Prostate cancer and ethnicity Luke Hounsome Public Health England ‘Hear me now’ workshop - Newham

Summary What is the picture on prostate cancer in Newham? How does this compare to the whole of England? Does your ethnicity affect your risk and outcomes? Prostate cancer and ethnicity – ‘Hear me now’ workshops

Where do the data come from? All newly diagnosed cases of cancer are registered by a regional office of the national Cancer Registration Service. Deaths records are sent to Public Health England from the Office for National Statistics. Ethnicity comes from hospital records which are linked to ONS deaths data – ethnicity is self reported. Data for the boroughs of Newham, Tower Hamlets, Waltham Forest, Haringey and City of London plus Hackney. Prostate cancer and ethnicity – ‘Hear me now’ workshops

Prostate cancer in Newham In 2008-10 combined there were 232 new cases of prostate cancer – 77 per year on average. Incidence in line with the England average. 81% had a recorded ethnicity – of these 49% were white, 31% black and 17% asian. In 2008-10 combined there were 84 deaths from prostate cancer – 28 per year on average. Mortality in line with the England average. 99% had a recorded ethnicity – of these 53% were white, 31% black and 14% asian. The population (based on 2009 ONS data) is 45% white, 16% black and 31% asian (Indian, Pakistani, Bangladeshi). One-year relative survival is 90% (lower than the England average) and five- year relative survival is 81%. Prostate cancer and ethnicity – ‘Hear me now’ workshops

Prostate cancer in Newham Prostate cancer accounts for 22% of new cases of cancer in men in Newham. In black men it is 39% of new cases, higher than average. 1 in 3 of the cancers in Newham with no known ethnicity are prostate cancers. Prostate cancer accounts for 12% of cancer deaths and 4% of all deaths in men in Newham. In black men it is 24% of cancer deaths, which is higher than average. In deaths for those aged under 75 (premature mortality) the percentages are 7% and 2% respectively. In black men it is 20% of premature cancer deaths and 7% of all premature deaths, both higher than average. Prostate cancer and ethnicity – ‘Hear me now’ workshops

Prostate cancer in Tower Hamlets In 2008-10 combined there were 162 new cases of prostate cancer – 54 per year on average. Incidence lower than the England average. 80% had a recorded ethnicity – of these 70% were white, 18% black and 9% asian. In 2008-10 combined there were 48 deaths from prostate cancer – 16 per year on average. Mortality lower than the England average. 96% had a recorded ethnicity – of these 76% were white, 13% black and 14% asian. The population (based on 2009 ONS data) is 53% white, 6% black and 30% asian (Indian, Pakistani, Bangladeshi). One-year relative survival is 93% and five-year relative survival is 82% (both in line with the England average). Prostate cancer and ethnicity – ‘Hear me now’ workshops

Prostate cancer in Tower Hamlets Prostate cancer accounts for 18% of new cases of cancer in men in Tower Hamlets. In black men it is 35% of new cases, higher than average. In asian men it is 8% of new cases, lower than average. 1 in 3 of the cancers in Tower Hamlets with no known ethnicity are prostate cancers. Prostate cancer accounts for 8% of cancer deaths and 3% of all deaths in men in Tower Hamlets. In asian men these numbers are 1% and 0%, lower than average. In deaths for those aged under 75 (premature mortality) the percentages are 5% and 2% respectively. Prostate cancer and ethnicity – ‘Hear me now’ workshops

Prostate cancer in City of London & Hackney In 2008-10 combined there were 316 new cases of prostate cancer – 105 per year on average. Incidence higher than the England average. 61% had a recorded ethnicity – of these 41% were white, 53% black and 2% asian. In 2008-10 combined there were 64 deaths from prostate cancer – 21 per year on average. Mortality lower than the England average. 100% had a recorded ethnicity – of these 45% were white, 50% black and 2% asian. The population (based on 2009 ONS data) is 64% white, 17% black and 11% asian (Indian, Pakistani, Bangladeshi). One-year relative survival is 95% and five-year relative survival is 84% (both in line with the England average). Prostate cancer and ethnicity – ‘Hear me now’ workshops

