Bowel Cancer Profile for Oldham, Business Intelligence Service

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1 Bowel Cancer Profile for Oldham, 2015 Business Intelligence Service December 2015

2 Overview of Report This report provides an assessment of a range of measures (prevalence, incidence, mortality, years of life lost and survival) of bowel cancer in England, the North West region and Oldham. Data used for analysis were obtained from the Health & Social Care Information Centre (HSCIC) Indicator Portal, Local Health, Cancer Research UK and the National Cancer Intelligence Network (NCIN) Cancer Commissioning Toolkit. Summary At the end of 2010 there were 714 people (393 males and 321 females) living with and beyond bowel cancer in Oldham. The incidence rate of bowel cancer has increased in the North West and England by 7% between the years 1995 and 2013, whilst the increase for Oldham has been lower, at just 1%. The incidence rate of bowel cancer is higher in males than females. This trend is mirrored nationally. Oldham has the lowest incidence rate of all GM MCDs, at a rate of per 100,000. For males under 75, Oldham has a higher incidence rate of bowel cancer than GM MCD, North West and England. The rate for females is similar to regional and national figures. There is considerable variation between the wards, with the ward with the highest incidence rate of bowel cancer (Hollinwood) having an incidence rate more than twice as high as the ward with the lowest incidence rate (St James'). There is also observed variation between different cancers, with Saddleworth North has the highest incidence for breast cancer, Medlock Vale for lung cancer and Saddleworth and Lees for prostate cancer. The mortality rates from bowel cancer for both North West and England have experienced a steady decline over the period. The Oldham rate has been much less stable, although the rate in Oldham did have a greater decline than that of the North West and England overall between 1995 and The mortality rate from bowel cancer in under75s was higher for males in Oldham than for GM MCDs, North West and England whereas the rate for females is lower than when compared to other GM MCDs and at a regional and national level. Males in Oldham have the second highest mortality rate from bowel cancer amongst GM MCD, females have the third lowest amongst GM MCD. Oldham has higher years of life lost rate due to bowel cancer than GM MCD, the North West and England for both males and females. It is the second highest amongst GM MCD.

3 Background Globally, an estimated 1.36 million new cases of bowel cancer were diagnosed in Around 477,000 of these are estimated to be of people in Europe and 41,900 in the UK. Bowel cancer is the fourth most common cancer in the UK and accounts for 12% of all new cases of cancer 1. In 2012, 694,000 people are estimated to have died as a result of bowel cancer worldwide. Around 215,000 of these were estimated to be in Europe and 16,200 people died of bowel cancer in the UK. The UK mortality rate from bowel cancer is 10 th lowest in Europe for males and 14 th lowest for females. Bowel cancer is the second most common cause of cancer death, second only to lung cancer. Mortality rates have been declining since the 1970s, over the last decade mortality rates have dropped by around 14% 2. Bowel cancer survival rates are improving and have more than doubled within the past 40 years in the UK. Bowel cancer survival is highest for those diagnosed aged and survival rates are higher in men than in women. The high survival rates amongst this particular age group are most probably attributable to the NHS Bowel Screening Programme, which began in England in 2006 and Scotland, Wales and Northern Ireland soon after. It is predicted that this screening programme will save over 2,000 lives each year by Around three quarters of people diagnosed with bowel cancer will survive one year or more, 59% will survive five years or more and 57% will survive ten years or more ( ). The earlier bowel cancer is diagnosed the higher the chance of survival, with 90% surviving five years or more when diagnosis occurs at the earliest stage and just 10% surviving five years or more when diagnosis occurs at the latest stage of bowel cancer 3. Links have been drawn between bowel cancer and lifestyle factors, with links being made in 54% of cases. Lifestyle factors linked to bowel cancer include; eating red and processed meat (21%), being overweight or obese (13%), lack of fibre consumption (12%) alcohol consumption (12%), smoking (8%), inadequate levels of physical activity (2%) and ionising radiation (2%)

