for females in HAST were Breast, Lung and Colon. These accounted for over 71% of all cases.

The chart above shows that in the North East, the most new cases of cancer are for Breast cancer (females) and Prostate cancer (males).

However, the most common cause of death from cancer for both females and males is Lung cancer.

In 2014-16, the under 75 mortality rate from cancer in Stockton-on-Tees (n=783) was statistically significantly higher than the national average. This has been the case since at least 2001-03.

In 2014-16, the under 75 mortality rate from cancers that were considered preventable in Stockton-on-Tees (n = 464) was statistically significantly higher than the national average. This has been the case since at least 2001-03.

In 2014-16, lung cancer registration rates in Stockton-on-Tees (n= 522) were statistically significantly higher than the national average. This has been the case since at least 2007-09.

In 2014-16, death rates from lung cancer in Stockton-on-Tees (n = 392) was statistically significantly higher than the national average. This has been the case since at least 2001-03

In 2014-16, oral cancer registration rates in Stockton-on-Tees (n = 99) were statistically significantly higher than the national average. This has been the case since 2012-14.

In 2014-16, death rates from oral cancer in Stockton-on-Tees (n = 39) was statistically significantly higher than the national average. This has been the case since 2012-14.

The chart above shows that in the North East, residents the most deprived areas are more than three times as likely to have lung cancer as those from the most affluent areas.

Inequalities in mortality

The following information identifies the causes of death that are driving inequalities in life expectancy.

The above chart compares what causes the excess deaths in Stockton-on-Tees when compared with the England average.

It shows that 36.6% (males) and 28.3% (females) of the excess deaths in Stockton-on-Tees are attributed to cancer.

This means that if Stockton-on-Tees has the same mortality rate as the national average, then 85 (males) and 49 (females) cancer deaths (out of a total of 822) would be prevented.

The above chart compares what causes the excess deaths in the most deprived areas of Stockton-on-Tees when compared with the most affluent areas of Stockton-on-Tees.

It shows that 26.9% (males) and 31.8% (females) of the excess deaths in the most deprived areas of Stockton-on-Tees are attributed to cancer.

This means that if the most deprived areas of Stockton-on-Tees has the same mortality rate as the most affluent areas of Stockton-on-Tees, then 130 (males) and 111 (females) deaths (out of a total of 221) would be prevented.

Screening

The chart above shows that in HAST, residents from the most deprived areas are less likely to take up an offer of cancer screening (for all cancer types) than those from the most affluent areas.

The chart also shows that in HAST, uptake rates of screening for Cervical and Breast cancer are higher than Bowel cancer.

More than a quarter of the eligible population do not take up the offer of cancer screening in HAST.

Source : Fingertips – Cancer Service Profiles - https://fingertips.phe.org.uk

The chart above shows that there is a wide variation of breast screening rates across practices in HAST CCG.

Source : Fingertips – Cancer Service Profiles - https://fingertips.phe.org.uk

The chart above shows that there is a wide variation of cervical screening rates across practices in HAST CCG.

Source : Fingertips – Cancer Service Profiles - https://fingertips.phe.org.uk

The chart above shows that there is a wide variation of bowel screening rates across practices in HAST CCG.

Emergency presentations and admissions to hospital

The above charts show that in the North East, rates of emergency presentations from the most deprived areas are much higher for Lung (40%) and Colorectal (29%) cancer than they are for Breast (5%) and Prostate (11%) cancer.

Survival rates

The above chart shows that in England, 1-year survival rates are much lower for Lung cancer than they are for other cancers.

Two week referral rates

Source : Fingertips – Cancer Service Profiles - https://fingertips.phe.org.uk

There is a wide variation of two week referral rates across practices in HAST CCG.

