Hull Public Health 

The Deep, Hull The Guildhall, Hull King William Statue, Market Place, Hull City Hall, Hull Spurn Lightship, The Marina, Hull

 

 

Cancer


Documents

The main documents providing information on cancer are as follows:

JSNA
Hull JSNA Toolkit: All Cancers
Hull JSNA Toolkit: Lung Cancer
Hull JSNA Toolkit: Breast Cancer
Hull JSNA Toolkit: Prostate Cancer
Hull JSNA Toolkit: Colorectal Cancer
Hull JSNA Toolkit: Screening
Cancer Equity Audit completed July 2006

Other documents which include information on cancer, mainly mortality or screening uptake, are as follows:

JSNA Hull Atlas
Public Health Outcomes Framework Main Report (to open this report on a particular PHOF indicator, click here)
Public Health Outcomes Framework Summary
Longer Lives Briefing Report
Director of Public Health Annual Reports

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ACORN

An analysis has been conducted examining lung cancer mortality among the different ACORN and Health ACORN classifications. Details are summarised within Hull JSNA Toolkit: Lung Cancer. Various classifications models of different characteristics of residents have been produced. These classifications use various data to create groups of people who are deemed to be similar with regard to certain characteristics. These 'types' are generally targeted or treated differently, based on their characteristics (lifestyle, attitudes or behaviour etc), in terms of marketing of commercial products (which could include health-related care or public health). One such classification in common usage is the ACORN classification (A Classification of Residential Neighbourhoods), and there is also an ACORN classification specifically for health. See Geo-demographic Segmentation for further details.

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Assets Approach

One of the key issues in Hull regarding cancer is that people tend to present late to their GP, having possibly had symptoms for a while that have been ignored. This has an impact on cancer survival rates. An asset approach to this problem has been to recruit 'cancer champions'. These are ordinary people in the community who may have jobs that put them in social contact with people (e.g. hairdressers) who can be trained to encourage people who may mention symptoms, to talk openly to their GP and to help them to overcome fears and myths associated with cancer.

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Breast Cancer

Hull JSNA Toolkit: Breast Cancer includes information on risk factors, incidence, hospital admissions, mortality and survival. Hospital admission and mortality information is also presented by deprivation. Information is also included on expenditure.

Uptake rates for breast cancer screening and factors influencing uptake is given within the Hull JSNA Toolkit: Breast Cancer and Hull JSNA Toolkit: Screening.

Breast cancer screening uptake is an indicator within Public Health Outcomes Framework and further analysis is given within the Public Health Outcomes Framework Main Report (to open this report on a particular PHOF indicator, click here) and Public Health Outcomes Framework Summary.

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Cervical Cancer

The number of deaths are relatively small per year, so there is not a topic-specific Hull JSNA Toolkit report on cervical cancer, but information is included on the incidence in the general section relating to the incidence of cancer and the number of deaths is given within the cause of death section within Hull JSNA Toolkit: All Cancers.

Uptake rates for cervical cancer screening and factors influencing uptake is given within Hull JSNA Toolkit: Screening.

Cervical cancer screening uptake is an indicator within Public Health Outcomes Framework and further analysis is given within the Public Health Outcomes Framework Main Report (to open this report on a particular PHOF indicator, click here) and Public Health Outcomes Framework Summary.

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Colorectal Cancer

There is a specific section on colorectal cancer within Hull JSNA Toolkit: Colorectal Cancer, which includes information on risk factors, incidence, hospital admissions, mortality and survival. Hospital admission and mortality information is also presented by deprivation.

Uptake rates for colorectal cancer screening is given within Hull JSNA Toolkit: Colorectal Cancer and Hull JSNA Toolkit: Screening.

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Expenditure and Programme Budgeting

Expenditure and Programme Budgeting is given in the disease-specific Hull JSNA Toolkit reports for the main diseases which includes cancer.

Programme Budgeting is a well-established technique for assessing investment in health programmes rather than services. It can provide an overall view of how Hull PCT expenditure (from Department of Health Programme Budgeting information) and health outcomes compare with other PCT's in England, and to identify programmes that may require further investigation. Quadrant charts are given in the disease-specific Hull JSNA Toolkit reports which plot expenditure and outcomes (in standardised units) for different disease areas.

