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 BPHDifficulty urinating / Increased need to urinateBlood in the Urine

Often no symptoms until metastatic disease occurs

Incidence & Mortality

Source: Cancer Research UK

0

20

40

60

80

100

120

1975

1977

1979

1981

1983

1985

1987

1989

1991

1993

1995

1997

1999

2001

2003

2005

Year of diagnosis/death

incidence mortality

Age standardised (European) incidence and mortality rates, prostate cancer, males, GB, 1975-2005

Ra

te p

er

10

00

00

po

pu

lati

on

Incidence Rates

Source: Cancer Research UK

Mortality Rates

Source: Cancer Research UK

Regional Variations

Wales

0

20

40

60

80

100

120

140

1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005

Rate

Northern Ireland

0.0

10.0

20.0

30.0

40.0

50.0

60.0

70.0

80.0

90.0

100.0

1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005

Rate

Scotland

-

10.0

20.0

30.0

40.0

50.0

60.0

70.0

80.0

90.0

100.0

Rate

England

0

20

40

60

80

100

120

Rate

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

England 1993 - 2005

0

20

40

60

80

100

120

1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005

Rate

Scotland 1993 - 2004

-

10.0

20.0

30.0

40.0

50.0

60.0

70.0

80.0

90.0

100.0

1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004

Rate

Impact on Health Services

All Male Genital Cancers 1998-99 to 2005-06England

0

50000

100000

150000

200000

250000

1998-99 1999-00 2000-01 2001-02 2002-03 2003-04 2004-05 2005-06

Finished Episodes Bed Days

Source: http://www.hesonline.nhs.uk

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

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

0

1,000

2,000

3,000

4,000

5,000

6,000

7,000

8,000

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 at diagnosis

Nu

mb

er

of

ca

se

s

0

200

400

600

800

1,000

Ra

te p

er

10

0,0

00

po

pu

lati

on

Male cases Male rates

Numbers of new cases and age specific incidence rates UK 2004

Population Details

Socioeconomic status

Incidence rates higher in more affluent menSurvival rates higher in more affluent menDifficult to identify socioeconomic status from

figures

Population Details

EthnicityDifficult to ascertain but some ethnic groups

appear to be more susceptibleWithin the USA, African-Americans have a

higher rate than Caucasian AmericansMigrants 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 SourcesCancer RegistriesOffice of National StatisticsHospital Episode StatisticsPrescription Cost Analysis

Data Quality

Cancer RegistriesSystematic collection of data to assist in the

management of diseaseCore data collected with optional categoriesCore 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