Breast Cancer Epidemiology Implications for public health practice

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1 Breast Cancer Epidemiology Implications for public health practice 15 June 2012 Dr Nevila Kallfa Consultant in Public Health NHS Gloucestershire 1

2 Overview UK breast cancer epidemiology Breast cancer public health current and future challenges 2

3 Myth No. 1: All women have a one in eight chance of developing breast cancer today. FALSE. The above figure applies to a woman closer to the end of her lifetime 3

4 Average Number of New Cases Per Year and Age-Specific Incidence Rates per 100,000 Population, Females, UK Breast Cancer (C50): Prepared by Cancer Research UK 4

5 European Age-Standardised Incidence Rates per 100,000 Population, Females, by Age, Great Britain, Prepared by Cancer Research UK 5

6 Myth No 2: Breast cancer mortality rate is on the increase FALSE. Overall, female breast cancer mortality rates have decreased in the UK since the early 1970s 6

7 Breast Cancer (C50) , European Age-Standardised Mortality Rates, Prepared by Cancer Research UK 7

8 Age-specific mortality rates, breast cancer, females, UK, Rate per 100,000 women Year of death Prepared by Cancer Research UK

9 Myth No 3: A diagnosis of breast cancer is a certain death sentence. FALSE. 95.8% of women survive their disease for at least one year and 85.1% survive for five years or more. 9

10 Age-Standardised One Year Relative Survival Rates, Breast Cancer (C50): Prepared by Cancer Research UK 10

11 Age-Standardised Five Year Relative Survival Breast Cancer (C50): Prepared by Cancer Research UK 11

12 Public health challenges a. Curbing down the increase in breast cancer incidence Myth buster No1 b. Improve efforts for the early diagnosis of breast cancer Myth buster No2 c. Breast cancer research and development Myth buster No3 12

13 0-10-year relative survival for breast cancer by stage, diagnosed in the West Midlands followed up to the end of 2004, as at December 2008 Prepared by Cancer Research UK 13

14 a. primary prevention Promotional campaigns to increase awareness of breast cancer risk factors amongst women and professionals 14 BCAM results Q19. Agreement that various factors increase the chance of getting breast cancer (All respondents) by area

15 Breast cancer risk factors Reproductive factors Age at menarche Age at first birth Parity Breastfeeding * Age at menopause hormones Hormone Replacement Therapy Breast density Previous breast disease Family history Non-reproductive lifestyle factors Bodyweight* Physical activity * Alcohol consumption * Diet* Shift work In-utero exposure * Lifestyle modifiable factors 15

16 b. secondary prevention Promotional campaigns for early diagnosis Campaigns to support women to overcome barriers to early presentation Breast cancer screening Family history breast cancer services 16

17 National Awareness and Early Diagnosis Initiative (NAEDI) Early diagnosis requires a patient to first recognise a symptom and its importance, and then to present promptly to their GP. 17

18 NHSG Breast awareness campaign overview Objectives Increase symptom awareness Encourage checking ( breast awareness ) Communicate importance of early presentation Reduce barriers to presentation Increase awareness of screening programme (2 nd objective) KPIs Shifts in symptom awareness Shifts in numbers of checkers (selfreported) Intention to visit primary care with relevant signs and symptoms Speed to seek help 2 week wait Evaluation Pre & post CAM What - Marketing, primary care engagement and community outreach in targeted wards Why - evidence suggests variation in levels of confidence and breast awareness based on age, ethnicity and socioeconomic group; research also highlights importance of GP-patient relationship to early presentation. How - capacity building and interagency working (GHT, primary care, voluntary sector, district council and other third sector providers) 18

19 c. tertiary prevention Research on breast cancer chemoprophylaxis Reduce complications Restore functionality Mitigate or avoid results of unnecessary excessive intervention Genetic variation in breast cancer prevention 19

20 Summary Prevention strategies that cross organisational boundaries are likely to have the highest impact on reducing the burden of breast cancer 20

Volunteering in NHSScotland Developing and Sustaining Volunteering in NHSScotland

Volunteering in NHSScotland Developing and Sustaining Volunteering in NHSScotland NG11-07 ing in NHSScotland Developing and Sustaining ing in NHSScotland Outcomes The National Group for ing in NHS Scotland agreed the outcomes below which formed the basis of the programme to develop