4 Prevalence of bowel cancer in Oldham Cancer prevalence is the number of people that have been diagnosed with cancer at some point in their lives and are alive at the time the data is captured. Developing a good understanding of the picture of bowel cancer prevalence within Oldham will give us a better understanding of the complete burden of cancer in Oldham and the impact this has on available services. At the end of 2010 there were 188,317 people living with and beyond bowel cancer in England. There were 714 people (393 males & 321 females) living with and beyond bowel cancer in Oldham. When interpreting prevalence data, it should be noted that prevalence counts will be higher relating to cancers with higher survival rates than for those with lower survival rates as people are living for longer following their diagnosis. Figure 1 shows the prevalence of bowel cancer in Oldham as at the end of Figure 1: Prevalence of bowel cancer in Oldham, NCIN, 2010 Incidence of bowel cancer in Oldham Figure 2 shows the trend of the incidence of bowel cancer between the years 1995 and The incidence rate of bowel cancer has increased in the North West and England by 7% for both areas, whilst the increase for Oldham has only been 1% from the start to the end of the period. The rate in Oldham has experienced much variation, being as low as per 100,000 in 2004/6. Although the Oldham rate spent a good few years below the North West and England rates, it now sits comparable to them in the latest figures, almost exactly matching the England rate.

5 Figure 2: Incidence of bowel cancer trend, HSCIC, 1995/7-2011/13 Incidence of bowel cancer in Oldham by gender Figure 3 shows the incidence of bowel cancer by gender within Oldham. The graph clearly shows that the incidence of bowel cancer is higher in males than females in both Oldham and nationally in England. In Oldham in 2007 and in 2008 the rate for males was more than double that of the rate for females. This drastic difference was not mirrored in the national figures during the same period. Figure 3: Incidence of bowel cancer in Oldham by gender, HSCIC,

6 Figure 4 shows the incidence rate of bowel cancer in males in Oldham, the North West and England. The rates for England and the North West have seen a steady, slight increase (6% and 5% respectively). The rate for Oldham has been much less stable over the period. In the latest available figures Oldham sits between the North West and England rates. Figure 5 shows the incidence rate for females only. Similarly to the male trend, the North West and England have both experienced increases over the period (7% and 5% respectively). The Oldham rate was clearly below the North West and England rates, the lowest point being 2005/7 when the rate was just per 100,000, 12% below the England rate at the time. Since 2005/7 however the Oldham rate has been on the increase and in the latest figures only sits slightly below the England and North West rates. Figure 4: Incidence of bowel cancer in males in Oldham, HSCIC, 1995/7-2011/13 Figure 5: Incidence of bowel cancer in females in Oldham, HSCIC, 1995/7-2011/13

7 Incidence of bowel cancer across GM MCD Figure 6 shows how Oldham compares to other GM MCDs in terms of incidence of bowel cancer. Looking at the latest figures (2013), Oldham has the lowest incidence rate of all the GM MCDs at a rate of per 100,000. Salford has the highest rate at per 10,0000. Only Oldham and Rochdale have rates below the England rate. For males only, Oldham also ranks lowest of all the areas with Wigan highest. For females, Oldham is 4th lowest but still remains below the North West and England rates. Rochdale, Wigan and Bolton are all lower than Oldham for the female group. Figure 6: Incidence of bowel cancer across GM MCD, HSCIC, 2013

8 Incidence of bowel cancer in under 75s in Oldham More than 4 in 10 (43%) cases of bowel cancer are diagnosed in people aged 75 and over in the UK 5. Figure 7 shows the incidence rate of bowel cancer in under 75s across Oldham, GM MCD, the North West and England. For males, Oldham has a higher incidence rate in under 75s than GM MCD, the North West and England. The rate for females is much more in line with the regional and national average, being extremely similar to GM MCD and the North West and only slightly higher than England. As the all age incidence rate in males as discussed in the previous section is so low when compared to GM MCDs and is much higher within this group this suggests that a higher rate of males under 75 are being diagnosed with bowel cancer than is average for other areas. It could also suggest that men in this age group are being diagnosed early. Correlation analysis between incidence and survival rate from bowel cancer in males under 75 years will guide in determining whether the higher rate of incidence in that age group is associated with early diagnosis. Figure 7: Incidence of bowel cancer in under 75s, HSCIC, Figure 8 compares the incidence rate of bowel cancer in under 75s in Oldham against the GM MCDs over a 3 year average: Oldham ranks centrally, at 5th highest for all persons. Tameside has the highest rate and Rochdale the lowest. For males only, Oldham also ranks 5th, with Tameside highest and Rochdale lowest for this group also. For females, Oldham fares slightly better and ranks 6th highest. For the female group, Salford has the highest incidence rate and Rochdale has the lowest. 5

9 Figure 8: Incidence of bowel cancer in under 75s across GM MCD, HSCIC, Incidence of bowel cancer by ward in Oldham Figure 9 shows the variation in incidence rates of bowel cancer between wards in Oldham. There is considerable variation between the wards, with the ward with the highest incidence rate (Hollinwood) having an incidence rate more than twice as high as the ward with the lowest incidence rate (St James'). It should be noted however that the confidence intervals for this data are quite large and as such these differences are not statistically significant, probably due to the small amount of data available for analysis.

