Huge Postcode Lottery in Prostate Cancer Death Rate, Warn Experts

FOR IMMEDIATE RELEASE

POSTCODE LOTTERY BLIGHTS NHS PROSTATE CANCER SERVICES

New figures uncovered by the Prostate Cancer Charter for Action show modest improvements in prostate cancer treatment are being blighted by appalling inequalities in death rates across the country which have increased by 45% over the past year.

At least 96 of England’s 529 parliamentary constituencies have a death rate from prostate cancer more than 25% above the England average (25 deaths per 100,000 population) with men in Tottenham almost five times more likely to die of prostate cancer than men in South East Cambridgeshire.

The gap between the highest and lowest prostate cancer mortality rates in England was 31 per 100,000 population in 2006, but by 2007 (the latest year for which figures are available) the gap had increased to 45 per 100,000 population.

The figures come shortly after the publication of a report by the Prostate Cancer Charter for Action which found that areas of the country that failed to implement NICE’s crucial Improving Outcomes Guidance had a mortality rate 4% higher than in those areas that had.

In addition to the implementation of the Improving Outcomes Guidance, the Prostate Cancer Charter for Action is calling on the Government to ensure that:

 Fewer men are diagnosed with prostate cancer once it has already spread  More accurate information is made available to all patients  The provision of clinical nurse specialists is increased

Commenting on the new figures, Prostate Cancer Charter for Action spokesperson and consultant urologist Dr Frank Chinegwundoh said:

“It is not enough that prostate cancer services are improving as a whole, if patients face such a lottery in the care they receive. We need better services for all patients across the country, not just a lucky few.

“ The failure of the NHS to implement NICE’s Improving Outcomes Guidance is partly responsible for these widening inequalities. We look to the Government and the NHS to ensure that this crucial guidance is implemented in full, so that the care prostate cancer patients receive is no longer left to chance.”

David Smith, of the patient-led Prostate Cancer Support Federation, said of the figures:

“All men with prostate cancer should benefit from better services, yet these figures suggest that the inequalities in prostate cancer are getting worse.

“There can be no excuse for services in some areas of the country to be performing so much worse than in others. This situation cannot be allowed to continue.”

Snapshot of the worst performing constituencies1 Parliamentary constituency Age-standardised Percentage above deaths from (-below) England prostate cancer average per 100,000 population Tottenham 57 131% Leeds West 49 100% Bury North 49 98% Northampton North 45 82% Wallasey 44 77% West Bromwich West 42 69% South Shields 41 68% Liverpool, Riverside 41 67% Mid Sussex 41 67% Workington 40 62% Cleethorpes 39 58% Holborn and St. Pancras 39 58% Hayes and Harlington 38 56% Mansfield 38 55% Canterbury 38 55% Brent South 38 54% Mid Worcestershire 38 54% East Surrey 38 54% Heywood and Middleton 37 53% Reigate 37 52%

Snapshot of the best performing constituencies:

1See editors Notes for full list Parliamentary constituency Age- Percentage standardised above (-below) deaths from England average prostate cancer per 100,000 population South East Cambridgeshire 12 -49% Chesterfield 13 -45% Cheltenham 14 -44% Kingswood 14 -42% Braintree 14 -41% Kensington and Chelsea 15 -40% Weston-super-Mare 15 -40% Harrow West 15 -40% City of York 15 -39% Rochford and Southend East 15 -39% Chorley 15 -38% Wantage 15 -37% Bournemouth East 16 -36% Crawley 16 -36% Haltemprice and Howden 16 -35% Bosworth 16 -35% Preston 16 -34% Old Bexley and Sidcup 16 -34% Winchester 16 -34% Newcastle upon Tyne North 16 -34%

-ENDS-

For more information, please contact: Andrew Bentham T: 0203 128 8103 M: 07525225924 E: [email protected]

Notes to Editors

About the Prostate Cancer Charter for Action

1. The Prostate Cancer Charter for Action is a campaigning coalition of key voluntary sector and professional organisations committed to the fight against prostate cancer. We believe that we can achieve more by campaigning together for better research, awareness, care and treatment to improve the lives of men with prostate cancer and those who will develop the disease in the future. Visit our website at: www.prostatecharter.org.uk.

New figures on deaths from prostate cancer

2. New figures on deaths from prostate cancer, broken down by parliamentary constituency, were placed in the House of Commons library in response to a Parliamentary Question answered on 31 March 2009 (source: Hansard, 31 March 2009, Col. 1051W; available here: http://www.publications.parliament.uk/pa/cm200809/cmhansrd/cm090331/text/90331w0005.htm (full deposited table available)). Because some areas of the country will have relatively older populations than other areas, age- standardised death rates have been used to provide a direct comparison. The figures show that:

 Deaths from prostate cancer declined from 25.11 per 100,000 population in 2006 to 24.56 per 100,000 population in 2007 (the latest year for which figures are available) (a decline of 2.2%)

 The gap between the area with the lowest death rate in 2006 (Bournemouth East, with 12 deaths per 100,000 population) and the highest (Cheltenham, with 43 deaths per 100,000 population) was 31 per 100,000 population. By 2007, the gap between the area with the lowest death rate (South East Cambridgeshire, with 12 deaths per 100,000 population) and the highest (Tottenham, with 57 deaths per 100,000 population) had increased to 45 per 100,000 population – an increase in the gap of 14 per 100,000 population (45%)

The figures show large variations in the death rate between different parliamentary constituencies, as shown in the table below. The table shows that:

 As stated above, deaths from prostate cancer in the South East Cambridgeshire constituency stand at just 12 per 100,000 people: less than a quarter of the figure in Tottenham West, and 49% below the England average  At least 96 of England’s 529 (18%) parliamentary constituencies have a death rate from prostate cancer more than 25% above the England average  At least 50 of England’s parliamentary constituencies (9.5%) have a death from prostate cancer 25% below the England average

The figures are shown in the table below. The right-hand column illustrates the percentage difference between any specific area and the England average.

