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Prostate Cancer

Volume 472: debated on Tuesday 26 February 2008

To ask the Secretary of State for Health how many cases of prostate cancer he estimates there will be in (a) 2011, (b) 2016 and (c) 2021; how many cases of prostate cancer there were in 2006; and what estimate he has made of the (i) inpatient, (ii) outpatient and (iii) other costs of treating prostate cancer in (A) 2006, (B) 2011, (C) 2016 and (D) 2021. (184258)

Estimates for cases of prostate cancer in individual years are not available, but estimates for the average annual registrations over a five year period are available:

Time period

Number of cases

2009-13

29,625

2014-18

33,026

2019-23

36,703

These estimates are projected from incidence rates from 1974-2003. Projections are not given for individual years because these would be subject to wide uncertainty.

The number of cases of prostate cancer in 2006 is not currently known, the most recently available data are for 2005, in which there were 28,886 registrations.

Source: Office for National Statistics.

The estimate of inpatient costs for prostate cancer are:

Time period

Average annual cost (£ million)

2009-13

67.4

2014-18

74.9

2019-23

82.7

All the cost estimates are in 2005-06 prices. The inpatient cost figures relate to admissions with a primary diagnosis of prostate cancer, and excludes chemotherapy and radiotherapy costs. It is not possible to provide reliable estimates of any other element of prostate cancer treatment costs because of the lack of appropriate data.

To ask the Secretary of State for Health what estimate he has made of the mean waiting time for a patient with prostate cancer between (a) their first clinic appointment and (b) diagnosis in each year since 1997. (184263)

Information on average waiting times between first outpatient attendance and diagnosis for cancer patients are not collected centrally and have not been estimated. The Department currently receives aggregate data on cancer waiting times that relate to the standards within the National Health Service Cancer Plan (2000).

For those patients following the 62-day referral to treatment pathway the Department monitors the time taken to complete the entire pathway. Performance against this standard for the most recent period for which figures are available (July, August and September 2007-08) was 97.2 per cent.

To ask the Secretary of State for Health what assessment he has made of the (a) actual and (b) optimum workloads of sites offering prostatectomies, expressed in terms of the number of operations per site. (184278)

The National Institute for Health and Clinical Excellence (NICE) issued guidance on “Improving Outcomes in Urological Cancers” in September 2002. It stated that:

“ideally, all radical prostatectomies undertaken in each network should be carried out by a single team. Radical prostatectomy should not be carried out by teams which carry out fewer than 50 radical operations (prostatectomies and cystectomies) for prostate and bladder cancers per year”.

The guidance went on to recommend that

“surgeons who currently carry out fewer than five radical prostatectomies per year should refer patients to designated surgeons who will become more specialised in this type of surgery.”

This guidance was converted into a series of measures for inclusion in the “Manual of Cancer Services 2004” against which cancer networks are peer reviewed. The Manual includes measures to assess:

the total number of radical prostatectomies and, separately, the total number of total cystectomies, performed by the multidisciplinary teams during the year prior to the team’s review; and

the total number of radical prostatectomies and, separately, the total number of total cystectomies, performed by individual surgical members of the team.

If teams were not compliant with the criteria set out in the improving outcomes guidance during the peer review, the peer review team would have raised this as an immediate risk with the trust chief executive or their representative on the day of the visit following up this concern in writing. A trust would be expected to address this concern as a matter of urgency.

Individual cancer networks’ performance against these measures in the 2004 to 2007 round of the national cancer peer review would be set out in their local peer review reports. These reports are available on the Cancer Quality Improvement Network System website at:

www.cquins.nhs.uk/published_reviews.php

A summary report of the 2004 to 2007 national cancer peer review process will be issued shortly.

To ask the Secretary of State for Health what recent estimate he has made of the proportion of prostate cancer patients who are cared for by a multidisciplinary team. (184279)

The recent round of cancer peer review (2004 to 2007) found that in 92 per cent. of local urology teams and 98 per cent. of specialist urology teams, all new patients with urological cancer, including prostate cancer, were reviewed by a multi-disciplinary team.