UK has 6th highest rate of obesity – OECD

Health at a Glance 2017: OECD Indicators | Organisation for Economic Cooperation and Development | OnMedica

A report from the Organisation for Economic Cooperation and Development (OECD) has found that the UK has the sixth highest rate of adult obesity. The report looks at health indicators across its 100 member countries.

weight-2036971_1920

It shows that almost 27% of the adult population of the UK is obese, compared with the OECD average of 19.4%. The UK has a smoking prevalence of 16.1%, which is below the OECD average of 18.4%.

However average alcohol consumption per UK adult is higher than the OECD average, with consumption averaging at 9.5 litres per adult.

The report highlights cancer by way of an example of both the good progress made and continuing challenges. Cancer survival has improved over time, due in part to high screening rates. Breast and rectal cancer survival rates are now slightly higher than the OECD average, with, respectively, 85.6% and 62.5% of people diagnosed living for at least a further five years, versus 85% and 61% in the OECD as a whole. Both rose at a faster pace than average over the course of ten years. But bowel cancer survival is still below the OECD average (60% compared to 62.8%), and overall cancer mortality rates remain relatively high (222 deaths per 100 000 people, compared with an OECD average of 204).

Full document: Health at a glance 2017 – OECD indicators.

Advertisements

Bowel cancer deaths drop by a third in 20 years

The rate of people dying from bowel cancer in the UK has plummeted by more than 30 per cent in the last 20 years | Cancer Research UK 

170814-bowel-cancer-mortality-rates

Image source: CRUK 

Bowel cancer was responsible for 38 deaths per 100,000 people in 1995, falling to 26 deaths per 100,000 people by 2015. The drop in rates, taking into account changing population figures, equates to a decrease in bowel cancer deaths from 17,600 in 1995 to 15,800 in 2015.

Experts believe better treatment lies behind the dramatic drop in deaths. Improved public awareness among both patients and doctors, the bowel screening programme, may also be playing a part.

Read the full blog post here

‘Burden of cancer’ increasing as UK trails behind Europe in cancer care

A new report published today shows that the UK is trailing behind the rest of Europe in the treatment of cancer | ABPI

ABPI

Image source: ABPI

British patients have worse survival rates after five years – the international benchmark for measuring the quality of cancer care – compared to the European average in nine out of ten cancers – only exceeding the EU average in melanoma.

​​​​​​​​​​​​Despite the increasing burden of cancer on society, the UK spends over 20 per cent less per person on cancer than the top five EU economies; 20 per cent less of its total health budget on cancer than the rest of the EU; and 10 per cent less of its GDP on healthcare than the rest of the EU.

On cancer survival:

  • UK cancer survival rates lag behind the European average in 9 out of 10 cancers
  • If the UK achieved the cancer survival rates of Germany, over 35,000 more people would be alive five years after diagnosis.
  • The UK has the worst survival outcomes across Europe for ovarian cancer. The UK’s Ovarian cancer survival rate is 34.0% of patients surviving for five years or more. European average is 40.8%​
  • The UK has the second worst survival rates for lung cancer – 8 per cent of patients surviving more than five years (ahead only of Bulgaria – 7 per cent). European average is 12.62 per cent.​
  • The UK has the second worst survival rates for pancreatic cancer – 3 per cent of patients surviving more than five years (ahead only of Iceland – 2.56 per cent) European average is 5.84 per cent.​
  • If the UK had the mortality rates of France, more than 100,000 women’s deaths could be prevented over the next ten years.

View the full report here

Characteristics and Outcome of Cancer Patients Admitted to the ICU

This study aims to describe trends in outcomes of cancer patients with an unplanned admission to the ICU between 1997 and 2013 and to identify risk factors for mortality of those admitted between 2009 and 2013 | Critical Care Medicine

393px-us_navy_030117-n-5996c-003_one_of_four_intensive_care_units_28icu29_aboard_comfort

Design: Retrospective analysis.

Measurements and Main Results: In solid tumor patients admitted between 2009 and 2013, hospital mortality was 26.4%. Independent risk factors for hospital mortality were metastatic disease (odds ratio, 1.99), cardiopulmonary resuscitation before ICU admission (odds ratio, 1.63), Intensive Care National Audit & Research Centre Physiology score (odds ratio, 1.14), admission for gastrointestinal (odds ratio, 1.12), respiratory (odds ratio, 1.48) or neurological (odds ratio, 1.65) reasons, and previous ICU admission (odds ratio, 1.18). In patients with a hematological malignancy admitted between 2009 and 2013, hospital mortality was 53.6%. Independent risk factors for hospital mortality were age (odds ratio, 1.02), cardiopulmonary resuscitation before ICU admission (odds ratio, 1.90), Intensive Care National Audit & Research Centre Physiology Score (odds ratio, 1.12), admission for hematological (odds ratio, 1.48) or respiratory (odds ratio, 1.56) reasons, bone marrow transplant (odds ratio, 1.53), previous ICU admission (odds ratio, 1.43), and mechanical ventilation within 24 hours of admission (odds ratio, 1.33). Trend analysis showed a significant decrease in ICU and hospital mortality and length of stay between 1997 and 2013 despite little change in severity of illness during this time.

