joint strategic needs assessment foundation profile - JSNA

Interative Hull Atlas: www.hullpublichealth.org/Pages/hull_atlas.htm More information: www.jsnaonline.org and www.hullpublichealth.org
10.2.1.9 Health Equity Audit
The cancer equity audit was completed during 2005/2006. This document is available at
www.hullpublichealth.org and 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 (Index of Multiple
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.
Essentially, the main findings in relation to potential inequalities are summarised in the
next few paragraphs.
Whilst the intention was to examine health equity for many different groups of
individuals, the data is often not available. For example, there is no readily-available
accurate information on ethnicity for incidence or mortality. Therefore, it was only
possible to examine whether inequity may exist based on gender, age and deprivation.
The incidence rates vary between males and females and between different age groups
differs reflecting both the different types of cancers as well as differences in the
underlying determinants of cancer.
Up until the age of 60 men had a lower inpatient admission rate for cancer compared to
women, and within the 30-49 year age group approximately half as many men were
admitted to hospital for cancer over the five year period compared to women. In the
older age groups, there was an increasing trend with more men being admitted as
inpatients with cancer than women. The number of men aged 60-64 admitted as an
inpatient for cancer was 9% higher than females, and this gradually increased as age
increased with twice as many men aged 85+ years being admitted compared to women.
These differences could reflect the different types of cancer, the age at which these
cancers generally occur, types of treatment available as well as other factors influencing
admission such as the presence of co-morbidities.
Cancer mortality rates differ considerably between men and women and across different
age groups. However, again this could be because of a number of factors such as type
of cancer, age at diagnosis, the prevalence of risk factors and co-morbidities, survival
rates, types of treatments. It does not necessarily mean that inequity is present.
Due to the strong association between smoking and deprivation, and between smoking
and the risk of lung cancer, there is a strong association between deprivation and lung
cancer incidence. The relative risk of developing other types of cancer due to different
types of risk factors is smaller, so even if there is an association between deprivation
and the prevalence of the risk factor, the resulting association between deprivation and
incidence will be weaker. For colorectal cancer and breast cancer in women there is not
a strong association between incidence and deprivation. For skin cancer and prostate
cancer in men, there is a higher incidence in the least deprived groups. For all cancers
Joint Strategic Needs Assessment Foundation Profile – Hull Health Profile: Release 3. March 2011. 523