Cancer In Waterloo Region: The facts and reducing your risk

Transcription

1 Cancer In Waterloo Region: The facts and reducing your risk

2 The picture of cancer across Canada A relative survival ratio compares the observed survival of people with cancer to the expected survival of people in the general population. Cancer affects almost everyone. The Canadian Cancer Society estimates that nearly half of all Canadians will develop cancer at some point in their lifetime. It is the leading cause of death in Canada, accounting for nearly 30 per cent of deaths. Most people who develop cancer are over 50. The number of new cancer cases in Canada has been increasing over the last 30 years. Most of the increase is a result of the aging population. Four types of cancer lung, breast, colorectal and prostate cancer account for over half of all new cancer cases and half of all cancer deaths in Canada. Prostate cancer is the most common type diagnosed in Canadian men. Breast cancer is the most common type diagnosed in Canadian women. Most cancer deaths occur in people over 50. Lung cancer is the leading cause of cancer death in Canada. Relative survival ratios for cancer in Canada have improved by over 50 per cent compared to two decades ago. This means that more people live longer after a cancer diagnosis now than ever before. 1

3 The facts about cancer in Waterloo Region From 1986 to 2009, the number of new cancer cases steadily increased over time in Waterloo Region, as the population increased. (Figure 1) Overall, cancer incidence rates in Waterloo Region were slightly lower than or on par with those in all of Ontario. The rate of cancer, which accounts for population size, increased only slightly, however, in both Waterloo Region and Ontario. Men had a higher cancer incidence than women but the incidence of cancer has increased more in women than in men over this time period. In Waterloo Region between 1986 and the early 1990 s, female breast cancer was the most common type of cancer, followed by prostate, colorectal and lung cancer. Since about 1990, prostate cancer incidence rates overtook female breast cancer rates to become the most common type of cancer in Waterloo Region. Improved detection of prostate cancer cases has played a role in the increase. An incidence rate measures the number of new cancer cases that occur per year, out of every 100,000 people in a geographic region. 2, , , , Waterloo Region Cases Waterloo Region Rate 2009 Rate per 100,000 people Number of cases Figure 1. Cancer incidence in Waterloo Region and Ontario, 1986 to 2009* 0 Ontario Rate Figure 2. Incidence of the four most common types of cancer in Waterloo Region, 1986 to 2009* Rate per 100,000 people Female breast Prostate 2000 Colorectal Lung

4 Cancer mortality in Waterloo Region From 1986 to 2009, the number of cancer deaths steadily increased over time in both Waterloo Region and Ontario as the population increased. The rate of cancer mortality, which accounts for population size, has steadily decreased over time. Overall, men had higher cancer mortality compared to women. The drop in mortality rates over time can be attributed to improvements in earlier detection and screening of cancer, as well as more effective cancer treatments. In addition, smoking rates have significantly declined since the 1950s and 1960s, especially among men, a trend that also contributed to the overall decrease in cancer mortality rates from 1986 to Waterloo Region deaths Waterloo Region rate 2009 Rate per 100,000 people Figure 3. Cancer mortality in Waterloo Region and Ontario, 1986 to 2009* Number of deaths A mortality rate measures the number of cancer deaths that occur per year, out of every 100,000 people in a geographic region. 0 Ontario rate Between 1986 and 2009, lung cancer was the leading cause of cancer death in Waterloo Region, followed by colorectal, female breast and prostate cancer. These four types of cancer were similarly the leading causes of cancer death in Ontario. Figure 4. The four leading causes of cancer mortality in Waterloo Region, 1986 to 2009* Rate per 100,000 people Female breast 1995 Prostate 2000 Colorectal Lung 3

