Wednesday, June 18, 2008

New cancer statistics

Cancer statistics for the UK were released today. Here in Dorset we have the highest incidence of cancer overall, but the lowest death rate for cancer.

These rather paradoxical results can be explained by several additional observations. This is a retirement area and cancer is commoner in old people. OK, but surely we should have a high incidence of deaths from cancer as well? Perhaps it's because Dorset has the best cancer doctors. modesty forbids me from answering that one, but there is another explanation.

That we have the lowest incidence comes from the types of cancer we have. Lung cancer used to be the commonest type of cancer, but in men it has been overtaken by prostate cancer and in women by breast cancer. But whereas lung cancer is fatal in 95% of cases, both breast and prostate cancer are less likely to kill you. In Dorset we have the lowest incidence of lung cancer in the country and the highest incidence of prostate cancer. Lung cancer mainly occurs in smokers; in Dorset we have the lowest incident of smoking in the country. Prostate cancer is mainly diagnosed from blood test in asymptomatic individuals and many cases never present clinically, the individuals living untreated to a ripe old age. It is the affluent who ask for the PSA test. Dorset is an area populated by the affluent middle classes who don't smoke.

Breast cancer occurs in women who delay their families, who don't have children at all, who take the contraceptive pill and who take HRT. It also is commoner in the overweight. This describes Dorset woman. There is also an element of better detection. Many cancers detected by mammogram would never have presented clinically. Wealthy women are more likely to attend for their mammogram.

Dorset also has the highest incidence of blood cancers that can be picked up in asymptomatic individuals, CLL and MDS.

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