What do we know?
Cancer is the second most common cause of death in Shropshire, accounting for around 27% of deaths annually. It's estimated that more than a third of all cancers could be prevented by reducing lifestyle risk factors such as smoking and poor diet.
In Shropshire there's a similar premature cancer mortality rate compared to the national figures and overall premature mortality has declined in the last two decades. However, since 2005-07 cancer trends increased slightly (not significant), although they decreased again in 2008-10. Premature mortality from cancer is higher in males than it is in females and there are significantly more premature deaths in the most deprived fifth of the county than the national average.
What are we doing?
Although much cancer is preventable, some is not. Therefore, early diagnosis, referral and effective treatment is key to preventing mortality from cancer. Cancer screening services are one way of early diagnosis of cancer. There are cancer screening programmes for breast, cervical and bowel cancer.
Currently the NHS breast screening programme is available to women aged 50-70 years, which is gradually being extended to include women aged 47-73 years by 2016. In Shropshire breast screening uptake is 81.7% (2011), which is higher than the national figure of 73.4% and also higher than the national target of 70%; however there is variation between GP practices for screening uptake rates. Similar proportions of women were screened for breast cancer in 2008 and 2011. There is a relationship between deprivation and screening, with women living in more deprived areas less likely to attend screening than those from more affluent areas. There is also a relationship between being a member of a black and minority ethnic (BME) group and lower uptake of screening across all three cancer screening programmes.
The cervical screening programme is open to women aged 25-64 years old. In Shropshire cervical screening uptake is 80.7% (April 2011) which is higher than the national figure (73.7%, 2010-11) and slightly higher than the national target (80%). Cervical screening uptake in Shropshire has decreased in the last year compared to previous years. Like breast screening there is variation in uptake between GP practices and there is also a relationship with deprivation similar to that seen in breast screening.
The NHS bowel screening programme is open to men and women aged 60-69 years. The uptake of bowel screening in Shropshire is 61.3% (2010-11) which is higher than the regional average (55.2%, 2010-11) and the national target (60%). Again there is variation between GP practices and also a relationship with deprivation similar to that seen in the other screening programmes.
What can we do?
Waiting times to treatment are important as they can increase the likelihood of positive outcomes for those with cancer. Nationally cancer waiting times are measured on the percentage of patients with an urgent cancer referral seen within 2 weeks and percentage of patients who started treatment within 31 days and 62 days. In Shropshire cancer waiting times at year end were all meeting the national standards.
A further key challenge and opportunity for public health in Shropshire during the next 5-10 years will be to effectively address the health and wellbeing needs of growing numbers of cancer survivors (people living with and beyond cancer). Nationally it's estimated that there are currently 2 million cancer survivors predicted to rise to 4 million by 2030. Given Shropshire’s ageing population there is a need to maximise the health and wellbeing of cancer survivors and reduce the health and social costs by focussing increasingly on health promotion, the prevention of late effects and effective symptom management. Public Health is contributing to new initiatives to meet the health improvement needs of survivors with the “Get Active, Feel Good”: Exercise and Cancer Survivorship Project.
The major preventable risk factor for cancer is smoking, which causes the majority of cases of lung cancer, and also causes cancer at many other sites including lips, tongue, mouth, gullet, stomach, liver, pancreas, bowel, kidney and bladder. Obesity and poor diet also increases cancer risks significantly, particularly cancers of the breast, bowel and womb. Excess alcohol consumption is another important risk factor, associated with cancers of the mouth, gullet, breast and bowel. Rates of skin cancer are strongly related to sun exposure without adequate skin protection, and are on the increase.Last updated: 02 March 2016 Print this page