Cancer in Huron County
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- Norma Cook
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1 Cancer in Huron County 2-29 Prepared by: Erica Clark, Epidemiologist April B London Road RR 5, Clinton, ON NM 1L F:
2 Cancer Health Status Report Background Cancers are characterized by the uncontrolled growth and spread of abnormal cells in some part of the body 1. They are typically named after the part of the body where the cancer originates. Cancer takes many years to develop and is caused by the complex interaction of genetic, social, lifestyle, and environmental factors. Common factors include, but are not limited, to: Age Tobacco Use Diets high in fat Sun exposure (U.V. radiation) Family history of cancer Alcohol use Reproductive factors Sexual activity Lack of physical activity Cancer is the leading cause of death in Canada and almost half of all Canadians (41 per cent of females and 46 per cent of males) will develop cancer during their lifetime 2. Overall Cancer Incidence and Mortality From 22 to 29, the crude incidence rate (number of new cases per 1, people) of cancer has been relatively stable in Huron County. Crude cancer incidence ranged from a low of cases per 1, Huron County residents in 24 to a high of cases per 1, Huron County residents in 27 (Figure 1). The number of new cancer cases diagnosed each year has ranged from 338 cases to 384 cases in this time period (average: 361 cases per year). The crude mortality rate (number of cancer deaths per 1, people) of cancer has also been relatively stable. From 22 to 29, the number of cancer deaths ranged from 154 deaths in 21 and 27 to 182 deaths in 26 (average: 166 deaths per year). 1
3 Rate per 1, Figure 1: The number of cancer diagnoses and deaths per 1, Huron County residents, for 2 to Incidence Mortality # Cases # Deaths Year of Diagnosis or Death NOTE: Number and rate of new cancer cases not available for 2 and 21 because a different classification system was in use Cancer Care Ontario - SEER*Stat - OCRIS (May12) Oct. 212 release. Population Data Source: Pop Est Summary (Statistics Canada, Ontario Ministry Finance), Ontario Ministry of Health and Long-Term Care: The top ten diagnosed cancers between 22 and 29 in Huron County males and females are show in Table 1. Among Huron County males, prostate cancer was the most frequently diagnosed cancer, accounting for almost one third (31 per cent) of all male cancer cases. Breast cancer was the most frequently diagnosed cancer among females, accounting for almost one quarter (24 per cent) of all female cancer cases in Huron County. Breast and prostate cancers are also the most commonly diagnosed cancers among Ontario males and females 3. 2
4 Table 1: Top ten diagnosed cancers in Huron County, by sex, for Males Females Type of Cancer # Cases Type of Cancer # Cases All Cancers 1,541 All Cancers 1,345 Prostate Cancer 473 Breast Cancer 326 Lung and Bronchial Cancer 193 Lung and Bronchial Cancer 168 Colorectal Cancer 153 Colorectal Cancer 126 Bladder Cancer 92 Uterine Cancer 87 Rectal Cancer 58 Urinary Cancer 75 Melanoma of the Skin 56 Thyroid Cancer 61 Leukemia 52 Melanoma of the Skin 6 Non-Hodgkin Lymphoma 5 Non-Hodgkin Lymphoma 56 Kidney and Renal Cancer 43 Ovarian Cancer 53 Oral Cancer 43 Kidney and Renal Cancer 39 Cancer Care Ontario - SEER*Stat - OCRIS (May12) Oct. 212 release. Population Data Source: Pop Est Summary (Statistics Canada, Ontario Ministry Finance), Ontario Ministry of Health and Long-Term Care: IntelliHEALTH ONTARIO, extracted March 212. Overall, the top four types of cancer diagnosed in Huron County are prostate, lung and bronchial, breast, and colorectal cancer. In the 29 Community Health Status Report, lung cancer (not lung and bronchial cancer) was the fourth most common type of cancer in Huron County. When Cancer Care Ontario released an updated Ontario Cancer Registry in 212, lung and bronchial cancers were grouped together. Grouping lung and bronchial cancers together made it the second most common type of cancer diagnosed in Huron County. The way lung cancer is classified in the registry changed but not how common it is. The top ten leading causes of cancer death between 2 and 29 in Huron County males and females are shown in Table 2. Like Ontario, lung and bronchial cancer was the leading cause of cancer death for both sexes. Among both males and females in Huron County, colorectal cancer was within the top three causes of cancer deaths, along with prostate cancer among males and breast cancer among females. 3
