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

2. Summary
What is the picture on prostate cancer in Nottingham City and Nottinghamshire
Nottinghamshire is defined as the Nottingham County area - excluding Bassetlaw (and Nottingham City).
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

3. 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 from cancer from the Office for National Statistics.
Ethnicity from hospital record – self reported.
Prostate cancer and ethnicity – ‘Hear me now’ workshops

4. Prostate cancer in Nottingham City
In combined there were 410 new cases of prostate cancer – 137 per year on average. Incidence is in line with the England average.
84% had a recorded ethnicity – of these 92% were white.
In combined there were 148 deaths from prostate cancer – 49 per year on average. Mortality in line with England average.
95% had a recorded ethnicity – of these 91% were white.
The population (based on 2009) is 79% white, 5% black and 10% asian (Indian, Pakistani, Bangladeshi).
One-year relative survival is 93% and five-year relative survival is 62% (this is below the England average).
Prostate cancer and ethnicity – ‘Hear me now’ workshops

5. Prostate cancer in Nottingham City
Prostate cancer accounts for 21% of new cases of cancer in men in Nottingham City.
1 in 6 of the cancers in Nottingham City with no known ethnicity are prostate cancers.
Prostate cancer accounts for 11% of cancer deaths and 4% of all deaths in men in Nottingham City.
In black men this is 31% of cancer deaths and 12% of all deaths – higher than the average.
In deaths for those aged under 75 (premature mortality) the percentages are 6% and 2% respectively.
Numbers are too small to infer any differences by ethnicity.
Prostate cancer and ethnicity – ‘Hear me now’ workshops

6. Prostate cancer in Nottinghamshire County (excluding Bassetlaw)
In combined there were 1,549 new cases of prostate cancer – 516 per year on average. Incidence is in line with the England average.
77% had a recorded ethnicity – of these 98% were white.
In combined there were 499 deaths from prostate cancer – 166 per year on average. Mortality in line with England average.
96% had a recorded ethnicity – of these 97% were white.
The population (based on 2009) is 94% white, 1% black and 3% asian (Indian, Pakistani, Bangladeshi).
One-year relative survival is 93% (this is below the England average) and five-year relative survival is 65% (this is below the England average).
Prostate cancer and ethnicity – ‘Hear me now’ workshops

7. Prostate cancer in Nottinghamshire County (excluding Bassetlaw)
Prostate cancer accounts for 26% of new cases of cancer in men in Nottinghamshire.
1 in 4 of the cancers in Nottinghamshire with no known ethnicity are prostate cancers.
Prostate cancer accounts for 14% of cancer deaths and 5% of all deaths in men in Nottinghamshire.
In black men this is 67% of cancer deaths and 27% of all deaths – higher than the average (but numbers are small even though statistically significant).
In deaths for those aged under 75 (premature mortality) the percentages are 8% and 4% respectively.
Numbers are too small to infer any differences by ethnicity.
Prostate cancer and ethnicity – ‘Hear me now’ workshops

8. Prostate cancer in England
In 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 combined there were deaths from prostate cancer – per year on average.
98% had a recorded ethnicity – of these 99% were white.
The population (based on 2009) 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

9. 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

10. 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.
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

11. Prostate cancer incidence in England – by age
Prostate cancer and ethnicity – ‘Hear me now’ workshops

12. Prostate cancer incidence in England – age adjusted
Prostate cancer and ethnicity – ‘Hear me now’ workshops

13. Prostate cancer mortality in England – by age
Prostate cancer and ethnicity – ‘Hear me now’ workshops

14. Prostate cancer mortality in England – age adjusted
Prostate cancer and ethnicity – ‘Hear me now’ workshops

15. 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

16. Prostate cancer survival in England – all stages
Prostate cancer and ethnicity – ‘Hear me now’ workshops

17. Prostate cancer survival in England – localised
Prostate cancer and ethnicity – ‘Hear me now’ workshops

18. Prostate cancer survival in England – locally advanced
Prostate cancer and ethnicity – ‘Hear me now’ workshops

19. Prostate cancer survival in England – advanced
Prostate cancer and ethnicity – ‘Hear me now’ workshops

20. 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