There are also specific programme budgeting and marginal analysis reports for cancer which examines expenditure in relation to outcomes for Hull and compares these with other comparator areas:

PBMA Cancer 2009/10
PBMA Cancer 2008/09
PBMA Cancer 2007/08

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Health Equity Audit

The Cancer Equity Audit was completed July 2006. This document includes information on risk factors, incidence, inpatient admissions and mortality for all cancers and for each of the main cancer sites. This information is examined in relation to age, gender and deprivation to assess potential inequalities that might exist among these groups. The document also examined breast and cervical screening rates, and potential programmes that could reduce health inequalities.

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Incidence

Incidence rates for all sites, oesophagus, stomach, colorectal, lung, malignant melanoma, prostate, bladder, breast and cervical cancer sites are given in Hull JSNA Toolkit: All Cancers, as well as for the relevant diseases in Hull JSNA Toolkit: Lung Cancer, Hull JSNA Toolkit: Breast Cancer, Hull JSNA Toolkit: Prostate Cancer and Hull JSNA Toolkit: Colorectal Cancer.

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Inpatient Admissions

The number of inpatient admissions and admission rate for all cancers combined, lung cancer, breast cancer, prostate cancer and colorectal cancer are given in the Hull JSNA Toolkit: All Cancers, Hull JSNA Toolkit: Lung Cancer, Hull JSNA Toolkit: Breast Cancer, Hull JSNA Toolkit: Prostate Cancer and Hull JSNA Toolkit: Colorectal Cancer, as well as the elective and non-elective admission rates by ward and by general practice. Admission rates are also examined in relation to deprivation.

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Longer Lives

Higher tier local authorities were also ranked on premature mortality rates from lung cancer, as well as all cancers combined, as part of Public Health England's Longer Lives project. Details are given in the Longer Lives Briefing Report.

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Lung Cancer

Hull JSNA Toolkit: Lung Cancer includes information on risk factors, incidence, hospital admissions, mortality and survival. Hospital admission and mortality information is also presented by deprivation. Information is also included on expenditure.

Lung cancer mortality rates have also been presented in the Director of Public Health Annual Reports.

Lung cancer premature mortality rates for 2006-08 were also examined for the four of the five national deprivation quintiles (not examined for least deprived quintile as so numbers in least deprived quintile too small for Hull) for Hull in relation to other comparable areas. This data is not readily available and analysis was completed with the assistance of the Yorkshire and Humber Public Health Observatory, who hold a copy of the national mortality file and have commissioned the Office for National Statistics (ONS) to produce the LLSOA population estimates. The summary of this analysis is given in Hull JSNA Toolkit: All Cancers.

Lung cancer mortality rates have also been examined in relation to the ACORN and Health ACORN geo-segmentation groups, with the results summarised within Hull JSNA Toolkit: Lung Cancer.

Social marketing work has been undertaken in relation to smoking and chronic obstructive pulmonary disease, but the findings are relevant to lung cancer. An important finding with regard to smoking was that there was a perceived health danger relating to quitting smoking "quit and you'll die". Details are given withinHull JSNA Toolkit: Smoking.

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Mortality

Mortality rates and mortality rates by deprivation are given in the JSNA Toolkit. The number and percentage of deaths from each of the main cancer sites are also examined for males and females separately, and compared with England within Hull JSNA Toolkit: All Cancers.

The mortality rates are also displayed within the JSNA Hull Atlas.

Cancer mortality rates for all cancers and lung cancer have also been presented in the Director of Public Health Annual Reports.

Premature mortality rates for 2006-08 were also examined for the four of the five national deprivation quintiles (not examined for least deprived quintile as so numbers in least deprived quintile too small for Hull) for Hull in relation to other comparable areas. This data is not readily available and analysis was completed with the assistance of the Yorkshire and Humber Public Health Observatory, who hold a copy of the national mortality file and have commissioned the Office for National Statistics (ONS) to produce the LLSOA population estimates. The summary of this analysis is given in Hull JSNA Toolkit: All Cancers and Hull JSNA Toolkit: Lung Cancer.

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Prevalence

As part of the Quality and Outcomes Framework (QOF), practices need to have registers of patients who have had a diagnosis of that specific disease. More information about QOF is given in the topic-specific Hull JSNA Toolkit reports and Glossary. The QOF general practice disease registers cover a range of medical conditions and diseases including cancer, and the prevalence of the disease is reported within the topic-specific Hull JSNA Toolkit reports. These are also presented by deprivation.

Some of the issues associated with comparing prevalence figures over all the Hull practices are discussed within the General Practice Comparator Groupings, topic-specific Hull JSNA Toolkit reports and Glossary, with more detailed information within the Why QOF Differs Among Practices report. Details of grouping practices into eight groups for benchmarking are given in the General Practice Comparator Groupings.

