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Cancer incidence and mortality.I checked these figures on 24th March 2016 and they are the latest data.Abbreviation.JCVI:Joint Committee on Vaccination and Immunisation NHL:non-Hodgkin LymphomaReferences.Cancer UK publishes the statistics that the exam committee will use.Statistics by type of cancer.Twenty most common cancer by incidence. Ten most common female cancers. 2013Twenty most common causes of death from cancer. 2012.Basic numbers.This table gives the 10 most common female cancers: 2013: breast – kidney. I have tagged on cervix, vulva and vagina, which rank below the top ten, for completeness. I could not find a rank for vaginal cancer, but I am sure you won’t be asked. The total number of cases was 172,754,RankLocationNumber%1Breast53,352312Lung21,044123Bowel18,155114Uterus9,02255Malignant melanoma7,35746Ovary 7,28447NHL6,15448Brain, Other CNS5,46039Pancreas4,692310Kidney4,4183Other38,9522312Cervix3,2071.8613Oesophagus2,90020Vulva1,3130.76Vagina 2360.14Total172,754The table below gives the 10 most common cancers causing death: 2012. I have added the “mortality to incidence” ratio. This is not a recognised ratio – I made it up, but it gives an idea of how lethal the different cancers are. This explains why lung cancer tops the mortality list although it is number 2 in the incidence table, with less than half the numbers of breast cancer. If you look at the mortality to incidence ratio, you see that lung cancer is more than three times as lethal as breast cancer. Similarly, cancers like those of pancreas and oesophagus are not high on the incidence list, but feature much higher on the mortality list because they kill most of those who get them..RankLocationNumber%Mortality to incidence ratio1Lung16,0672176.35%2Breast11,6431521.82%3Bowel7,3921040.724Pancreas4,383 693.4%5Ovary4,271 658.6%6Oesophagus2,461 384.9%7Brain2,286 341.9%8NHL2,126 334.5%9Leukaemia2,084 310Uterus2,025 322.4%Cervix 919 128.7%Vulva 4050.530.8%Vagina 1110.1447%Choriocarcinoma~ 200.03Total78,755Cervix ranked 12th. in the incidence list of female cancers and vulva came 20th. with < 1% of all new cases of female cancer. Vaginal cancer is rare and I could not find where it ranked and I don’t think you will be asked. Choriocarcinoma is even rarer, with only about 20 cases per annum. These mainly derive from molar pregnancies, which are not malignant and do not feature in these figures. The latest figures I could find for molar pregnancies was 1784 for the year 2011. With all gestational trophoblastic disease registered in the UK, I had anticipated that it would be easy to find more recent figures.VulvaThere were around 1,300 new cases of vulval cancer in the UK in 2013, that’s around 4 cases diagnosed every day.Vulval cancer accounts for less than 1% of all new cases in the UK (2013).In females in the UK, vulval cancer is the 20th most common cancer, with around 1,300 cases diagnosed in 2013.Almost 6 in 10 (56%) vulval cancer cases in the UK each year are diagnosed in females aged 70 and over (2011-2013).Since the late-1970s, vulval cancer incidence rates have remained stable in Great Britain.Over the last decade, vulval cancer incidence rates have remained stable in the UK.Vulval cancer in England is more common in females living in the most deprived areas.1 in 275 women will be diagnosed with vulval cancer during their lifetime.VaginaThere were around 240 new cases of vaginal cancer in the UK in 2013, that’s too low cases diagnosed every day.Vaginal cancer accounts for less than 1% of all new cases in the UK (2013).In females, there were around 240 cases of vaginal cancer diagnosed in the UK in 2013.Almost half (47%) of vaginal cancer cases in the UK each year are diagnosed in females aged 70 and over (2011-2013).Since the late-1970s, vaginal cancer incidence rates have remained stable in Great Britain.Over the last decade, vaginal cancer incidence rates have remained stable in the UK.1 in 1,270 women will be diagnosed with vaginal cancer during their lifetime.Vagina: 111 deaths in 2012Breast (C50) 53,352 31% Lung (C33-C34) 21,044 12% Bowel (C18-C20) 18,155 11% Uterus (C54-C55) 9,022 5% Malignant Melanoma (C43) 7,357 4% Ovary (C56-C57.4) 7,284 4% Non-Hodgkin Lymphoma (C82-C86) 6,154 4% Brain, Other CNS and Intracranial Tumours (C70-C72, C75.1-C75.3, D32-D33, D35.2-D35.4, D42-D43, D44.3-D44.5) 5,460 3% Pancreas (C25) 4,692 3% Kidney (C64-C66,C68) 4,418 3% Other Sites 38,952 23% Total 172,754Mortality 919 ca cervix deaths 2012. Cervical cancer statisticsCasesNew cases of