Lecture 7: Global and Local patterns of cancer Flashcards
what is cancer? how is it distinguished?
- cancer is a family of diseases
- morphology/types of cells (carcinoma, sarcoma, leukaemia etc)
- organ affected: (liver, stomach, breast etc)
what measures are relevant to support cancer?
- mortality
- 5 year survival
- DALYs
- incidence (NZ cancer registry)
- prevalence
what is the NZ Cancer Registry Act 1993?
an act to make better provision for the compilation of a satistical record for the incidence of cancer in its various forms, to provide a better direction of programmes for research and for cancer prevention
what are the cancer registry regulations 1994?
- timeframe for reports
content of reports, details are:
- who carried out the test
- who requested the test
- person who had the test
The test:
- type
- anatomical site
- primary or secondary
The cancer:
- pathological nature
- stage
what does the NZ cancer registry collect?
Data on all new diagnosis of primary malignant tumours (invasive and in-situ):
- not basal or squamous cell skin cancers (unless of genitalia)
- in-situ cancer not counted in reports of incidence
- reports of incidence include number of new diagnoses of cancer, not number of individuals with new diagnoses (someone with 7 cancer sites will have 7 reports)
Demographic information of person with tumour
what tumour details are collected?
- date of diagnosis
- site of primary tumour
- type of test (basis of diagnosis)
- morphology
- grade
- staging information: (SEER summary staging, TNM classfication, tumour, node, metastases)
- site-specific information
what are the sources of data for cancer?
laboratries give labortory reports (hard or electronic copy) to the NZCR
how are cancers classified?
the ICD (internationally classified diseases) is an internationally accepted classifcation system that collects information on disease, and each disease has a code.
why should we examine patterns of cancer, incidence and mortality?
- provide clues about possible causes
- set priorities for prevention/control
- set priorities for treatment services
- identify potential inequities in access to screening, diagnosis, treatment
helps identify person, place, time - public health model!
what is the importance of age-standardised data?
cancer is age-related so we need to be awate of the age structure of population. age-standardised data is more accurate.
- for example, Maori have younger populations so you would expect maori to have smaller proportions of age-related cancer
what does this show?
- Maori have higher incidence of breast, lung, kidney, pancreatic, head/neck cancer and leukemia compared to non-maori
- non-maori have higher incidence of melanoma, prostate and colorectal cancer than maori
- age and sex standardised incidence rate
what does this show?
age specific data! in 2019
leukemia commonly diagnosed in 1-4, 5-9 age groups
lymphoma commonly diagnosed in 5-9, 10-14 age group
what does this show?
2018 data of cancer diagnosed by age group
lymphomas commonly diagnosed in 20-24 age group
carcinomas commonly diagnosed in 20-24 age group
what is cancer like for maori and pacific peoples
maori are 20% more likely to develop cancer than non-maori, but are twice as likely to die from it
- are commonly diagnosed with preventable cancers but have a poor prognosis
- for example, stomach cancer and liver cancer are infection related which is indication of inequities
- however, screening programmes don’t work so well as not many maori or pacific participate.
- maori and pacific also have a high rate of co-morbidities
what this show?
age and sex standardised cancer-related mortality rates 2007-2017
lung cancer is very dangerous for maori
- significantly high mortality rate!
what this show?
age-standardised mortality and mortality rates globally in 2018, both sexes and ages
- liver and stomach cancer are more important globally
- some cancers are more lethal than others, e.g. breast has high incidence compared to mortality, while lung cancer has high incidence and high mortality
what this show?
age-standardised mortality and mortality rates globally in 2018 for males of all ages
- lung cancer is important for males
- liver, stomach and prostate cancer are most important in males
- however, most men appear to die WITH prostrate cancer, not of
what does this show?
age-standardised mortality and mortality rates globally in 2018, females all ages
- breast cancer is important for females, and is the most fatal
what this show?
age-standardised mortality and mortality rates globally in 2018, low income, both sexes, all ages
- there is less difference between incidence and mortality
- could be due to less access to early diagnosis and effective treatment
- can see that infection related cancers are important here
- these are largely preventable but very high in low income countries (low rate of vaccination and screening) e.g. cervical cancer
