Free Pancreatic Cancer Status Report: Malta Report Sample
In 2009, pancreatic cancer was the third most common cause of cancer-related deaths among adult males and females in the Economic Union after stomach and colorectal cancer (Malvezzi et al. 2014). Estimates of mortality for 2014 indicate that deaths due to pancreatic cancer will continue to rise in the region. This malignancy is associated with a very low survival rate at 5% within 5 years. In Malta, characterizing the incidence, prevalence, and risk factors of pancreatic cancer through a status report can aid in the development of risk reduction and other clinical interventions to improve population outcomes.
Status Report Data Sources
Global Cancer Observatory
For incidence, prevalence, and mortality, the Global Cancer Observatory (2012), through the EUCAN national estimates website, is a regional source of country-by-country age-standardised rates of pancreatic cancer per 100,000 persons in bar chart, table, or map format. The latest data is for 2012 and disaggregated by gender. Incidence and mortality numbers are also available on the EUCAN website. One-year, 3-year, and 5-year prevalence are provided as well. The Observatory derives its data from cancer registries at the national and regional levels and the mortality database of the WHO (Global Cancer Observatory 2012). Data is analysed using a standardised methodology to estimate cancer burden and allow comparability. However, variations in methodology may lead to differences in figures derived by EUCAN and national registries. Thus, the Global Cancer Observatory data is useful when one attempts to compare the status of pancreatic cancer in Malta with other EU countries and the EU as a whole.
National Cancer Registry - Malta
National data on incidence and mortality in Malta is provided by the National Cancer Registry established by the Department of Health Information Research (DHIR 2014). It recently made available individual datasets by cancer on its website. The table for pancreatic cancer includes the number of new cases, rates per 100,000 persons, number of deaths, and mortality rate by age, gender, and the year the cancer was registered (DHIR 2014). The Cancer Registry also calculated the overall pancreatic cancer crude incidence rate, as well as aged-standardised rates using the World Standard Population per 100,000 persons and the European Standard Population per 100,000 persons (DHIR 2014). As such, the statistics provided by the Registry can be used by EUCAN because the latter also uses the European Standard Population.
There are several major sources of data used by the National Cancer Registry. Clinical notification is provided by physicians in accordance with the law. Copies of autopsy, histology, and cytology reports are obtained from public and private pathology laboratories (DHIR 2014). The death certificates used are from the National Mortality Registry, and data on new referrals are given by oncologists. Provided that the surveillance system ensures accurate notification and reporting for all data available and accurate entries into the registry are made then the Cancer Registry is a reliable source for a status report.
National Mortality Registry – Malta
For mortality data only, a Maltese source is the National Mortality Registry also maintained by the DHIR. The Mortality Registry includes in its annual report the number of deaths attributed to pancreatic cancer in Malta and compares the death rate with other cancers and other causes of death (DHIR, 2012). Data is in bar chart, pie chart, and table form. The death rate is computed using the European Standard Population per 100,000 persons. As such, the Mortality Registry can countercheck its data with the Cancer Registry that also provides mortality statistics. Both registries get information on mortality from death certificates submitted to the Public Registry of Malta (DHIR, 2012). The death certificate includes the cause of death as well as age, gender, and residence information. The death certificate is a verified and official document that makes the Mortality Registry a trustworthy source of data.
European Core Health Indicators (ECHI)
The major modifiable risk factors for pancreatic cancer are smoking and alcohol consumption (Cancer Research UK 2014). The ECHI database within the European Commission website makes available country information on health determinants that includes the proportion of persons 15 years or over who report being regular smokers or those who smoke on a daily basis (European Commission 2010). Proportions are also available for men and women and for the subset of persons aged 15-24 years. Statistics are in a line graph presentation with data available for the years 2003 through 2011. However, the data is based on self-reports which may be subject to bias but self-report is the most efficient way to determine population-level smoking status per country.
In addition, the ECHI database has statistics on the total recorded plus unrecorded alcohol consumption per person aged 15 years or over in each member country yearly (European Commission 2010). Alcohol consumption is recorded as pure alcohol which means that beverages are converted into pure form based on the actual percentage of volume of the product. The line graph presents data from 2005 through 2012. Sales, tax, and other economic data from countries and from the WHO Global Information System on Alcohol and Health are analysed to come up with pure alcohol consumption figures. The methodology also includes calculating for non-taxed alcoholic beverages most of which are those produced locally. No data on the drinking patterns of the population is available albeit this also influences risk.
European Health for All Database
This database complements the ECHI on smoking statistics by providing country data on the number of cigarettes consumed by each smoker each year (World Health Organisation Regional Office for Europe 2014). The unit used is million pieces and the most recent data is for 2012. Moreover, the European Health for All Database has datasets for alcohol consumption by type of beverage, i.e. spirits, wine, and beer (World Health Organisation Regional Office for Europe 2014). Each type of drink corresponds to a typical percentage volume or the volume of alcohol contained in the beverage. Spirits have the greatest alcohol content compared with wine and beer as it takes greater amounts for the latter types of drinks to consume 10 grams of alcohol. The type of beverages consumed by the population helps inform public health awareness campaigns on preventing excessive alcohol consumption.
Incidence and Prevalence Data: Global Cancer Observatory versus National Cancer Registry
For purposes of a national status report on pancreatic cancer, the National Cancer Registry is a preferred source of incidence data because it is based on actual reports obtained through the existing surveillance system. The Global Cancer Observatory makes use of the Registry data second-hand. However, the National Cancer Registry does not provide data on prevalence in its published reports. For prevalence, then, the Global Cancer Observatory would be the source of choice.
European Cancer Observatory. 2012. European Cancer Observatory (online). Available at http://eu-cancer.iarc.fr/Default.aspx. (Accessed: 17 January 2015).
European Commission. 2010. European Community Health Indicators (online). Available at http://ec.europa.eu/health/indicators/indicators/index_en.htm. (Accessed: 17 January 2015).
Malvezzi, M., Bertuccio, P., Levi, F., La Vecchia, C., & Negri, E. (2014). European cancer mortality predictions for the year 2014. Annals of Oncology. 0. pp. 1-7.
World Health Organisation Regional Office for Europe. 2014. European Health for All Database (online). Available at http://data.euro.who.int/hfadb/. (Accessed: 17 January 2015).
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