cervical cancer, 2013, UKDeathsDeaths from cervical cancer, 2012, UKSurvivalSurvive cervical cancer for 10 or more years, 2010-11, England and WalesPreventionPreventable cases of cervical cancer, UKAround 920 women died from cervical cancer in 2012 in the UK, that is more than 2 every day.More than half of cervical cancer deaths occur in women aged between 25 and 64.Cervical cancer death rates have decreased by 71% in the UK since the early 1970s.In Europe, around 24,400 women were estimated to have died from cervical cancer in 2012. The UK mortality rate is ninth lowest in Europe.Worldwide, more than 265,000 women are estimated to have died from cervical cancer in 2012, with mortality rates varying across the world.There were around 3,200 new cases of cervical cancer in the UK in 2013, that’s around 9 cases diagnosed every day.Cervical cancer is the 20th most common cancer in the UK (2013).Cervical cancer accounts for less than 1% of all new cases in the UK (2013).In females in the UK, cervical cancer is the 12th most common cancer, with around 3,200 cases diagnosed in 2013.More than half (52%) of cervical cancer cases in the UK each year are diagnosed in?females aged under 45 (2011-2013).Since the late-1970s, cervical cancer incidence rates in women have decreased by almost a half (46%) in Great Britain.Over the last decade, cervical cancer incidence rates in women have decreased by less than a tenth (4%) in the UK.Cervical cancer incidence in Great Britain decreased by nearly half between the late 1980’s until the early 2000s, but the last decade has seen an increase in rates in younger women.Cervical cancer in England is more common in females living in the most deprived areas.In Europe, around 58,400 new cases of cervical cancer were estimated to have been diagnosed in 2012. The UK incidence rate is 12th lowest in Europe.Worldwide, more than 527,000 women were diagnosed with cervical cancer in 2012, with incidence rates varying across the world.1 in 135 women will be diagnosed with cervical cancer during their lifetime.Vaginal cancer statisticsCasesNew cases of vaginal cancer, 2013, UKDeathsDeaths from vaginal cancer, 2012, UKPreventionPreventable cases of vaginal cancer, UKVulval cancer incidence statisticsCasesNew cases of vulval cancer, 2013, UK?Proportion of all casesPercentage vulval cancer is of total cancer cases, 2013, UK?AgeAge that almost 6 in 10 of vulval cancer cases are diagnosed, 2011-2013, UKThe 10 Most Common Causes of Cancer Death in Females, UK, 2012 9. How common are molar pregnancies?The figures for the UK in 2011 show that there were 1784 molar pregnancies registered in England and Wales and that there were 700,000 live births. From past data, this equates to around 1 molar pregnancy for every 500 babies born. This means that for each obstetric unit molar pregnancies are quite rare perhaps 1 or 2 cases per year, but for the treatment centres they are quite common with 1200 patients registered at CXH and 120 treated. What is GTD? GTD is a group of conditions that may occur when a pregnancy does not develop properly and includes complete and partial molar pregnancy. Sometimes a molar pregnancy can lead to another form of GTD known as gestational trophoblastic neoplasia (GTN) - see ‘What is GTN?’ below. GTD is an uncommon condition. For approximately every 700 pregnancies which end with a live baby, there will be one pregnancy which develops GTDGTG 38GTD (hydatidiform mole, invasive mole, choriocarcinoma, placental-site trophoblastic tumour) is a rare event in the UK, with a calculated incidence of 1/714 live births.1 There is evidence of ethnic variation in the incidence of GTD in the UK, with women from Asia having a higher incidence compared with non-Asian women (1/387 versus 1/752 live births). However, these figures may under represent the true incidence of the disease because of problems with reporting, particularly in regard to partial moles. GTN may develop after a molar pregnancy, a non-molar pregnancy or a live birth. The incidence after a live birth is estimated at 1/50 000. Because of the rarity of the problem, an average consultant obstetrician and gynaecologist may deal with only one new case of molar pregnancy every second year.In the UK, there exists an effective registration and treatment programme. The programme has achieved impressive results, with high cure (98–100%) and low (5–8%) chemotherapy rates. Choriocarcinomas?are extremely rare with about 20 cases per year in the UK. They develop from cells of the placenta and can occur some time after any type of