5 Rate per 1, Table 2: Top ten leading causes of cancer deaths in Huron County, by sex, for 2-29 Males Females Type of Cancer # Cases Type of Cancer # Cases All Cancers 89 All Cancers 768 Lung and Bronchial Cancer 241 Lung and Bronchial Cancer 168 Prostate Cancer 112 Breast Cancer 123 Colorectal Cancer 96 Colorectal Cancer 84 Pancreatic Cancer 43 Pancreatic Cancer 46 Esophageal Cancer 35 Leukemia 3 Non-Hodgkin Lymphoma 34 Ovarian Cancer 29 Leukemia 3 Non-Hodgkin Lymphoma 27 Bladder Cancer 28 Uterine Cancer 21 Rectal Cancer 27 Kidney Cancer 21 Stomach Cancer 2 Myeloma 17 Brain 2 Cancer Care Ontario - SEER*Stat - OCRIS (May12) Oct. 212 release. Population Data Source: Pop Est Summary (Statistics Canada, Ontario Ministry Finance), Ontario Ministry of Health and Long-Term Care: IntelliHEALTH ONTARIO, extracted March 212. To make comparisons to the province, cancer incidence rates were standardized for age and are shown in Figure 2 for each gender. Although there appear to be some differences between Huron County and Ontario, none are statistically significant. Age-standardized cancer incidence rates for 22 to 29 were similar for Huron County and Ontario (confidence intervals not shown). For Ontario females, age-standardized cancer incidence rates have experienced a slight increase from 22 to 29. Ontario males experienced a slight decline. The trend for Huron County males and females is less clear due to fluctuating rates. In both Huron County and Ontario, males experienced a higher agestandardized cancer incidence rate than females. Figure 2: Age-standardized incidence rates for cancer (at all sites) for males and females in Huron County and Ontario (22 to 29) Year of Diagnosis Huron Males Ont Males Huron Females Ont Females Source: Cancer Care Ontario - SEER*Stat Release 9 - OCRIS (May 212) Oct. 212 release. Population Data Source: Pop Est Summary (Statistics Canada, Ontario Ministry of Finance), Ontario Ministry of Health and Long-Term Care: IntelliHEALTH ONTARIO, extracted March
6 Rate per 1, Age-standardized cancer mortality (death) rates for Huron County and Ontario are shown in Figure 3 for both genders. Although there appear to be some differences between Huron County and Ontario, none are statistically significant. Age-standardized cancer mortality cancer mortality rates for 2 to 29 were similar for Huron County and Ontario (confidence intervals not shown). Both Ontario males and females experienced gradual declines in age-standardized cancer mortality rates. The trends are less clear for Huron County due to fluctuating rates caused by a smaller number of deaths. As with new cancer diagnosis, mortality rates were higher among males compared to females for Huron County and Ontario. Figure 3: Age-standardized mortality rates for cancer (at all sites) for males and females in Huron County and Ontario (2 to 29) Year of Death Huron Males Ont Males Huron Females Ont Females Source: Cancer Care Ontario - SEER*Stat Release 9 - OCRIS (May 212) Oct. 212 release. Population Data Source: Pop Est Summary (Statistics Canada, Ontario Ministry of Finance), Ontario Ministry of Health and Long-Term Care: IntelliHEALTH ONTARIO, extracted March 212. Selected Cancers The most frequently diagnosed cancers and leading causes of cancer death in Huron County breast, prostate, colorectal and lung and bronchial cancer will be explored here in more detail. Breast Cancer Breast cancer begins in cells of the breast. While breast cancer can affect both men and women, less than one per cent of Canadian cases are male 4. Risk factors for breast cancer include, but are not limited to Age Having a family history of breast or ovarian cancer An above average exposure to estrogen Dense breast tissue Being obese Alcohol use Taking birth control pills 5. Recent studies have also shown that both vitamin D and physical activity are associated with a reduced breast cancer risk 6. 5