Prostate cancer in City of London & Hackney Prostate cancer accounts for 28% of new cases of cancer in men in City & Hackney. In black men it is 44% of new cases, higher than average. In asian men it is 10% of new cases, lower than average. 2 in 5 of the cancers in City & Hackney with no known ethnicity are prostate cancers. Prostate cancer accounts for 10% of cancer deaths and 3% of all deaths in men in City & Hackney. In black men these numbers are 20% and 8%, higher than average. In deaths for those aged under 75 (premature mortality) the percentages are 4% and 1% respectively. In black men these numbers are 9% and 4%, higher than average. Prostate cancer and ethnicity – ‘Hear me now’ workshops

Prostate cancer in Waltham Forest In 2008-10 combined there were 420 new cases of prostate cancer – 140 per year on average. Incidence higher than the England average. 80% had a recorded ethnicity – of these 68% were white, 22% black and 7% asian. In 2008-10 combined there were 96 deaths from prostate cancer – 32 per year on average. Mortality in line with the England average. 100% had a recorded ethnicity – of these 75% were white, 21% black and 3% asian. The population (based on 2009 ONS data) is 62% white, 14% black and 16% asian (Indian, Pakistani, Bangladeshi). One-year relative survival is 96% (in line with the England average) and five- year relative survival is 77% (lower than England average). Prostate cancer and ethnicity – ‘Hear me now’ workshops

Prostate cancer in Waltham Forest Prostate cancer accounts for 32% of new cases of cancer in men in Waltham Forest. In black men it is 50% of new cases, higher than average. 2 in 5 of the cancers in Waltham Forest with no known ethnicity are prostate cancers. Prostate cancer accounts for 15% of cancer deaths and 4% of all deaths in men in Waltham Forest. In black men 10% of all deaths are prostate cancer, higher than average. In asian men 2% of all deaths are prostate cancer, lower than average. In deaths for those aged under 75 (premature mortality) the percentages are 7% and 3% respectively. In black men 9% of all deaths in under 75s are from prostate cancer, higher than average. Prostate cancer and ethnicity – ‘Hear me now’ workshops

Prostate cancer in Haringey In 2008-10 combined there were 357 new cases of prostate cancer – 119 per year on average. Incidence higher than the England average. 71% had a recorded ethnicity – of these 57% were white, 27% black and 6% asian. In 2008-10 combined there were 95 deaths from prostate cancer – 32 per year on average. Mortality in line with the England average. 99% had a recorded ethnicity – of these 60% were white, 29% black and 2% asian. The population (based on 2009 ONS data) is 67% white, 15% black and 10% asian (Indian, Pakistani, Bangladeshi). One-year relative survival is 97% and five-year relative survival is 86% (both in line with the England average). Prostate cancer and ethnicity – ‘Hear me now’ workshops

Prostate cancer in Haringey Prostate cancer accounts for 29% of new cases of cancer in men in Haringey. No differences between ethnic groups. 2 in 5 of the cancers in Haringey with no known ethnicity are prostate cancers. Prostate cancer accounts for 13% of cancer deaths and 5% of all deaths in men in Haringey. In black men 22% of cancer deaths and 8% of all deaths are prostate cancer, higher than average. In asian men 2% of all deaths are prostate cancer, lower than average. In deaths for those aged under 75 (premature mortality) the percentages are 7% and 3% respectively. Prostate cancer and ethnicity – ‘Hear me now’ workshops

Prostate cancer in England In 2008-10 combined there were 102,252 new cases of prostate cancer – 34,084 per year on average. 74% had a recorded ethnicity – of these 94% were white. In 2008-10 combined there were 24.363 deaths from prostate cancer – per year on average. 98% had a recorded ethnicity – of these 99% were white. The population (based on 2009 ONS data) is 87% white, 3% black and 6% asian (Indian, Pakistani, Bangladeshi). One-year relative survival is 95% and five-year relative survival is 84%. Prostate cancer and ethnicity – ‘Hear me now’ workshops