5 Finding it Early: Screening for cancer In Ontario, there are province-wide screening programs for three types of cancer: breast, colorectal and cervical. These programs offer screening tests free of charge to anyone in Ontario who is eligible. For more information about these Ontario cancer screening programs, visit the Cancer Care Ontario website: Breast Cancer In 2009, there were 310 new female breast cancer cases and 81 deaths due to breast cancer in females in Waterloo Region. Breast cancer accounts for 28 per cent of all female cancer cases in Waterloo Region. How do we screen for breast cancer in Ontario? Breast cancer screening is the regular examination of a woman s breasts to find breast cancer early. It involves doing a breast x-ray, called a mammogram, in eligible women, usually once every two years. Why get screened? When breast cancer is found early, there is a better chance of treating the cancer successfully. It is less likely to spread, and there may be more treatment options. How are we doing in screening? In 2010/2011, just over 60 per cent of eligible women in Waterloo Region had up-to-date breast screening. This rate was similar to that for all of Ontario. Breast screening rates have been increasing over time since 2004/2005. Cancer screening means doing medical tests in people without any symptoms, to detect cancer earlier. Cancer screening sees what we can t. Who should be screened? Currently, the Ontario Breast Screening Program offers free, high-quality breast cancer screening for women aged 50 to 74 years. Women outside of this age range who have been confirmed to be at high risk for breast cancer are also eligible. 4

6 Finding it early: Screening for cancer Colorectal Cancer The Fecal Occult Blood Test is performed at home and involves taking three separate stool samples on three different days over a ten day period, and mailing them free of charge to a lab for analysis. A colonoscopy is a medical test done by a doctor that examines the lining of the large intestine for abnormal growths that may indicate cancer. In 2009, there were 288 new colorectal cancer cases and 124 deaths due to colorectal cancer in Waterloo Region. Colorectal cancer accounts for 13 per cent of all cancer cases in Waterloo Region. How do we screen for colorectal cancer in Ontario? Colorectal cancer screening for most people involves doing a free, simple at home test the Fecal Occult Blood Test (FOBT) once every two years. For those at increased risk because of a family history of one or more first-degree relatives (parent, sibling or child) with a diagnosis of colorectal cancer, a colonoscopy is recommended. Why get screened? Often there are no early warning symptoms of colorectal cancer, but if caught early, a person with colorectal cancer can have up to a 90 per cent chance of being cured. Early detection also avoids more invasive forms of treatment, like the removal of portions of the colon. How are we doing in screening? In 2010/2011, just over one-third of eligible adults aged 50 to 74 years had up-to-date colorectal cancer screening. This rate was slightly higher than that for all of Ontario. Colorectal cancer screening rates have been increasing over time since 2004/2005. Who should be screened? Currently, the ColonCancerCheck program recommends that all Ontarians aged 50 and over be screened for colorectal cancer, either through the FOBT at-home test (for those at average risk) or colonoscopy (for those at increased risk). For some at increased risk, screening may be recommended prior to age 50. 5

7 Finding it early: Screening for cancer Cervical Cancer In 2009, there were 15 new cervical cancer cases in Waterloo Region. There was an average of six cervical cancer deaths each year in Waterloo Region from 1986 to Cervical cancer accounts for nearly two per cent of female cancer cases in Waterloo Region. Why get screened? Pap tests check for cervical cell changes that are caused by a Human Papillomavirus (HPV) infection. Cervical cancer may be prevented entirely by following these cell changes closely and treating them if necessary. Screening with a Pap test is the only way to find these cell changes in your cervix that may lead to cancer. How do we screen for cervical cancer in Ontario? Cervical cancer screening involves doing free, regular Pap tests, usually every three years. A Pap test is a simple procedure which takes some cells from the cervix using a swab. It only takes a few minutes to do during a visit to a health care provider. How are we doing in screening? In 2009 to 2011, two-thirds of eligible women in Waterloo Region had up-to-date cervical screening. This rate was slightly higher than that for all of Ontario. Cervical screening rates have been increasing slightly over time since the early 2000s. Cervical cancer can also be prevented by being immunized against Human Papillomavirus (HPV), the virus that causes a majority of cases. Being screened for cervical cancer and being immunized against HPV are both recommended. Who should be screened? Currently, the Ontario Cervical Screening Program recommends that screening should begin at age 21 for women who have ever been sexually active (that is, who have ever had any sexual skin-to-skin contact, including intercourse, intimate touching or oral sexual contact). Women who are not sexually active by age 21 should delay cervical cancer screening until they are sexually active. Cervical cancer screening may be discontinued at age 70. 6