pregnancy (including miscarriages or terminations). Choriocarcinoma is more likely after a molar pregnancy.What a risk factor isA risk factor is anything that can increase your chance of developing a particular disease. Each type of cancer has different risk factors. Researchers have not yet been able to identify what causes GTT, but we do know of some factors that increase a woman's risk of developing it.Remember?that having one or more risk factors does not mean that you will definitely get GTT. Most people who have one or more of the risk factors never have a GTT, and some people who have none of the risk factors do develop the disease. These cancers are very rare and this information is only a guide to what might increase your risk.How common GTTs areGestational trophoblastic tumours are very rare. In the UK there is 1 case of a?molar pregnancy?for every 590 pregnancies.?Choriocarcinoma?only happens in around 1 case for every 50,000 babies born.Question 1.Lead-inWhich is the most common female cancer?Option ListBowelBreastCervixEndometriumLungAnswer.B. RankSiteNumber% of total1Breast53,35231Question 2.Lead-inWhich is the 2nd. most common female cancer? Option ListBowelBreastCervixEndometriumLungAnswer.E.RankSiteNumber% of total1Breast53,352312Lung21,04412Question 3.Lead-inWhich is the 3rd. most common female cancer?Option ListBowelBreastCervixEndometriumLungAnswer. A. Bowel.RankLocationNumber%1Breast53,352312Lung21,044123Bowel18,15511Question 4.Lead-inWhich is the 4th. most common female cancer?Option ListBowelBreastCervixEndometriumLungAnswer. D.RankLocationNumber%1Breast53,352312Lung21,044123Bowel18,155114Uterus9,0225Cancer UK distinguishes between uterine and cervical cancer. Almost all of the cases in the “uterus” category are endometrial cancer – there will be a few rarities such as myometrial sarcomas. The figures for the “uterus” category will be used for endometrial cancer by the examiners.Question 5.Lead-inWhich is the 5th. most common female cancer?Option ListCervixMalignant melanomaNon-Hodgkin’s lymphomaOvaryVulvaAnswer. B. Malignant melanoma.RankLocationNumber%1Breast53,352312Lung21,044123Bowel18,155114Uterus9,02255Malignant melanoma7,3574Question 6.Lead-inWhich is the 6th. most common female cancer?Option ListCervixNon-Hodgkin’s lymphomaOvarySkin VulvaAnswer. C.RankLocationNumber%1Breast53,352312Lung21,044123Bowel18,155114Uterus9,02255Malignant melanoma7,35746Ovary 7,2844Question 7.Lead-inWhere does cervical cancer feature in the list of the most common female cancers?Option List10th.12th.16th.20th. 24th. Answer. B. 12th.RankLocationNumber%1Breast53,352312Lung21,044123Bowel18,155114Uterus9,02255Malignant melanoma7,35746Ovary 7,28447Non-Hodgkin Lymphoma6,15448Brain, Other CNS5,46039Pancreas4,692310Kidney4,4183Other38,9522312Cervix3,2071.86The HPV vaccination programme started with girls aged 12-13 years in September 2008. These girls will be in their twenties this year. We can expect the vaccination programme to produce a reduction in rates of CIN, but not to make a difference to cervical cancer rates for ten years or more as cancer of the cervix is rare in women < 30 years. However, Cancer UK says that “52% of cervical cancer … is diagnosed … under age 45”. We can expect to see a significant impact on incidence by the time they are 45 and the preceding ten years or so. The first girls immunised were born in 1995 and 1996, so they will hit their mid-forties around 2040. I guess there will be a detectable effect on incidence from 2030 or thereabouts.Cancer Research UK says:“More than half (52%) of cervical cancer cases in the UK each year are diagnosed in?females aged under 45 (2011-2013).Since the late-1970s, cervical cancer incidence rates in women have decreased by almost a half (46%) in Great Britain.Over the last decade, cervical cancer incidence rates in women have decreased by less than a tenth (4%) in the UK.Cervical cancer incidence in Great Britain decreased by nearly half between the late 1980’s until the early 2000s, but the last decade has seen an increase in rates in younger women”.Question 6.Lead-inWhich is the 6th. most common female cancer?Option ListCervixNon-Hodgkin’s lymphomaOvarySkin VulvaAnswer. C.RankSiteNumber% of total6Ovary 7,2844RankLocationNumber%1Breast53,352312Lung21,044123Bowel18,155114Uterus9,02255Malignant melanoma7,35746Ovary 7,28447Non-Hodgkin Lymphoma6,15448Brain, Other CNS5,46039Pancreas4,692310Kidney4,4183Other38,9522312Cervix3,207 1.8613Oesophagus2,90020Vulva1,313 0.76Vagina 236 0.14Total172,754Question .Lead-inWhere does vulval cancer feature in the