7 Rate (per 1,) Like Canada, breast cancer is the most commonly diagnosed cancer among Huron County women. Crude breast cancer incidence and mortality rates are shown in Figure 4, along with the number of new cases and number of deaths annually. Figure 4: Crude breast cancer incidence and mortality rates for Huron County females, including the number of breast cancer cases and deaths for 2 to Incidence Mortality # Cases # Deaths Year NOTE: Number and rate of new cancer cases not available for 2 and 21 because a different classification system was in use Source: Cancer Care Ontario - SEER*Stat Release 9 - OCRIS (May 212) Oct. 212 release. Population Data Source: Pop Est Summary (Statistics Canada, Ontario Ministry of Finance), Ontario Ministry of Health and Long- Term Care: IntelliHEALTH ONTARIO, extracted March 212. Between 22 and 29, a range of 31 to 5 new cases were diagnosed per year (average: 41 cases per year). Forty-five per cent of all cases were aged years when diagnosed. An average of 12 deaths occurred per year from 2 to 29 (range: 9 to 19 deaths). Crude breast cancer mortality rates have remained relatively stable in Huron County, ranging from 32.2 deaths per 1, females to 62.2 deaths per 1, females. Age-standardized breast cancer incidence rates for Huron County and Ontario females are shown in Figure 5. Rates from 22 to 29 were similar for Huron County and Ontario (confidence intervals not shown). In Ontario, age-standardized breast cancer incidence rates have remained around 1 new cases diagnosed per 1, population over this time period. By contrast, Huron County rates have fluctuated between 69.3 cases per 1, population in 24 to cases per 1, population in 22. 6
8 Rate (per 1,) Rate (per 1,) Figure 5: Age-standardized incidence rates for breast cancer among Huron County and Ontario females for 2 to Year of Diagnosis Huron Rate Ontario Rate Source: Cancer Care Ontario - SEER*Stat Release 9 - OCRIS (May 212) Oct. 212 release. Population Data Source: Pop Est Summary (Statistics Canada, Ontario Ministry of Finance), Ontario Ministry of Health and Long- Term Care: IntelliHEALTH ONTARIO, extracted March 212. Because Huron County has a relatively small number of deaths due to breast cancer each year, age-specific mortality rates were calculated for 2 to 29 combined and compared to Ontario (Figure 6). Huron County age-specific mortality rates were not significantly different from Ontario for this time period. In both regions, mortality rates were highest among females aged 75 years and older. Figure 6: Age-specific breast cancer mortality rates for females in Huron County and Ontario, 2-29 combined. Error bars represent 95% confidence intervals for the rates Huron Rate Ontario Rate Age Group (Years) Source: Cancer Care Ontario - SEER*Stat Release 9 - OCRIS (May 212) Oct. 212 release. Population Data Source: Pop Est Summary (Statistics Canada, Ontario Ministry of Finance), Ontario Ministry of Health and Long-Term Care: IntelliHEALTH ONTARIO, extracted March
9 Rate (per 1,) Prostate Cancer Beginning in the cells of the prostate gland, prostate cancer is the most common cancer in Canadian men 7. Because prostate cancer takes many years to develop, being over the age of 65 years increases the risk of developing prostate cancer. High fat diets and a family history of prostate cancer can also increase the risk of developing prostate cancer 8. Prostate cancer is the most commonly diagnosed cancer among Huron County men and is the third leading cause of cancer death. The crude prostate cancer incidence and mortality rates, along with the number of cases diagnosed and number of deaths annually, is shown in Figure 7 for Huron County. Between 2 and 29, the crude prostate cancer incidence rate decreased 31 per cent from 21.2 new cases diagnosed per 1, males in 2 to cases per 1, males in 29. Annually, an average of 59 new cases of prostate cancer were diagnosed in Huron County (range: 39 to 73 cases). Most cases were diagnosed between ages 45 and 74 (37% between and years). The crude mortality rate for prostate cancer has remained relatively constant for this time period, hovering around 4 deaths per 1, males. On average, 11 deaths occurred each year in Huron County males due to prostate cancer. Figure 7: Crude prostate cancer incidence and mortality rates for Huron County males, including