1. Prostate cancer and ethnicity Luke Hounsome Public Health England

2. 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. All information in this presentation has been supplied through Public Health England. 2Prostate cancer and ethnicity

3. About the results The stage of prostate cancer has been broken into three parts: Localised (TNM stage I/II) – the cancer is within the prostate gland Locally advanced (TNM stage III) – the cancer has spread to lymph nodes near the prostate Advanced (TNM stage IV) – the cancer has spread to other parts of the body (metastasised) Survival figures are relative survival taking into account background mortality rates by age, deprivation and region. This allows the percentages to be fairly compared. Age-standardised incidence/mortality rates take into account different age structures in different populations, to allow fair comparisons to be made. The 1976 European Standard Population is used. 3Prostate cancer and ethnicity

4. Prostate cancer in England In 2008-10 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 2008-10 combined there were 24.363 deaths from prostate cancer – per year on average. 98% had a recorded ethnicity – of these 99% were White. The population (based on 2009 estimates) is 87% White, 3% Black and 6% Asian (Indian, Pakistani, Bangladeshi). One-year relative survival (based on 2006-10 diagnoses) is 95% and five- year relative survival (based on 2002-06 diagnoses) is 84%. 4Prostate cancer and ethnicity

5. 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 5Prostate cancer and ethnicity

6. Prostate cancer in England - stage Stage data is only available for 26% of newly diagnosed prostate cancers in 2008-10. The following are expressed as percentage of cases where the stage is known. 6Prostate cancer and ethnicity BlackAsianWhiteOtherMixedNot known All men Localised53% (243) 47% (92) 52% (10,075) 40% (36) 46% (21) 61% (3,800) 54% (14,267) Locally advanced 17% (79) 24% (46) 15% (2,961) 20% (18) 11% (5) 17% (1,066) 16% (4,175) Advanced30% (140) 29% (56) 32% (6,182) 39% (445) 43% (20) 22% (1,384) 30% (7,817)

7. Prostate cancer incidence in England – by age 7Prostate cancer and ethnicity

8. Prostate cancer incidence in England – age adjusted 8Prostate cancer and ethnicity

9. Prostate cancer mortality in England – by age 9Prostate cancer and ethnicity

10. Prostate cancer mortality in England – age adjusted 10Prostate cancer and ethnicity

11. Prostate cancer in England 11Prostate cancer and ethnicity 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.

12. Prostate cancer survival in England – all stages 12Prostate cancer and ethnicity

13. Prostate cancer survival in England – localised 13Prostate cancer and ethnicity

14. Prostate cancer survival in England – locally advanced 14Prostate cancer and ethnicity

15. Prostate cancer survival in England – advanced 15Prostate cancer and ethnicity

16. Prostate cancer in England 16Prostate cancer and ethnicity 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%