10 Figure 9: Incidence of bowel cancer by ward in Oldham, Local Health, Mortality from bowel cancer in Oldham Figure 10 shows the mortality rate as a result of bowel cancer on a 3 year rolling average between the years 1995/7 and 2011/13. The rates for both North West and England experienced a steady decline over the period with the Oldham rate being much less stable, although the rate in Oldham did have a greater decline than that of the North West and England. The most recent figures show the Oldham rate to be slightly higher than both the North West and England rates. Figure 10: Mortality from bowel cancer trend, HSCIC, 1995/7-2011/13

11 Mortality from bowel cancer by gender in Oldham The rate for females only over the period has decreased across Oldham, the North West and England. Oldham has seen a decline although less consistent than the North West and England. Although Oldham began the period with a rate above the other areas, in the most recent figures it is largely comparable to the regional and national figures. The male trend follows a similar pattern with a steady decrease over the period for both the North West and England and a less stable and a greater decline for Oldham than regional and national figures show. Figure 11: Mortality from bowel cancer in males trend, HSCIC, 1995/7-2011/13 Figure 12: Mortality from bowel cancer in females trend, HSCIC, 1995/7-2011/13 Throughout the period, the mortality rate for males was higher than the mortality rate for females in England. Oldham mirrored this pattern with the exception of two years

12 (2005 and 2006) where the mortality rate was higher for females than for males. Other than these years, the rate for males is considerably higher than for females, with the rate for males being as much as almost four times as high as for females in the year with the largest difference within Oldham. Figure 13: Mortality from bowel cancer by gender in Oldham, HSCIC, Mortality from bowel cancer in under 75s in Oldham The mortality rate from bowel cancer in under75s was higher for males in Oldham than for GM MCDs, North West and England whereas the rate for females is lower than when compared to other GM MCDs and at a regional and national level. It should be noted that the confidence intervals surrounding the Oldham figures are quite large and as a result these differences do not represent significant differences. The difference between the under 75 mortality rate from bowel cancer in males and females in Oldham does represent a significant difference however, with the mortality rate for males higher than the mortality rate for females. This mirrors the gender difference identified when analysing the mortality rate for all ages.

13 Figure 14: Mortality from bowel cancer in under 75s, HSCIC, Looking at the most recently available figures (figure 15) for the under 75 mortality rate from bowel cancer ( ) males in Oldham have the second highest mortality rate when compared against other Greater Manchester authorities, with only Salford having a higher rate. Females in Oldham have the 3rd lowest mortality rate for this age group, with only Bury and Rochdale having lower mortality rates. For all persons, Oldham ranks in a central position with the 5th highest mortality rate.

14 Figure 15: Mortality from bowel cancer in under 75s across GM MCD Years of life lost from bowel cancer in Oldham Figure 16 shows the years of life lost rate as a result of bowel cancer for residents in Oldham, GM MCD, the North West and England over a 3 year average between 2011 and Oldham has a higher years of life lost rate due to bowel cancer than GM MCD, the North West and England for both males and females. Although these differences are quite considerable, these differences are not statistically significant.

15 Figure 16: Years of life lost due to bowel cancer, HSCIC, When compared against the other Greater Manchester authorities, Oldham has the second highest rate of years of life lost due to bowel cancer of all the GM MCDs. Males in Oldham have the highest rate of years of life lost due to bowel cancer amongst GM MCD and females rank in a central position at 5th highest (Figure 17). Figure 17: Years of life lost due to bowel cancer across GM MCD, HSCIC,

16 Conclusion Data analysis showed higher rates of bowel cancer incidence and mortality in males under 75 years in Oldham compared to Greater Manchester MCD, North West and England average. This points to the need for bowel cancer screening awareness programmes targeted at this age group in order to ensure early diagnosis and adequate management of bowel cancer.