the number of prostate cancer cases and deaths for 2 to Incidence Mortality # Cases # Deaths Year NOTE: Number and rate of new cancer cases not available for 2 and 21 because a different classification system was in use Source: Cancer Care Ontario - SEER*Stat Release 9 - OCRIS (May 212) Oct. 212 release. Population Data Source: Pop Est Summary (Statistics Canada, Ontario Ministry of Finance), Ontario Ministry of Health and Long-Term Care: IntelliHEALTH ONTARIO, extracted March 212. Prostate cancer incidence rates, adjusted for age, are shown in Figure 8 for Huron County and Ontario. For all years except 28, the Huron County age-standardized prostate cancer incidence rates were similar to the province. In 28, the Huron County age-standardized prostate cancer incidence was significantly lower than Ontario. 8
10 Rate (per 1,) Rate (per 1,) Figure 8: Age-standardized incidence rates for prostate cancer among Huron County and Ontario males for 2 to Year of Diagnosis Huron Rate Ontario Rate Source: Cancer Care Ontario - SEER*Stat Release 9 - OCRIS (May 212) Oct. 212 release. Population Data Source: Pop Est Summary (Statistics Canada, Ontario Ministry of Finance), Ontario Ministry of Health and Long-Term Care: IntelliHEALTH ONTARIO, extracted March 212. Age-specific prostate cancer mortality rates for 2-29 combined are shown below in Figure 9. Huron County had a significantly higher prostate cancer mortality rate than Ontario for year old males; however, there were no significant differences in other age categories. In both regions, mortality rates were highest among males aged 75 years and older. This age group accounted for almost three-quarters of all prostate cancer deaths in Huron County (77 deaths or 71%). Figure 9: Age-specific prostate cancer mortality rates for males in Huron County and Ontario, 2-29 combined. Error bars represent 95% confidence intervals for the rates Huron Rate rate suppressed Ontario Rate rate suppressed Age Group (Years) Source: Cancer Care Ontario - SEER*Stat Release 9 - OCRIS (May 212) Oct. 212 release. Population Data Source: Pop Est Summary (Statistics Canada, Ontario Ministry of Finance), Ontario Ministry of Health and Long-Term Care: IntelliHEALTH ONTARIO, extracted March
11 Rate (per 1,) Colorectal Cancer Most colorectal cancers begin in the cells of the colon or rectum, which make up the large intestine 9. There are factors which may increase the risk of developing colorectal cancer including Age Presence of polyps in the colon or rectum Personal and/or family history of colorectal cancer Inflammatory bowel disease A diet high in fat High intake of red meat and meats that have been cooked at high temperatures Alcohol and tobacco use Physical inactivity 1. Crude colorectal cancer incidence and mortality rates are shown in Figure 1 (males) and Figure 11 (females) between 2 and 29. Unlike mortality rates, which were relatively similar for Huron County males and females, crude colorectal cancer incidence rates were higher among males when compared to females. In 25 and 29, the difference was statistically significant. Figure 1: Crude colorectal cancer incidence and mortality rates for Huron County males, including the number of colorectal cancer cases and deaths for 2 to Incidence Mortality # Cases # Deaths Year NOTE: Number and rate of new cancer cases not available for 2 and 21 because a different classification system was in use Source: Cancer Care Ontario - SEER*Stat Release 9 - OCRIS (May 212) Oct. 212 release. Population Data Source: Pop Est Summary (Statistics Canada, Ontario Ministry of Finance), Ontario Ministry of Health and Long- Term Care: IntelliHEALTH ONTARIO, extracted March 212. Figure 11: Crude colorectal cancer incidence and mortality rates for Huron County females, including the number of colorectal cancer cases and deaths for 2 to 29 1