8 Reducing your risk: Lifestyle factors that affect cancer risk There are many factors that affect our risk for developing cancer. Some we cannot change, such as our age, whether we are male or female, and our genetic make-up. There are many factors that affect our risk of developing cancer that we can change, however. Some of the most important modifiable risk factors for cancer are discussed here. A modifiable risk factor is something that we can control which affects our risk of developing cancer. Examples include smoking, healthy eating, and physical activity. Tobacco and second-hand smoke Healthy eating How does it affect cancer risk? It increases risk for lung cancer and many other types of cancer. Tobacco use and exposure is the leading preventable cause of disease and death in Ontario. How does it affect cancer risk? High consumption of red meat, processed meat and salt increases cancer risk, while high consumption of vegetables, fruit, fibre and whole grains reduces cancer risk. About 20 per cent of the population in Waterloo Region currently smoke, similar to Ontario. Nearly 17 per cent of non-smokers are regularly exposed to second-hand smoke. Over a third of those in Waterloo Region consume vegetables and fruit at least five times per day, similar to Ontario. Just over 40 per cent of Waterloo Region adults are at a healthy weight, similar to Ontario. What can you do? Avoid exposure to tobacco. If you don t smoke, remain smoke-free. If you smoke, reduce the amount you smoke, or quit altogether. What can you do? Make healthier eating choices more often. Reduce your salt and red meat intake. Increase your vegetable and fruit intake. Maintain a healthy body weight. Aim for a Body Mass Index (BMI) between 20 to 25. 7

9 Physical activity Drinking alcohol How does it affect cancer risk? Inadequate levels of physical activity increase the risk of colorectal and breast cancer. Long periods of sedentary activity, even within a lifestyle that includes adequate physical activity, can also increase the risk of cancer. How does it affect cancer risk? Drinking alcohol, especially high amounts regularly over time, has been associated with oral, throat, esophageal, colorectal, breast and liver cancer. A lower proportion of the population is active during their leisure time in Waterloo Region than in Ontario. Nearly two-thirds of people are sedentary during their leisure time, doing things such as watching TV or using computers, for 15 hours or more every week. What can you do? Stay active. Move often. Break up long periods of sedentary activity with short bouts of movement. Almost two-thirds of the population regularly drinks in Waterloo Region and 17 per cent have had at least one episode of drinking heavily in the past year, similar to Ontario. Men used to be more likely to regularly drink, but alcohol consumption in women has increased and now women and men are equally likely to regularly drink. About half of cancers can be prevented through healthy eating, active living, avoiding tobacco and getting screened regularly. What can you do? Follow Canada s Low-Risk Alcohol Drinking Guidelines to lower your overall risk from drinking alcohol.* The guidelines are available from the Canadian Centre on Substance Abuse at: topics/alcohol/drinkingguidelines *Cancer Care Ontario and the Canadian Centre on Substance Abuse have recently reported on more stringent alcohol drinking guidelines which specifically aim to reduce cancer risk. Region of Waterloo Public Health will be reviewing these cancer-specific alcohol drinking guidelines and the Low-Risk Alcohol Drinking Guidelines and may update recommendations in the future. For more information on these alcohol drinking guidelines, see: 8

