Health & Wellbeing Priority:
Improve cancer early detection and prevention
Why is cancer prevention and early detection a priority in Trafford?
Cancer is the most common cause of premature death in Trafford and two thirds of these deaths are preventable. An estimated 42% of new cancer cases each year are preventable by tackling lifestyle risk factors.
How many people are affected by cancer in Trafford?
Incidence (new cancer registrations)
- Between 2013 and 2015 there were 3,861 new cases of cancer registered across Trafford CCG (1,905 females and 1,956 males). The overall age standardised cancer incidence rate (628 per 100,000) was statistically similar to the average for England (615 per 100,000)
- Among females, the most common tumour sites were breast (584 cases - 31% of total), lung (250 cases - 13% of total) and bowel (183 cases - 9% of total). The age standardised rates for these three tumour sites among women were statistically similar to the average for England.
- Among males, the most common tumour sites were prostate (462 cases – 24% of total), lung (302 cases - 15% of total) and bowel (231 cases - 12% of total). The age standardised rate for prostate and bowel cancer among men were statistically similar to the average for England; however, the lung cancer incidence rate was statistically significantly higher.
- Time trends: Overall, there has been a rise in cancer incidence rates both locally and nationally. The age standardised incidence rate for all cancers in Trafford for 2013-15 was 4.6% higher compared to a 2001-03 baseline; although this was proportionally less than the rise across England as a whole (9%). According to tumour site, the greatest increases were seen for breast and lung cancers, whereas bowel and prostate cancer saw a decrease on this measure.
As at mid-2016/17, there were 6,993 patients on a Trafford CCG GP cancer register (defined as patients with a diagnosis of cancer excluding nonmelanotic skin cancers and diagnosed on or after 1 April 2003). This represents 2.9% of all registered patients, compared to 2.6% across England as a whole. The number on Trafford registers increased between 2015/16 and 2016/17 by 755. According to GP practices within Trafford CCG, prevalence ranges more than two-fold from 1.56% to 4.24%, and is linked to the age structure of practices (practices with an older age profile tend towards higher prevalence) but also to deprivation levels.
- Between 2013 and 2015 there were 1,663 deaths from cancer (770 females and 893 males). The age standardised cancer mortality rate (275 per 100,000) was statistically similar to the average for England (279 per 100,000)
- For deaths of females, the most common tumour sites were lung (170 deaths – 22% of total), breast (115 deaths - 15% of total) and bowel (71 deaths - 9% of total). The age standardised death rates for these three tumour sites among women were statistically similar to the average for England.
- Among men, the most common tumour sites were lung (212 deaths – 24% of total), prostate (108 deaths – 12% of total) and bowel (95 deaths – 11% of total). Again, the age standardised death rates for these three tumour sites among men were statistically similar to the average for England.
- Time trends: Overall, there has been a continued decline in cancer death rates both locally and nationally. Looking at the most common cancer sites, with the exception of bowel cancer among women, death rates are lower in 2013-15 compared to 2001-03 baseline.
Premature and preventable mortality
Between 2014 and 2016 there were 737 deaths from cancer of people aged under 75 in Trafford. The age standardised under 75 death rate from cancer continues to decline, and the Trafford rate remains statistically similar to the England average. Of these 737 deaths, almost two- thirds (459 or 62%) are considered preventable. Deaths are considered preventable if, in the light of the understanding of the determinants of health at the time of death, all or most deaths from the underlying cause (subject to age limits if appropriate) could potentially be avoided by public health interventions in the broadest sense.
About 1 in 5 (22.1%) of patients in NHS Trafford CCG are diagnosed with cancer through an emergency route (similar to England average of 20.1%). The proportion of staged cancer that are diagnosed early (at stage 1 or 2) in Trafford CCG (56.2%) is also similar to England (54.3%).
Which groups within Trafford are most at risk from cancer?
Men are more likely than women to die early from preventable cancers: the directly age standardised under 75 death rate from cancers considered preventable among males in Trafford (92.4 per 100,000) is 28% higher than the rate for females (72.2 per 100,000)
Geographical area and deprivation
Public Health England publishes data for electoral wards within Trafford on incidence of all cancers and broken down by the main cancer sites (breast, bowel, lung and prostate). There is wide variation between wards which, for all cancers combined and for bowel and lung cancer, is linked to deprivation, with increased incidence in more deprived areas.
Mortality data is published for all cancers combined for all ages and for under 75. Again, there is wide variation between wards which, especially for premature mortality, is linked to deprivation, with higher mortality in more deprived areas.
What services are in place to contribute to detecting cancer earlier and preventing cancers?
Cancer screening saves lives. It can detect cancers at an early stage and in some cases even prevent cancers from developing in the first place.
Across all of the main cancer screening programmes in Trafford (breast, bowel and cervical) coverage in the most deprived 20% of GP practices is significantly lower than coverage in the least deprived 20% of practices. Work to narrow this gap can be expected to impact on the geographical and social inequalities in cancer incidence and mortality.
There are also a variety of groups and organisations which are in place for support when it comes to cancer. They include: