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EPAD 2017 Ian Banks


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Addressing inequalities in access to care for PCa in Europe
Ian Banks, President European Men’s Health Forum (EMHF)

Published in: Health & Medicine
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EPAD 2017 Ian Banks

  1. 1. Inequalities in cancer care Prostate Cancer EPAD Brussels 2017 Ian Banks European Society of Medical Oncologists Leeds University Medical School European Cancer Organisation European Mens Health Forum Royal Society Public Health University of Ulster Queens University
  2. 2. Inequalities in Prostate Cancer Prostate Cancer UK identifies five inequalities facing men with or are at risk of prostate cancer: • Diagnosis, awareness, information and support • Inequalities by ethnicity – Black men with prostate cancer • Variation in quality of care across the UK/Europe • Age • Access to treatments Men United v Prostate Cancer: Five Inequalities, five solutions. 2014
  3. 3. Diagnosis, awareness, information and support • Awareness of signs and symptoms amongst men is still low - A Prostate Cancer UK study in 2013 revealed that: Only 40% of people know that being 50 or over increases a man’s risk of prostate cancer Only 5% of people know that being a black man increases your risk 46% of people could identify where the prostate is 63% of people have never heard of the PSA test
  4. 4. Inequalities in Prostate Cancer – Black men with prostate cancer • Black men in the UK have double the risk of developing prostate cancer than white men and are diagnosed at a younger age. • Prostate cancer mortality rates are 30% higher for black men than white men. • National Cancer Patient Experience Survey 2013 – for all cancers black respondents reported overall poorer experiences of care compared to white respondents • Deprivation based health inequalities are inextricably linked with ethnicity. • Lack of data by ethnicity fuels inequalities
  5. 5. Variation in quality of care across the UK Treatment & Age • Significant variation in the proportion of prostate cancer patients who said they had been given information about how to get financial help or benefits • Wide variations in access to a specialist nurse – Average 88% and only five Trusts reported 100%. • Older men diagnosed with prostate cancer are far less likely to be told about side effects of treatment and at times have fewer treatment options offered to them than younger men. • Age alone may limit the options for some men regardless of their physical fitness
  6. 6. Cancer Inequalities in Europe Data from the European Cancer Patient Coalition – Survey of patient organisations 2015 Main reasons for inequalities in access to cancer care: • 78% cited lack of adequate information about different treatment options because doctors/physicians are not always aware of new available treatments (40%) • Cost of treatment and price affordability • Geographical variations in access to new treatments • Geographical variations in access to screening • Geographical variations in access to medicines
  7. 7. Prostate Cancer Inequalities in Europe • Generally cancer survival rates are 40% higher in Western Europe than in Eastern Europe • Differences in Prostate Cancer survival range from 88% in Central Europe to 72% in Eastern Europe.
  8. 8. Prostate Cancer Inequalities in Europe • A man in Italy has a 90% chance of being alive 5 years after diagnosis compared to 71% chance for a man in Croatia. • Disparities in Prostate Cancer outcomes in Europe are wider than other cancers. (Prostate 35%, Testis 28%, Breast 18%) (Ira Nathanson. Cancer results of treatment. NEJM 1943: 468-480)
  9. 9. Recommendation #1 EAU White Paper European institutions and Member States need to ensure that PCa patients receive high quality, standardized, and integrated care with a focus on a patient-centred multidisciplinary approach.