Conclusions: Between 1997 and 2013, the outcome of cancer patients with an unplanned admission to ICU improved significantly. Among those admitted between 2009 and 2013, independent risk factors for hospital mortality were age, severity of illness, previous cardiopulmonary resuscitation, previous ICU admission, metastatic disease, and admission for respiratory reasons.

Full reference: Ostermann, M. et al. (2107) Characteristics and Outcome of Cancer Patients Admitted to the ICU in England, Wales, and Northern Ireland and National Trends Between 1997 and 2013. Critical Care Medicine. Published online: 4th July 2017

Cancer survival in England

Cancer survival in England for specific cancer sites by age, sex and stage at diagnosis. | Office for National Statistics

Key findings:

  • Among the 25 cancers forming the National Statistics, 1-year survival was highest for melanoma of the skin in both men (97.1%) and women (98.5%) and 5-year survival was highest for testicular cancer in men (95.9%) and melanoma of the skin in women (93.9%).
  • Pancreatic cancer had the lowest 1-year survival for men (22.9%) and women (24.7%) and 5-year survival was the lowest for mesothelioma for men (5.5%) and women (3.4%).
  • Adults diagnosed with late cancer (stage 4) in 2015, which had already spread to other parts of the body, have lower 1-year survival compared with those diagnosed in the earliest stage (stage 1), with the lowest survival in lung cancer in men (17.1%) and women (21.6%).
  • Adults diagnosed with melanoma of the skin, prostate and breast cancer (women only) in the earliest stage (stage 1) now have 1-year survival that is comparable to the general population of the same age who have not been diagnosed with cancer.
  • For all childhood cancers combined, the general trend of increasing 5-year survival has continued for children (0 to 14 years), from 67.2% for those diagnosed in 1990 to 85.1% predicted for those children diagnosed in 2016; a similar increasing trend has been observed for 10-year survival.

The full document, Cancer survival in England: adult, stage at diagnosis and childhood – patients followed up to 2016 can be downloaded here

Related: Public Health England blog:  Statistics are important, but some statistics are more important than others!

Cancer mortality in patients with schizophrenia

Previous studies have reported conflicting results on the association between schizophrenia and cancer mortality | The British Journal of Psychiatry

Aims: To summarise available evidence and quantify the association between schizophrenia and cancer mortality using meta-analysis.

Method: We systematically searched literature in the PubMed and Embase databases. Risk estimates and 95% confidence intervals reported in individual studies were pooled using the DerSimonian–Laird random-effects model.

Results: We included 19 studies in the meta-analysis. Among them, 15 studies reported standardised mortality ratios (SMRs) comparing patients with schizophrenia with the general population, and the pooled SMR was 1.40 (95% CI 1.29–1.52, P<0.001). The other four studies reported hazard ratios (HRs) comparing individuals with schizophrenia with those without schizophrenia; the pooled HR was 1.51 (95% CI 1.13–2.03, P = 0.006).

Conclusions: Patients with schizophrenia are at a significantly increased risk of cancer mortality compared with the general population or individuals without schizophrenia.

Full reference: Zhuo, C. et al. (2017) Cancer mortality in patients with schizophrenia: systematic review and meta-analysis. The British Journal of Psychiatry. Published online: 8 June 2017.

Pre-diagnosis diet and survival after a diagnosis of ovarian cancer

The relationship between diet and survival after ovarian cancer diagnosis is unclear as a result of a limited number of studies and inconsistent findings.

vegetables-790022_960_720

Methods: We examined the association between pre-diagnostic diet and overall survival in a population-based cohort (n=811) of Australian women diagnosed with invasive epithelial ovarian cancer between 2002 and 2005. Diet was measured by validated food frequency questionnaire. Deaths were ascertained up to 31 August 2014 via medical record review and Australian National Death Index linkage. We conducted Cox proportional hazards regression analysis, controlling for diagnosis age, tumour stage, grade and subtype, residual disease, smoking status, body mass index, physical activity, marital status, and energy intake.

Results: We observed improved survival with highest compared with lowest quartile of fibre intake (hazard ratio (HR)=0.69, 95% CI: 0.53–0.90, P-trend=0.002). There was a suggestion of better survival for women with highest compared with lowest intake category of green leafy vegetables (HR=0.79, 95% CI: 0.62–0.99), fish (HR=0.74, 95% CI: 0.57–0.95), poly- to mono-unsaturated fat ratio (HR=0.76, 95% CI: 0.59–0.98), and worse survival with higher glycaemic index (HR=1.28, 95% CI: 1.01–1.65, P-trend=0.03).

Conclusions: The associations we observed between healthy components of diet pre-diagnosis and ovarian cancer survival raise the possibility that dietary choices after diagnosis may improve survival.

Full reference: Playdon, M.C. et al. (2017) Pre-diagnosis diet and survival after a diagnosis of ovarian cancer. British Journal of Cancer. 116. pp. 1627–1637