A patient should be included on the QOF cancer register when the patient has had 'a diagnosis of cancer since the 1st April 2003'. Some of these patients might be in remission but some might be currently suffering with the symptoms of cancer and be having treatment. There is no distinction between those in remission and those who currently have cancer.

The prevalence of behavioural and lifestyle risk factors is summarised within Hull JSNA Toolkit: Smoking, Hull JSNA Toolkit: Diet, Hull JSNA Toolkit: Exercise, Hull JSNA Toolkit: Acohol Consumption and Hull JSNA Toolkit: Overweight and Obesity with more detailed information in the Adult and Young People Health and Lifestyle Survey reports (see Prevalence for more information).

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Prostate Cancer

There is a specific section on prostate cancer within Hull JSNA Toolkit: Prostate Cancer, which includes information on risk factors, incidence, hospital admissions, mortality and survival. Hospital admission and mortality information is also presented by deprivation.

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Public Health Outcomes Framework

Cancer screening uptake rates and the premature (under 75 years) mortality rate from cancers and from cancers which are considered preventable are indicators within Public Health Outcomes Framework and further analysis is given within the Public Health Outcomes Framework Main Report (to open this report on a particular PHOF indicator, click here) and Public Health Outcomes Framework Summary. The mortality rates are also displayed within the JSNA Hull Atlas.

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Risk Factors

Risk factors for cancer are discussed within the Cancer Equity Audit, Hull JSNA Toolkit: All Cancers, Hull JSNA Toolkit: Lung Cancer, Hull JSNA Toolkit: Breast Cancer, Hull JSNA Toolkit: Prostate Cancer and Hull JSNA Toolkit: Colorectal Cancer.

The prevalence of behavioural and lifestyle risk factors are summarised within Hull JSNA Toolkit: Smoking, Hull JSNA Toolkit: Diet, Hull JSNA Toolkit: Exercise, Hull JSNA Toolkit: Acohol Consumption and Hull JSNA Toolkit: Overweight and Obesity with more detailed information in the Adult and Young People Health and Lifestyle Survey reports (see Prevalence for more information).

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Screening

Uptake rates for breast, cervical and colorectal cancer screening, and factors influencing uptake rates in breast and cervical cancer are given within Hull JSNA Toolkit: Screening, with breast and colorectal screening uptake rates also given in Hull JSNA Toolkit: Breast Cancer and Hull JSNA Toolkit: Colorectal Cancer respectively.

Cancer screening uptake rates are indicators within Public Health Outcomes Framework and further analysis is given within the Public Health Outcomes Framework Main Report (to open this report on a particular PHOF indicator, click here) and Public Health Outcomes Framework Summary.

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Smoking

Mortality rates from lung cancer are compared with the prevalence of smoking by local deprivation quintile within Hull JSNA Toolkit: Lung Cancer, while Hull JSNA Toolkit: Smoking provides an estimate of the numbers of deaths from lung cancer attributable to smoking.

Social marketing work has been undertaken in relation to smoking and chronic obstructive pulmonary disease, but the findings are relevant to lung cancer. An important finding with regard to smoking was that there was a perceived health danger relating to quitting smoking "quit and you'll die". Details are given within Hull JSNA Toolkit: Smoking and Hull JSNA Toolkit: Chronic Obstructive Pulmonary Disease.

See Smoking for further information.

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Survival

The one-year and five-year survival rates are presented within Hull JSNA Toolkit: All Cancers for a small number of cancers for Hull. These cancers include lung cancer, colorectal cancer, breast cancer and prostate cancer. Trends in survival rates for these four cancers are presented in Hull JSNA Toolkit: Lung Cancer, Hull JSNA Toolkit: Breast Cancer, Hull JSNA Toolkit: Prostate Cancer and Hull JSNA Toolkit: Colorectal Cancer respectively. The one-year and five-year survival rates are presented within the JSNA Toolkit for the Humber and Yorkshire Coast Cancer Network for 20+ different cancer sites as well as all cancers.

The Cancer Equity Audit revealed that whilst premature cancer mortality was strongly associated with deprivation, incidence was less strongly associated and the relationship between incidence and mortality was not consistent among the deprivation quintiles. This suggested that survival rates are lower in the most deprived national quintile, and this is discussed in more detail within the Cancer Equity Audit. A brief summary of the findings is included within Hull JSNA Toolkit: All Cancers.

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