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Introduction to cancer epidemiology basics mr es021012
Introduction to cancer epidemiology basics mr es021012
Introduction to cancer epidemiology basics mr es021012
Introduction to cancer epidemiology basics mr es021012
Introduction to cancer epidemiology basics mr es021012
Introduction to cancer epidemiology basics mr es021012
Introduction to cancer epidemiology basics mr es021012
Introduction to cancer epidemiology basics mr es021012
Introduction to cancer epidemiology basics mr es021012
Introduction to cancer epidemiology basics mr es021012
Introduction to cancer epidemiology basics mr es021012
Introduction to cancer epidemiology basics mr es021012
Introduction to cancer epidemiology basics mr es021012
Introduction to cancer epidemiology basics mr es021012
Introduction to cancer epidemiology basics mr es021012
Introduction to cancer epidemiology basics mr es021012
Introduction to cancer epidemiology basics mr es021012
Introduction to cancer epidemiology basics mr es021012
Introduction to cancer epidemiology basics mr es021012
Introduction to cancer epidemiology basics mr es021012
Introduction to cancer epidemiology basics mr es021012
Introduction to cancer epidemiology basics mr es021012
Introduction to cancer epidemiology basics mr es021012
Introduction to cancer epidemiology basics mr es021012
Introduction to cancer epidemiology basics mr es021012
Introduction to cancer epidemiology basics mr es021012
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Introduction to cancer epidemiology basics mr es021012

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  • 1. The Christie NHS Foundation TrustIntroduction to CancerEpidemiology BasicsDr Chris HarrisonMedical Director, The ChristieClinical Director (Cancer), NHS London
  • 2. The Christie NHS Foundation TrustWhat is Epidemiology?• ?
  • 3. The Christie NHS Foundation TrustDefinition of Epidemiology• “The study of the occurrence and distributions ofhealth related states or events in specifiedpopulations, including the study of thedeterminants influencing such states, and theapplication of this knowledge to control healthproblems”• A Dictionary of Epidemiology
  • 4. The Christie NHS Foundation TrustAlternatively• “Epidemiology is the study of the health ofhuman communities”Prof Alwyn SmithDescriptive v Analytic EpidemiologyUses of Epidemiology
  • 5. The Christie NHS Foundation TrustKey Terms• Incidence• Mortality• Survival• Prevalence
  • 6. The Christie NHS Foundation TrustKey Terms• Incidence – rate of new cases in a definedperiod• Mortality – rate of death in the total population ina defined period• Prevalence – proportion of total population whohave had a cancer diagnosis and are still alive• Survival – proportion of cases surviving adefined period of time
  • 7. The Christie NHS Foundation TrustCancer Incidence
  • 8. The Christie NHS Foundation TrustCancer IncidenceEngland Wales ScotlandNorthernIrelandUKMaleCases 134,636 9,130 14,271 4,260 162,297Crude Rate 527.7 623 567.4 484.9 534.3AS Rate 424.3 449.6 451.7 451.1 428.7AS Rate - 95% LCL* 422 440.3 444.3 437.6 426.7AS Rate - 95% UCL* 426.6 458.8 459.2 464.7 430.8FemaleCases 130,043 8,623 15,295 4,209 158,170Crude Rate 494.6 562.2 571 462.4 503.4AS Rate 366.9 385.7 407.1 386.7 372.1AS Rate - 95% LCL* 365 377.6 400.7 375.1 370.3AS Rate - 95% UCL* 368.9 393.8 413.6 398.4 373.9PersonsCases 264,679 17,753 29,566 8,469 320,467Crude Rate 510.9 591.9 569.2 473.4 518.6AS Rate 389.8 411.3 423.6 410.9 394.5AS Rate - 95% LCL* 388.4 405.3 418.7 402.2 393.2AS Rate - 95% UCL* 391.3 417.4 428.4 419.7 395.9
  • 9. The Christie NHS Foundation TrustIncidence - Common Cancers
  • 10. The Christie NHS Foundation TrustIncidence - Age
  • 11. The Christie NHS Foundation TrustIncidence Key Messages• Cancer Incidence is increasing• About 320,000 cases per year in the UK• In both men and women 4 cancers make upabout 70% of cases• Cancer gets more common with increasing age
