Transcript No Slide Title

The Cancer Council NSW
HSC PDHPE
Cancer
Carla Saunders
Medical and Scientific Policy Manager
The Cancer Council NSW
[email protected]
Cancer Facts
* Cancer is not one disease
* Some risk factors modifiable
* Others cannot be avoided through
personal action
…..unknown risk factors
* Synergic risks
* Individual susceptibility
Extent of the Problem
http://www.aihw.gov.au/publications/index.cfm/title/10476
Extent of the Problem
http://www.cancercouncil.com.au/
Extent of the Problem
http://www.health.nsw.gov.au/research/index.html
Extent of the Problem (2006)
Incidence: 106,000 new cases
Mortality: 39,200 deaths
* Australian males have a 1 in 3 chance of a
cancer diagnosis before age 75 years, and a
1 in 2 chance before age 85.
* Australian females have a 1 in 4 chance of
a cancer diagnosis before age 75 years, and
a 1 in 3 chance before age 85.
Extent of the Problem (2006)
* The most common cancers diagnosed in
males are prostate cancer, colorectal
(bowel) cancer, melanoma, lung cancer
and lymphoma.
* The most common cancers diagnosed in
females are breast cancer, colorectal
(bowel) cancer, melanoma, lung cancer
and lymphoma.
Trends - Incidence (AIHW)
• The total number of cancers diagnosed
in 2003 was 26% higher in 2003 than in
1993 (24% for males and 29% for
females)
• Compared with a 12% increase in the
Australian population during this
period.
• However, the age-standardised
incidence rate for ‘all cancers’ was
0.7% lower in 2003 than in 1993.
Trends - Incidence (AIHW)
• Among the NHPA cancers the largest
decrease in rate from 1993 to 2003 was
for cervical cancer (41%), followed by
prostate cancer (12%), lung cancer
(11%) and colorectal cancer (1.5%)
• The largest increase in rate for NHPA
cancers from 1993 to 2003 was for
melanoma (up 14%), followed by nonHodgkin lymphoma (7.2%) and breast
cancer in females (6.1%).
Trends - Mortality (AIHW)
• The total number of deaths from
cancer in 2003 was 15% higher than
in 1993 (14% for males and 17% for
females)
• Compared with a 9.1% increase in
deaths from all causes over this time.
• However, the age-standardised
death rate for ‘all cancers’ was
12% lower in 2003 than in 1993.
Trends - Mortality (AIHW)
• Among the NHPA cancers the largest
decrease in death rate from 1993 to
2003 was for cervical cancer (41%),
followed by colorectal cancer (25%),
prostate cancer (22%), breast cancer in
females (20%), non-Hodgkin lymphoma
(15%) and lung cancer (14%).
• Among the NHPA cancers the only
increase in death rate from 1993 to 2003
was for melanoma (up 4.4%: 3.3% in
males, 9.1% in females).
Cancer Incidence – why
the fluctuations?
• Age
• Detection rates
• Risk factor reduction
• Advances in technology and
understanding of cancer
development and causes
Cost of Cancer
The average lifetime financial
cost of cancer on a household
in NSW is around 1.7 years of
annual household income.
Cost of Cancer
The NSW Government spends
approximately $800 million each year
on the prevention, management and
treatment of cancer.
In addition, the Australian Government
in NSW spends about $200 million on
cancer through general practitioners
and other services.
Social justice and Cancer Control
1. Equity
Equitable allocation, or more precisely benefits from, cancer control
interventions and resources.
• Conveniently located resources may not
bring equal benefit
• Positive discrimination often necessary to
increase the opportunity to benefit
Annotated Bibliography on Equity in Health
http://www.equityhealthj.com/content/1/1/1
Social justice and Cancer Control
2. Access
• Cancer prevention, early detection and
care services are available to everyone
entitled.
• Access is free of any form of
discrimination irrespective of a persons
location, socioeconomic status,
ethnicity, race, age, religion etc
• There is equal use of services across
different population groups
Social justice and Cancer Control
3. Participation
Information and understanding
of cancer prevention, early
detection and care services
(and the capacity to act on
such knowledge) is available
to everyone who is entitled.
Social justice and Cancer Control
4. Rights
• Opportunities for appropriate cancer
care are available
• Information and understanding of
health care rights and provisions for
disadvantaged groups (and the
capacity of individuals to act on such
knowledge) is available to everyone
who is entitled.
Poverty is the single most
important determinant of
poor health.
However, poor health is
far from the single most
important determinant of
poverty.
Applying the principles of the
Ottawa Charter (in Cancer Control)
1. Build healthy public policy
2. Create supportive environments
3. Strengthen community action
4. Develop personal skills
5. Reorient health services
+ Principles of the Jakarta Declaration
Health Improvement - Ottawa Charter
Investment
partnerships
infrastructure
Contemporary health promotion rightly accords greater attention
to research evidence, the social determinants of health, multiple
strategies/players and building the capacity of others
Building Healthy Public Policy
Aim: To protect health across the population
irrespective of SES, rurality, race ……….etc
• Regulation e.g laws preventing minors under
18 yrs purchasing alcohol and tobacco, OH&S
• Fiscal Measures e.g. Medicare reimbursement
• Taxation e.g. Tobacco, alcohol, ?junk food
• Policy e.g Vaccination / Screening programs
• Evidence Based Practice e.g. Clinical care
guidelines, continuing professional
development, cost effective interventions
Create Supportive Environments
Aim: Generate living, playing and working
conditions that support health and safety
Infrastructure e.g Women's health centres,
walking paths, shade structures, libraries etc
Technology e.g Accessible and reliable Internet
and broadband access, specialist diagnostic etc
Services e.g Free phone quit (smoking) service,
Cancer Helpline, Free cancer telegroup
counselling, interpreter and sign lang. services
Training and Resources e.g Cancer education
and information, OH&S information & training
Community Capacity
“the ability of people and
communities to do the work
needed in order to address the
determinants of health for those
people in that place”
Bopp, GermAnn, Bopp, Baugh Littlejohns, & Smith (2000)
Strengthen Community Action
Aim: Empowering communities to increase
control over and improve health
Community Development (Information,
training and learning opportunities,
resources) e.g. volunteer recruitment and
training, consumer advocacy training,
information on community health statistics
and harmful environmental substances,
cancer support group resources, financial
reimbursement for volunteer transport
services, community consultation etc etc….
Develop Personal Skills
Aim: Empowering individuals to increase
control over and improve health
Personal Development (Information, training
and learning opportunities, resources) e.g.
strengthen individual skills through free and
readily available health information; target
functional literacy skills to enable individuals
to interpret written and oral information about
health, conduct store tours to educate people
about healthy foods, thereby enabling them
to make healthier food choices etc etc….
Reorient Health Services
Aim: Shift the focus towards prevention in
settings focused on providing clinical and
curative services.
Health Professional e.g. Educate
paediatricians and family doctors about
assessing second hand smoke exposure in
children and counselling in smoking cessation.
Organisational Change e.g. Training to
support cross-cultural competence in health
care. Allocation of adequate resources for
interpreters and multilingual information.
Activities
• Cancer, population statistics, human
behaviour and the determinants of health
are all complex. There are a number of
very difficult concepts to grasp
• Start with simple tasks and work up to the
more complex. Allow reasonable time for
fact gathering and understanding
• Need to stimulate thinking and problem
solving but also correct misconceptions
quickly
Questions? Comments?