The prostate cancer charter for action was first launched at the House of Commons on 29 January 2003. It represents the coming together of all the key charities and professional organisations working in the field of prostate cancer, speaking with a collective voice. The actions agreed by the charter are being considered by the prostate cancer advisory group (PCAG), chaired by Professor Mike Richards, the National Cancer Director. Some of these actions will have an impact on cancer networks, but not all.
The main driver to improve prostate cancer services is the National Institute for Health and Clinical Excellence (NICE) guidance on ‘Improving Outcomes in Urological Cancers’, including prostate cancer, which was issued in September 2002. Each strategic health authority was asked to demonstrate that its cancer network(s) had suitable action plans in place for the implementation of this guidance. Progress towards the implementation of these plans is assessed by both the Department and the Healthcare Commission.
The main part of the Department’s research and development budget is allocated to and managed by national health service organisations. These organisations account for their use of the allocations they receive from the Department in an annual research and development report. The reports identify total, aggregated expenditure on national priority areas, including cancer. Details of individual projects supported in the NHS, including those concerned with site-specific cancers, can be found on the national research register at www.dh.gov.uk/research.
The total of the Department’s annual spend on cancer research as reported by NHS organisations and by the Department’s national research programmes since 1997 is shown in the following table.
The National Cancer Research Institute’s 2004 strategic analysis of the directly funded cancer research supported by Government and charities showed that, as at 1 April 2004, 62 per cent. of total funding was dedicated to supporting research that could be applicable to all cancers.
£ million 1997-98 53 1998-99 75.4 1999-2000 77.4 2000-01 83.8 2001-02 113.4 2002-03 124.1 2003-04 139.8 2004-05 150.3 2005-06 1168 Note: This figure and the figure for 2004-05 are provisional
The NHS prostate cancer programme confirmed the NHS Plan commitment to increase the Department’s funding for directly commissioned prostate cancer research to £4.2 million by 2003-04. The Department’s expenditure on directly commissioned prostate cancer research was £4.2 million in that year and in 2004-05. A similar level of funding will be maintained for future years, subject to the quality of research proposals received.
This figure and the figure for 2004-05 are provisional.
The latest assessment from the Office for National Statistics on prostate cancer incidence and mortality are shown in the following tables.
Government office region Number Crude rate Age standardised rate North East 1,321 106.8 82.8 North West 4,468 134.4 109.9 Yorkshire and the Humber 2,909 118.3 96.1 East Midlands 2,415 114.5 89.5 West Midlands 3,377 128.9 103.2 East 3,164 117.3 89.9 London 3,012 82.0 91.3 South East 4,752 119.6 95.4 South West 3,988 162.2 112.7
Government office region Number Crude rate Age standardised rate North East 392 31.48 23.43 North West 1,109 33.23 25.69 Yorkshire and the Humber 795 32.13 24.30 East Midlands 756 35.54 25.71 West Midlands 889 33.72 24.98 East 1,015 37.28 25.54 London 953 25.62 25.73 South East 1,456 36.37 25.36 South West 1,128 45.56 27.63 Notes 1. Per 100,000 population. 2. The age standardised rate (ASR) is the rate per 100,000 population standardised to the European standard population. 3. Cause of death was defined using the International Classification of Diseases, Tenth Revision (ICD-10) code C61 (prostate cancer). 4. Based on the Government office region (GOR) boundaries as of 2005. Source: Office for National Statistics.
There is variability in incidence and deaths from prostate cancer around the country with a slightly higher than average incidence across London and the South of England. A similar pattern exists for mortality, although there was less variation than for incidence. The mortality rate has started to decline in recent years.
Geographical variations in incidence may, to some extent, be explained by regional differences in the availability and uptake of prostate-specific antigen (PSA) testing. The introduction of the PSA test in the early 1990s led to a big increase in the diagnosis of prostate cancer, although this was on top of an existing underlying trend of more cases. Figures on PSA testing are not collected centrally.