10 Reducing your risk: Lifestyle factors that affect cancer risk HPV vaccination How does it affect cancer risk? Human Papillomavirus (HPV) is the most common sexually transmitted infection, and it causes 70 per cent of all cases of cervical cancer. Two-thirds of the population aged 15 to 49 years in Waterloo Region report a sexual debut under 20 years of age. The proportion of the population with two or more sexual partners in the past year is lower in Waterloo Region compared to all of Ontario. Men are more likely to have had multiple partners in the past year than women. What can you do? Females in grades 8 through 12 should get vaccinated against HPV. Use physical barrier methods such as a condom during sexual activity to further help prevent transmission of HPV and other sexually transmitted infections. For more information on what you can do to reduce your risk of cancer, visit the Region of Waterloo Public Health website: en/healthylivinghealthprotection/ cancerprevention.asp. 9

11 What is Public Health doing about cancer in Waterloo Region? Within our mandate set out by the Ontario Public Health Standards, Region of Waterloo Public Health aims to reduce the burden of chronic diseases, including cancer, in the population of Waterloo Region. We work towards this goal with a number of cancer prevention strategies, including those that focus on tobaccofree living, improving eating habits, increasing physical activity, reducing alcohol consumption, and increasing cancer screening and early detection. Below are some examples of specific Region of Waterloo Public Health initiatives which aim to help prevent and reduce the incidence of cancer in Waterloo Region: Comprehensive tobacco use reduction activities We provide brief smoking cessation counselling over the phone and smoking cessation workshops with free nicotine replacement therapy for eligible smokers. We work with workplaces, health care organizations and other interested community partners to create comprehensive smoke-free policies. We also work with local youth volunteers to promote tobacco-free living and healthy lifestyles among Waterloo Region youth. Reducing exposure to second-hand smoke We partner with Waterloo Region Housing (WRH) and the Propel Centre for Population Health Impact at the University of Waterloo to implement and monitor the Waterloo Region Housing smoke-free policy which came into effect on April 1, Promoting healthy lifestyle to reduce breast cancer risk We support the Hook Up to Breast Cancer Prevention program aimed at young women in secondary and post-secondary schools which encourages reduced alcohol and tobacco consumption, increased physical activity, and healthy eating to reduce the risk of breast cancer. Promoting provincial cancer screening programs for early cancer detection We partner with Waterloo Region Housing and the Waterloo Wellington Regional Cancer Program to increase awareness and participation in screening for breast, cervical, and colorectal cancers among neighbourhoods where there are low screening rates. Supporting community projects that encourage healthy eating We support several community garden development projects in Waterloo Region, which provide health benefits including increased vegetable and fruit consumption, improved mental health and increased opportunities for physical activity. Comprehensively promoting healthy living We established and coordinate the Waterloo Region Healthy Communities Partnership to oversee health promotion activities carried out by local partners to promote healthy eating, physical activity and mental health in a comprehensive way. Since its inception, the Partnership has accomplished a number of initiatives that have encouraged community participation in the promotion and implementation of healthy public policies. Promoting and directly providing access to HPV vaccination We provide the HPV vaccine Gardasil to females from grades 8 through 12 at no cost through a school-based immunization program and promote the benefits of HPV vaccination to health care providers and the public. *Source: Cancer Care Ontario SEER*Stat OCRIS (May 2012) October 2012 release. Note: Rates illustrated in this report have been age-standardized to the 1991 Canadian population. 10

12 Cancer In Waterloo Region: The facts and reducing your risk For more detailed, technical information and statistics, see Cancer in Waterloo Region: a Population Health Status Report available at: researchresourcespublications/resources/wr_cancerreport.pdf Region of Waterloo Public Health (2014). Cancer in Waterloo Region: The facts and reducing your risk. Waterloo, ON. For more information, please contact: Epidemiology and Health Analytics Region of Waterloo Public Health 99 Regina Street South, 3rd floor Waterloo, Ontario N2J 4V3 Phone: eha@regionofwaterloo.ca Accessible formats of this document are available upon request. Please call the Coordinator, Marketing and Communications at ext (TTY ) to request an accessible format