12 Rate (per 1,) Rate (per 1,) Incidence Mortality 29. suppressed # Cases # Deaths 9 suppressed Year NOTE: Number and rate of new cancer cases not available for 2 and 21 because a different classification system was in use Source: Cancer Care Ontario - SEER*Stat Release 9 - OCRIS (May 212) Oct. 212 release. Population Data Source: Pop Est Summary (Statistics Canada, Ontario Ministry of Finance), Ontario Ministry of Health and Long-Term Care: IntelliHEALTH ONTARIO, extracted March 212. Age-standardized colorectal cancer incidence rates are shown in Figure 12 for Huron County and Ontario. For all years, the age-standardized colorectal cancer incidence rate for Huron County was similar to the province. Figure 12: Age-standardized incidence rates for colorectal cancer in Huron County and Ontario for 22 to Year of Diagnosis Huron Rate Ontario Rate Source: Cancer Care Ontario - SEER*Stat Release 9 - OCRIS (May 212) Oct. 212 release. Population Data Source: Pop Est Summary (Statistics Canada, Ontario Ministry of Finance), Ontario Ministry of Health and Long-Term Care: IntelliHEALTH ONTARIO, extracted March 212. Age-specific colorectal cancer mortality rates for 2-29 combined are shown for males and females in Figure 13. There was no significant difference in age-specific colorectal 11
13 Rate (per 1,) cancer mortality rates for Huron County and Ontario during this time period. In both regions, mortality rates were higher among males aged 45 years and older when compared to females, although this difference was not statistically significant for Huron County in the age range. In Huron County, over half of all deaths in this time period were among males and females aged 75 years and older (54% and 64%). Figure 13: Age-specific colorectal cancer mortality rates for males and females in Huron County and Ontario, 2-29 combined. Error bars represent 95% confidence intervals for the rates Male Female Huron suppressed suppresed Ontario Source: Cancer Care Ontario - SEER*Stat Release 9 - OCRIS (May 212) Oct. 212 release. Population Data Source: Pop Est Summary (Statistics Canada, Ontario Ministry of Finance), Ontario Ministry of Health and Long-Term Care: IntelliHEALTH ONTARIO, extracted March 212. Lung and Bronchial Cancer Lung and bronchial cancer begins in cells of the lung. There are two main types of lung and bronchial cancer: non-small cell lung cancer, which is the most common and can originate anywhere in the lungs and small cell lung cancer, which usually begins in the cells of the bronchi, bronchioles or alveoli 11. The major risk factor for lung and bronchial cancer is smoking. Other risk factors include: exposure to second-hand smoke; working with materials such as asbestos, arsenic, nickel and petroleum products; and exposure to radon gas 12. Lung and bronchial cancer is the third most commonly diagnosed cancer and the leading cause of cancer death in Huron County. The crude incidence and mortality rates for lung and bronchial cancer are shown in Figure 14 (males) and Figure 15 (females). Unlike other cancers presented here, crude incidence rates were similar to crude mortality rates for both sexes (i.e. the number of new cases diagnosed each year roughly matched the number of deaths each year). Among Huron County males, there was an average of 24 new cases and 22 deaths each year between 2 and 29. By contrast, there was an average of 21 Huron County women diagnosed with lung and bronchial cancer and 17 deaths each year. 12
14 Rate (per 1,) Rate (per 1,) Figure 14: Crude lung and bronchial cancer incidence and mortality rates for Huron County males, including the number of colorectal cancer cases and deaths for 2 to Incidence Mortality # Cases # Deaths Year NOTE: Number and rate of new cancer cases not available for 2 and 21 because a different classification system was in use Source: Cancer Care Ontario - SEER*Stat Release 9 - OCRIS (May 212) Oct. 212 release. Population Data Source: Pop Est Summary (Statistics Canada, Ontario Ministry of Finance), Ontario Ministry of Health and Long- Term Care: IntelliHEALTH ONTARIO, extracted March 212. Figure 15: Crude lung and bronchial cancer incidence and mortality rates for Huron County females, including the number of colorectal cancer cases and deaths for 2 to Incidence Mortality # Cases # Deaths Year NOTE: Number and rate of new cancer cases not available for 2 and 21 because a different classification system was in use Source: Cancer Care Ontario - SEER*Stat Release 9 - OCRIS (May 212) Oct. 212 release. Population Data Source: Pop Est Summary (Statistics Canada, Ontario Ministry of Finance), Ontario Ministry of Health and Long-Term Care: IntelliHEALTH ONTARIO, extracted March
