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Prostate Cancer

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  1. Prostate Cancer Craig Blundred

  2. Overview • Disease Definition • Epidemiological Classification • Symptoms • Disease Burden • Incidence • Mortality • Health Services • Who? • Geographical Distribution

  3. 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

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

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

  6. Incidence Rates Source: Cancer Research UK

  7. Mortality Rates Source: Cancer Research UK

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

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

  10. 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

  11. Population Details • 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

  12. 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

  13. 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

  14. International Comparisons Eurostat Atlas of Mortality in the European Union 2002

  15. Data Quality • Main Data Sources • Cancer Registries • Office of National Statistics • Hospital Episode Statistics • Prescription Cost Analysis

  16. 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

  17. 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

  18. 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