Prostate cancer in England Prostate cancer accounts for 26% of new cases of cancer in men in England. 3 in 5 of the cancers in England with no known ethnicity are prostate cancers. 42% of cancers known to be in black men are prostate cancer 18% of cancers known to be in asian men are prostate cancer Prostate cancer accounts for 12% of cancer deaths and 4% of all deaths in men in England. 22% of cancer deaths in black men and 8% of all deaths 8% of cancer deaths in asian men, and 2% of all deaths In deaths for those aged under 75 (premature mortality) the percentages are 7% and 3% respectively. 15% of cancer deaths in black men and 6% of all deaths 5% of cancer deaths in asian men, and 1% of all deaths Prostate cancer and ethnicity – ‘Hear me now’ workshops

Prostate cancer in England - stage Stage data is only available for 26% of newly diagnosed prostate cancers. The following are expressed as percentage of cases where the stage is known. Source: National Cancer Data Repository; Hospital Episode Statistics Black Asian White Other Mixed Not known Localised 53% (243) 47% (92) 52% (10,075) 40% (36) 46% (21) 61% (3,800) Locally advanced 17% (79) 24% (46) 15% (2,961) 20% (18) 11% (5) 17% (1,066) Advanced 30% (140) 29% (56) 32% (6,182) 39% (445) 43% (20) 22% (1,384) Prostate cancer and ethnicity – ‘Hear me now’ workshops

Prostate cancer incidence in England – by age Source: National Cancer Data Repository; Hospital Episode Statistics Prostate cancer and ethnicity – ‘Hear me now’ workshops

Prostate cancer incidence in England – age adjusted Source: National Cancer Data Repository; Hospital Episode Statistics Prostate cancer and ethnicity – ‘Hear me now’ workshops

Prostate cancer mortality in England – by age Source: Office for National Statistics; Hospital Episode Statistics Prostate cancer and ethnicity – ‘Hear me now’ workshops

Prostate cancer mortality in England – age adjusted Source: Office for National Statistics; Hospital Episode Statistics Prostate cancer and ethnicity – ‘Hear me now’ workshops

Prostate cancer in England What do all these numbers/graphs mean? The risk of getting prostate cancer is over double (RR 2.3) for black men, but nearly half (RR 0.54) for asian men, compared to white men. The risk of dying from prostate cancer is about double (RR 2.06) for black men, and under half (RR 0.46) for asian men, compared to white men. What about the individual? The lifetime risk of getting prostate cancer is 27% for a black man, 7% for an asian man, and 12% for a white man. The lifetime risk of dying from prostate cancer is 8% for a black man, 2% for an asian man, and 4% for a white man. Prostate cancer and ethnicity – ‘Hear me now’ workshops

Prostate cancer survival in England – all stages Source: National Cancer Data Repository; Hospital Episode Statistics Prostate cancer and ethnicity – ‘Hear me now’ workshops

Prostate cancer survival in England – localised Source: National Cancer Data Repository; Hospital Episode Statistics Prostate cancer and ethnicity – ‘Hear me now’ workshops

Prostate cancer survival in England – locally advanced Source: National Cancer Data Repository; Hospital Episode Statistics Prostate cancer and ethnicity – ‘Hear me now’ workshops

Prostate cancer survival in England – advanced Source: National Cancer Data Repository; Hospital Episode Statistics Prostate cancer and ethnicity – ‘Hear me now’ workshops

Prostate cancer in England Survival from prostate cancer is high, and (given the amount of data we have) does not appear to vary by ethnicity. Survival is primarily driven by how advanced the cancer is at diagnosis. Difference between localised and advanced at one year is about 20% Difference at five years is about 55% Difference at ten years is nearly 80% Prostate cancer and ethnicity – ‘Hear me now’ workshops