Cancer (health and wellbeing needs in South Tyneside)

Cancer is a condition where cells in a specific part of the body grow and reproduce uncontrollably. The cancerous cells can invade and destroy surrounding healthy tissue, including organs (NHS Choices). Cancer is not just one disease, but a wide-range of diseases across a wide range of components of the body. Suspected cancer has a number of pathways available to support the diagnosis. The most important cancers with regard to the number of people affected and the number of early deaths relate to cancer of the breast, colon, lung and prostate.

Achieving World-Class Cancer Outcomes a Strategy For England 2015-2020, is the national strategy for England and has highlighted areas of population risk.

• Every two minutes someone in England will be told they have cancer.
• Half of people born since 1960 will be diagnosed with cancer in their lifetime, with that proportion continuing to rise.
• The good news is that cancer survival is at its highest ever, with significant improvements made over the last 15 years.
• More than half of people receiving a cancer diagnosis will now live ten years or more.
• 280,000 individuals are now diagnosed with cancer in a year, a number which has been growing by around 2% per annum.
• Around half of these diagnoses will be of the most common cancers - breast, lung, prostate, and colorectal.
• Incidence is expected to reach over 300,000 diagnoses in 2020, and more than 360,000 in 2030. The rise is due partly to the ageing and growth of the population, a result of the overall success of the healthcare system, such that people are less likely to die early from other conditions, such as cardiovascular disease.
• Cancer is the biggest cause of death from illness or disease in every age group, from the very youngest children through to old age, with mortality significantly higher in men than in women. Death rates in England have fallen by more than a fifth over the last 30 years and by 10 per cent over the last decade5. They are expected to continue to fall, with a drop of around 17% by 2030. But 130,000 people still die from cancer each year - a number that has remained relatively constant as incidence has increased.
• There also remain groups of patients for whom outcomes and quality of life are particularly poor. Survival has improved significantly in some types of cancer, notably malignant melanoma, breast, testicular and prostate cancers. However, in lung, pancreas and oesophageal cancers and most brain tumours, survival has remained stubbornly low to date.
• We see significant variation in survival outcomes for patients across England. This variability cannot be explained solely by correlation with deprivation levels. It can be quantified across a number of indicators. For example, there is around a two-fold difference in the proportion of cancers diagnosed at an early stage.
• Health inequalities across England mean there is potentially avoidable variation in survival outcomes. There would be around 15,300 fewer cases and 19,200 fewer deaths per year across all cancers combined if socio-economically deprived groups had the same incidence rates as the least deprived .
• More than half of the inequity in overall life expectancy between social classes is linked to higher smoking rates among poorer people. The combination of improvements in survival and detection, and a growing and ageing population has resulted in an estimated 2 million people living in England who have had a cancer diagnosis.

• Historically, there has been less focus on the care received by patients after their initial treatment.
• We know that patients who have been diagnosed with cancer have a greater risk of being diagnosed with cancer again in the future.
• Many of the treatments we use can have long-term physical and mental health consequences, which result in a high proportion of individuals requiring subsequent health and social care support, and there are also practical impacts for patients such as loss of income.

• Key risk groups for cancer depend upon the cancer type e.g. some types of breast cancer have a strong familial link whereas lung cancer is strongly associated with smoking.
• There are other key drivers of these risk factors including:
  • Socio-economic deprivation.
  • Gender - cancer prevalence in females is higher than males in the NE.
  • Age increases the prevalence of cancer.