list of the most common female cancers?Option List10th.12th.16th.20th. 24th. Answer. B. 20th.1Breast53,352312Lung21,044123Bowel18,155114Uterus9,02255Malignant melanoma7,35746Ovary 7,28447Non-Hodgkin Lymphoma6,15448Brain, Other CNS5,46039Pancreas4,692310Kidney4,4183Other38,9522312Cervix3,207 1.8620Vulva1,313 0.76Vagina 236 0.14Question 6.Lead-inWhich is the most common cancer causing female death in the UK?Option ListBreastBowelLungOvary PancreasAnswer. C.LocationNumber%Lung16,06721Question 7.Lead-inWhich is the 2nd. most common cancer causing female death in the UK?Option ListBreastBowelLungOvary PancreasAnswer. A.LocationNumber%Lung16,06721Breast11,64315Question 8.Lead-inWhich is the 3rd. most common cancer causing female death in the UK?Option ListBreastBowelLungOvary PancreasAnswer. BLocationNumber%Lung16,06721Breast11,64315Bowel7,39210Question 9.Lead-inWhich is the 4th. most common cancer causing female death in the UK?Option ListBrainOesophagusOvary PancreasUterusAnswer. D.LocationNumber%Lung16,06721Breast11,64315Bowel7,39210Pancreas4,383 6Question 10.Lead-inWhich is the 5th. most common cancer causing female death in the UK?Option ListBrainOesophagusOvary PancreasUterusAnswer. C. Deaths. 2012. UK. LocationNumber%Lung16,06721Breast11,64315Bowel7,39210Pancreas4,383 6Ovary4,271 6Oesophagus2,461 3Brain2,286 3NHL2,126 3Leukaemia2,084 3Uterus2,025 3Cervix 919 1Vulva 405<1Vagina 111<1Total78,755Question .Lead-inThe incidence of cervical cancer fell from the 1970s until now. What is the approximate figure for the fall?Option List10%25%50%60%75%Answer. C. Cancer UK says: “Since the late-1970s, cervical cancer incidence rates …have decreased by … 46%”.Question .Lead-inThe incidence of cervical cancer fell in the past decade. What is the approximate figure for the fall?Option List5%10%15%20%25%Answer. A. Cancer UK says: “Over the last decade, cervical cancer incidence rates …have decreased by … 4%.Question 9.Lead-inWhat proportion of cervical cancer is diagnosed in women < 45 years?Option List20%30%40%50%60%Answer. D. Cancer UK says: “52% of cervical cancer … is diagnosed … under age 45”.Question 9.Lead-inWhen was routine HPV vaccination of girls introduced in the UK?Option List20002002200420062008Answer. E.Question 9.Lead-inFrom what year might we expect to see a reduction in cervical cancer incidence as a result of the HPV vaccination programme?Option List20202025203020402050Answer. C.The HPV vaccination programme started with girls aged 12-13 years in September 2008. These girls will be in their twenties this year. We can expect the vaccination programme to produce a reduction in rates of CIN in the next few years, but not to make a difference to cervical cancer rates for ten years or more as cancer of the cervix is rare in women < 30 years.However, Cancer UK says that “52% of cervical cancer … is diagnosed … under age 45”. We can expect to see a significant impact on incidence by the time they are 45 and the preceding ten years or so. The first girls immunised were born in 1995 and 1996, so they will hit their mid-forties around 2040. I guess there will be a detectable effect on incidence from 2030 or thereabouts.Question 9.Lead-inWhen was routine HPV vaccination of boys introduced in the UK?Option List2010201120122014None of the aboveAnswer. E. Routine immunisation of boys has been discussed by the JCVI, but it has not been included in the national programme. Cancer Research UK says:“More than half (52%) of cervical cancer cases in the UK each year are diagnosed in?females aged under 45 (2011-2013).Since the late-1970s, cervical cancer incidence rates in women have decreased by almost a half (46%) in Great Britain.Over the last decade, cervical cancer incidence rates in women have decreased by less than a tenth (4%) in the UK.Cervical cancer incidence in Great Britain decreased by nearly half between the late 1980’s until the early 2000s, but the last decade has seen an increase in rates in younger women”.More than half (52%) of cervical cancer cases in the UK each year are diagnosed in?females aged under 45 (2011-2013).Since the late-1970s, cervical cancer incidence rates in women have decreased by almost a half (46%) in Great Britain.Over the last decade, cervical cancer incidence rates in women have decreased by less than a tenth (4%) in the UK.Cervical cancer incidence in Great Britain decreased by nearly half between the late 1980’s until the early 2000s, but the last decade has seen an increase in rates in younger women”. ................
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