March Dr Kadhim Alabady, Principal Epidemiologist Dr Shamsher Diu, Public Health Consultant

Transcription

1 March 2014 Dr Kadhim Alabady, Principal Epidemiologist Dr Shamsher Diu, Public Health Consultant

2 Background Screening Evaluate the current cervical screening programme. Population Provide information on uptake over 5 years (2007/8 2011/12). Coverage by GP. Cervical cancer trends Rates of incidence and mortality.

3 Current situation Facts The report provides baseline key findings. 1 in 5 eligible women have not been a screened. Significant variations between GP practices (is it deprivation, age groups, GP special interest, etc.). Issues It is not possible to distinguish the cervical cancers detected as a result of women presenting symptomatically from those identified through the screening programme. Since 2012/13 we were unable to access data by GP practice level.

4 Population General There are 248,586 women aged in Norfolk and Waveney, 49.6% of the total (females) population. The number of women aged by CCG were: GY&W: 57,092 North Norfolk: 41,596 Norwich: 53,629 South Norfolk: 54,952 West Norfolk: 41,317 BME The balance in ethnic groups in the area of Norfolk & Waveney in the age range is predominantly white British with the main ethnic groups populated as follows: British: 213,075 (96.7) white Mixed/multiple ethnic group: 1,968 (0.8%) Asian/Asian British: 4,393 (1.8%) Black/African/Caribbean/Black British: 1,302 (0.5%)

5 Incidence of cervical cancer (ICD10 C53) During North Norfolk had the highest directly age standardised rate per 100,000 women of cervical cancer. The rate was 14 for women aged < 75 years (17 cases), and 13.6 for women of all ages (18 cases). During the same period of time Norwich had the highest number of new cases of cervical cancer (25 cases among women aged < 75 years and 28 among women of all ages). This could be possibly related to deprivation and to early detection.

6 Incidence of cervical cancer (ICD10 C53) Over the years , the directly age standardised rate per 100,000 of cervical incidence for women of all ages in Norfolk on seven occasions (1993, 1995, 2004, 2007, 2008, 2009, and 2010) were higher than East of England and England average. Between 2001 and 2010, there were 419 new cases of cervical cancer in Norfolk, giving an average of 42 new cases per year.

7 Mortality from cervical cancer (ICD10 C53) Women < 75 years and All ages Directly age-standardised mortality rates of cervical cancer (DSR) per 100,000 European Standard populations by district, (pooled) Area Number Women <75 of age Rate per 100, /12 Women all ages 95% confidence 95% confidence interval Rate per Number interval 100,000 LL UL LL UL Breckland < Broadland Great Yarmouth <5 <5 Kings Lynn & West Norfolk < North Norfolk Norwich South Norfolk <5 <5 Waveney Norfolk East of England England 1, , Mortality trends over time from cervical cancer for women <75 years and for women of all ages vary across Norfolk due to small number of deaths from cervical cancer each year, there is considerably year-on-year variability associated with the estimates so it would be expected that a change would occur simply due to random variation.

8 Mortality from cervical cancer (ICD10 C53) Data since 1993 the rates of deaths from cervical cancer have fallen in Norfolk and better than England. However, data during indicate the trends for cervical cancer deaths may be changing.

9 Screening population coverage Overall, Norfolk (NHS Norfolk area and Great Yarmouth and Waveney CCG) has achieved the coverage target 2 times out of for the 6 reporting years 2007/ /13 for the target group of women aged but failed to achieve the target for the lower age group (The overall coverage for East of England and England was not achieved in each year for the 25-49).

10 Great Yarmouth and Waveney CCG The age group never achieved the target but it is increasing, while the age group is declining and never achieved the target since 2008/9.

11 North Norfolk CCG The age group achieved the target over the 5 financial years, while the age group is declining and never achieved the target in the last three financial years.

12 Norwich CCG The age group achieved the target over the 5 financial years, while the age group either achieved the target or near by in the 3 financial years.

13 South CCG The age group achieved the target very well over the 5 financial years, while the age group is declining steadily and only once not achieved the target in 2011/12.

14 West CCG The age group never achieved the target but near by less than 1%over the 5 financial years, while the age group is declining steadily and only once not achieved the target in 2007/8.

15 Future Projected increase in population. Investigate mechanisms to increase coverage. Increase uptake in GP practices who failed to achieve the targets. Increase uptake in deprived areas and specific age groups. Future cervical and other screening programmes data (bowel, breast).