  • 12. The Christie NHS Foundation TrustMortality - Trends
  • 13. The Christie NHS Foundation TrustMortalityEngland Scotland Wales Northern Ireland UKMaleDeaths 68,207 7,807 4,388 2,079 82,481Crude Rate 264.8 308.5 298.3 235.1 269.2AS Rate 198.4 232 200.8 209.3 201.6AS Rate - 95% LCL* 196.9 226.9 194.9 200.3 200.3AS Rate - 95% UCL* 199.9 237.2 206.8 218.2 203FemaleDeaths 61,316 7,516 4,088 1,874 74,794Crude Rate 231.6 279.2 266.2 204.8 236.5AS Rate 143.9 170.7 152.2 146.7 146.8AS Rate - 95% LCL* 142.8 166.9 147.6 140 145.8AS Rate - 95% UCL* 145.1 174.6 156.9 153.3 147.9PersonsDeaths 129,523 15,323 8,476 3,953 157,275Crude Rate 248 293.4 281.9 219.7 252.6AS Rate 167.1 195.9 172.7 172.5 170AS Rate - 95% LCL* 166.2 192.8 169 167.1 169.2AS Rate - 95% UCL* 168 199 176.4 177.8 170.9
  • 14. The Christie NHS Foundation TrustKey Messages - Mortality• Population Mortality has been falling• Cancer is 28% of all deaths in UK
  • 15. The Christie NHS Foundation TrustSurvival – Cancer Types2%6%8%13%15%22%34%36%43%45%48%52%61%68%76%79%83%90%3%6%7%12%13%24%38%45%45%46%51%61%67%71%78%84%95%PancreasLungOesophagusStomachBrainMultiple myelomaOvaryLeukaemiaKidneyColonRectumNHLBladderCervixUterusBreastHodgkins lymphomaMelanomaPancreasLungOesophagusStomachBrainMultiple myelomaLeukaemiaKidneyRectumColonNHLProstateLarynxBladderMelanomaHodgkins lymphomaTestisWomenMenFive-year relative survival10-50% survival:29% of cases diagnosedMore than 50% survival:38% of cases diagnosedless than 10% survival:24% of cases diagnosedMore than 50% survival:50% of cases diagnosed10-50% survival:27% of cases diagnosedless than 10% survival:15% of cases diagnosed
  • 16. The Christie NHS Foundation Trust5 Year Survival – All Cancers• People – 50%• Men – 43%• Women – 56%• National (CRUK) and Manchester Target is 66%
  • 17. The Christie NHS Foundation TrustSurvival - Trends-4 -2 0 2 4 6 8 10 12PancreasLarynxBrainBladderCervixLungOesophagusStomachMultiple myelomaUterusTestisNHLLeukeamiaOvaryColonMelanomaKidneyBreastRectumProstateAverage % change every five yearsMenWomen
  • 18. The Christie NHS Foundation TrustSurvival – Key Messages• Survival for most cancers has been increasing• Beware artefacts of change in diagnosis• Survival does vary across the UK but not asmuch as mortality• UK survival compares poorly with Europe
  • 19. The Christie NHS Foundation TrustPrevalence - UK                           1 year prevalence 5 year prevalence 10 year prevalenceMales   98,726 339,971 507,840Females   101,796 382,030 622,875Persons   200,522 722,001 1,130,715
  • 20. The Christie NHS Foundation TrustPrevalence – Key Messages• Prevalence increasing due to higher incidenceand better survival• Much higher prevalence then previous estimatesand expected to grow
  • 21. The Christie NHS Foundation TrustNorth and EastCMO: Kathy Pritchard-JonesDirector: Charlotte WilliamsSouth and WestInterim CMO:Arnie PurushothamProject manager: Claire Dowling21Two integrated cancer systems
  • 22. The Christie NHS Foundation TrustLargest and most complex network• 3.2 million population• 11 primary care trusts• 11 acute trusts• 15 hospitals• Secondary care referrals• 1 tertiary cancer centre
  • 23. The Christie NHS Foundation TrustThe North West
  • 24. The Christie NHS Foundation TrustThe Organisation of European CancerCentresMission• To bring together cancerresearch, care and educationalinstitutes within Europe tocreate a critical mass ofexpertise and competence• Founded in 1977 now has 81cancer centre members fromacross Europe
  • 25. The Christie NHS Foundation TrustWP 12EurocanPlatformMEMBERSDonnées cartographiqueMEMBERSDonnées cartographique
  • 26. The Christie NHS Foundation TrustKey Points• Cancer Services need to be organised acrosslarge populations• No single organisation has the critical massrequired• The epidemiology of cancer is a key factor indriving how services, research and educationare organised

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