 

Last updated: 15/10/19

4. Which population groups are at risk and why?

Last updated: 15/10/19

5. Consultation and engagement

Last updated: 15/10/19

6. Strategic issues

Last updated: 15/10/19

7. Evidence base

 

Issue number

1 = highest priority

 

1

Source

NICE

Title incl. web link

Lung cancer: diagnosis and management

https://www.nice.org.uk/guidance/cg121

Summary

This guideline covers diagnosing and managing non-small-cell and small-cell lung cancers in children, young people and adults. It aims to improve outcomes for patients by raising awareness of causes, symptoms and signs of lung cancer and ensuring testing, treatment and follow-up care is consistent.

Source

Stockton JSNA

Title incl. web link

Stockton-on-Tees Smoking JSNA

http://www.teesjsna.org.uk/stockton-smoking/

Summary

Links to evidence around smoking prevention and cessation.

2

Source

Cancer Research UK

Title incl. web link

Cancer and Michael Marmot, 2006 health inequalities: An introduction to current evidence

Link

Summary

Evidence given supports an inverse correlation between socioeconomic status and cancer incidence and mortality (with particular focus upon the impact of tobacco consumption) and evidence of differing rates of cancer among Black and Minority Ethnic communities, other harder to reach groups and the general population.

Source

Macmillan Cancer Support

Title incl. web link

Cancer inequalities report

Link

Summary

Report of the All Party Parliamentary Group on Cancer’s Inquiry into Inequalities in Cancer.

Source

NICE

Title incl. web link

Suspected cancer: recognition and referral

https://www.nice.org.uk/guidance/ng12

Summary

This guideline covers identifying children, young people and adults with symptoms that could be caused by cancer. 

Source

Leeds Metropolitan University (2010)

Title incl. web link

Community health Champions: Evidence review

Link

Summary

This evidence review looks at the evidence base for community health champions and similar roles. Community members (either as volunteers or paid community health workers) undertake health promotion activities within the neighbourhoods and communities where they live and/or work. “Altogether Better” is based on an empowerment model. At the heart of this model is the concept that community health champions can be equipped with the knowledge, confidence and skills to make a difference in their communities. The evidence indicates that using Health Champions has improved access and increased uptake to services.

 

 

Last updated: 15/10/19

8. What is being done and why?

Public health

Breast cancer screening is offered to all females (registered with a GP), 50-70 years old, through the breast cancer screening unit at North Tees Hospital. They are invited for screening for the first time between their 50th and 53rd birthdays and every three years thereafter up to but not including their 71st birthdays. Over this 21 year window a woman who responds to each invitation should be screened 7 times. They are generally invited by post.

Cervical cancer screening is offered to all females (registered with a GP), 25-49 years old every 3 years and females aged 50-64 are invited for a routine screening every 5 years, through the cervical cancer screening unit at North Tees Hospital. They are generally invited by post.

Bowel cancer screening is offered to all people (registered with a GP), 55 years or over, through the bowel cancer screening unit at North Tees Hospital. They are generally invited by post.

  • 55 year olds are automatically invited for a one-off bowel scope screening test.
  • 60-74 year olds are automatically invited to do a home testing kit every 2 years.
  • 75 year olds or over can ask for a home testing kit every 2 years by calling the free bowel cancer screening helpline.

Primary Care

TBC

Secondary Care

TBC

Macmillan/Voluntary Sector

TBC

 

Last updated: 15/10/19

9. What needs are unmet?

Last updated: 15/10/19

10. What needs to be done and why?

Last updated: 15/10/19

11. What additional needs assessment is required?

No additional needs assessment is required at present

Last updated: 15/10/19

12. Key contact

Name: Andy Copland

Job title: Commissioning Lead

Organisation: NHS Hartlepool and Stockton-on-Tees CCG

Phone number: 01642 745957

Contributor/s:

James O’Donnell (Stockton-on-Tees Borough Council)

Karen Eastwood (North of England Commissioning Support Unit)

Yuki Smith (NHS Hartlepool and Stockton-on-Tees CCG)

Anna Waller (University Hospital of North Tees)         

Northern Cancer Alliance

 

Last updated: 15/10/19

13. References

.

Last updated: 15/10/19

Email: andrewcopland@nhs.net