15 Rate (per 1,) Both crude lung and bronchial cancer incidence and mortality rates were higher in Huron County males when compared to females between 2 and 29. This difference was only statistically significant for 23. Lung and bronchial cancer incidence rates, adjusted for age, are shown in Figure 16 for Huron County and Ontario. Age-standardized lung and bronchial cancer incidence rates have declined 6% in Ontario and 13% in Huron County from 22 to 29. For all years examined, age-standardized lung and bronchial cancer incidence rates for Huron County were similar to the province. Figure 16: Age-standardized incidence rates for lung and bronchial cancer in Huron County and Ontario for 22 to Year of Diagnosis Huron Rate Ontario Rate Source: Cancer Care Ontario - SEER*Stat Release 9 - OCRIS (May 212) Oct. 212 release. Population Data Source: Pop Est Summary (Statistics Canada, Ontario Ministry of Finance), Ontario Ministry of Health and Long-Term Care: IntelliHEALTH ONTARIO, extracted March 212. Age-specific lung and bronchial cancer mortality rates for males and females for 2 to 29 combined and are shown in Figure 17 for Huron County and Ontario. Rates were significantly higher for males compared to females for those aged years and 75+ years in Huron County and Ontario. Huron County and Ontario mortality rates were similar for all age groups. 14
16 Rate (per 1,) Figure 17: Age-specific lung and bronchial cancer mortality rates for males and females in Huron County and Ontario, 2-29 combined. Error bars represent 95% confidence intervals for the rates Male Female Huron suppresse suppresse Ontario Source: Cancer Care Ontario - SEER*Stat Release 9 - OCRIS (May 212) Oct. 212 release. Population Data Source: Pop Est Summary (Statistics Canada, Ontario Ministry of Finance), Ontario Ministry of Health and Long-Term Care: IntelliHEALTH ONTARIO, extracted March 212. Comparing Cancer Data in the 29 Community Health Status Report Cancer statistics for 2 to 22 are reported here and in the 29 Community Health Status Report, however, the numbers will not be the same. The 29 Community Health Status Report uses data released by Cancer Care Ontario in July, 27. This report uses data released by Cancer Care Ontario in October 212. The information released by Cancer Care Ontario comes from the Ontario Cancer Registry. The information in the Ontario Cancer Registry is updated when new information is received. Between releases of information there can be changes in any of the pieces of information in the Ontario Cancer Registry including cancer diagnosis, date of birth for a person, and population for a region. Conclusion Cancer is a common chronic condition experienced by Huron County residents; about 3 new cases are diagnosed every year. Rates of new cancer cases and cancer deaths in Huron County are similar to the rest of Ontario. The most common types of cancer diagnosed in Huron County and Ontario are breast, prostate, lung and bronchial, and colorectal cancer. 1 Canadian Cancer Society. Cancer Information: What is cancer? Accessed 31 March 214 from 2 Canadian Cancer Society. Cancer Information: Cancer statistics at a glance. Accessed 31 March 214 from 3 Cancer Care Ontario. Cancer Surveillance: Incidence & mortality, Ontario. Accessed 31 March 214 from 4 Canadian Cancer Society. Cancer Information: Breast cancer in men. Accessed 31 March 214 from 15
17 5 Canadian Cancer Socity. Cancer Information: Risk factors for breast cancer. Accessed 31 March 214 from 6 Canadian Cancer Socity. Cancer Information: Research and development in breast cancer. Accessed 31 March 214 from 7 Canadian Cancer Society. Cancer Information: What is prostate cancer? Accessed 31 March 214 from 8 Canadian Cancer Society. Cancer Information: Risk factors for prostate cancer. Accessed 31 March 214 from 9 Canadian Cancer Society. Cancer Information: What is colorectal cancer? Accessed 31 March 214 from 1 Canadian Cancer Society. Cancer Information: Risk factors for colorectal cancer. Accessed 31 March 214 from 11 Canadian Cancer Society. Cancer Information: What is lung cancer? Accessed 31 March 214 from 12 Canadian Cancer Society. Cancer Information: Risk factors for lung cancer. Accessed 31 March 214 from 16
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