Parliamentary constituency Age- Percentage standardised above (-below) deaths from England average prostate cancer per 100,000 population South East Cambridgeshire 12 -49% Chesterfield 13 -45% Cheltenham 14 -44% Kingswood 14 -42% Braintree 14 -41% Kensington and Chelsea 15 -40% Weston-super-Mare 15 -40% Harrow West 15 -40% City of York 15 -39% Rochford and Southend East 15 -39% Chorley 15 -38% Wantage 15 -37% Bournemouth East 16 -36% Crawley 16 -36% Haltemprice and Howden 16 -35% Bosworth 16 -35% Preston 16 -34% Old Bexley and Sidcup 16 -34% Winchester 16 -34% Newcastle upon Tyne North 16 -34% Fylde 16 -34% North West Durham 16 -34% Derby North 16 -33% Beckenham 17 -32% Amber Valley 17 -32% Enfield, Southgate 17 -32% Eccles 17 -31% Mid Bedfordshire 17 -31% Vale of York 17 -30% North West Norfolk 17 -30% North Cornwall 17 -29% Ealing North 17 -29% North Shropshire 18 -29% West Derbyshire 18 -29% Calder Valley 18 -28% Keighley 18 -28% St. Ives 18 -28% Ribble Valley 18 -28% Oxford East 18 -28% Harwich 18 -27% Scunthorpe 18 -27% Burnley 18 -27% Sutton Coldfield 18 -27% Orpington 18 -27% Coventry South 18 -27% Westmorland and Lonsdale 18 -26% Richmond (Yorks) 18 -26% Harrow East 18 -26% Leicester East 18 -26% Cotswold 18 -26% Suffolk Coastal 18 -25% Spelthorne 18 -25% Dover 18 -25% Hertford and Stortford 19 -25% Northampton South 19 -25% West Worcestershire 19 -24% North Thanet 19 -24% Fareham 19 -24% Surrey Heath 19 -23% Bassetlaw 19 -23% Middlesbrough 19 -23% Salisbury 19 -23% Wyre Forest 19 -22% Milton Keynes South West 19 -22% Beaconsfield 19 -21% Feltham and Heston 19 -21% Brent North 19 -21% Cities of London and Westminster 19 -21% Leicester West 19 -21% Stone 19 -21% Kingston and Surbiton 19 -21% Bexhill and Battle 20 -21% Houghton and Washington East 20 -20% Ealing, Acton and Shepherd's Bush 20 -20% Brentford and Isleworth 20 -20% Barnsley East and Mexborough 20 -20% Penrith and The Border 20 -19% Somerton and Frome 20 -19% Skipton and Ripon 20 -19% Redditch 20 -19% Lancaster and Wyre 20 -19% Christchurch 20 -19% North East Milton Keynes 20 -18% Portsmouth North 20 -18% Bristol South 20 -18% Sevenoaks 20 -18% High Peak 20 -18% Ashton under Lyne 20 -18% Bridgwater 20 -18% Southend West 20 -18% Havant 20 -18% Stretford and Urmston 20 -18% Mole Valley 20 -17% North Warwickshire 20 -17% Slough 20 -17% Wythenshawe and Sale East 20 -17% Aldridge-Brownhills 20 -17% Hazel Grove 20 -17% Colne Valley 21 -16% Morecambe and Lunesdale 21 -16% Kingston upon Hull West and Hessle 21 -16% Rushcliffe 21 -16% Regent's Park and North Kensington 21 -16% Huntingdon 21 -16% East Hampshire 21 -16% Watford 21 -16% Gateshead East and Washington West 21 -16% Oxford West and Abingdon 21 -15% Stroud 21 -15% Easington 21 -15% East Devon 21 -15% Upminster 21 -15% Chichester 21 -14% Romsey 21 -14% Croydon South 21 -14% Hammersmith and Fulham 21 -14% Windsor 21 -14% Chingford and Woodford Green 21 -14% Stoke-on-Trent North 21 -14% Southampton, Itchen 21 -14% Brentwood and Ongar 21 -13% South Thanet 21 -13% Southampton, Test 21 -13% North East Hertfordshire 21 -13% Epsom and Ewell 22 -12% Birmingham, Hall Green 22 -12% Leeds East 22 -12% Bradford North 22 -12% Stockton South 22 -12% Bournemouth West 22 -12% Lincoln 22 -12% Tonbridge and Malling 22 -12% Plymouth, Sutton 22 -12% Elmet 22 -11% Sheffield, Attercliffe 22 -11% Kingston upon Hull North 22 -11% Maidenhead 22 -11% West Lancashire 22 -10% Stafford 22 -10% Hendon 22 -10% East Yorkshire 22 -10% South Swindon 22 -10% Ludlow 22 -10% Esher and Walton 22 -10% South Dorset 22 -9% St. Helens North 22 -9% Pudsey 22 -9% Richmond Park 22 -9% Carshalton and Wallington 22 -9% South Cambridgeshire 22 -9% Bristol North West 22 -9% Tatton 23 -8% Wycombe 23 -8% Maidstone and The Weald 23 -8% Rotherham 23 -8% Peterborough 23 -8% South East Cornwall 23 -8% Oldham West and Royton 23 -8% Ashfield 23 -8% Croydon Central 23 -8% North East Cambridgeshire 23 -7% Newbury 23 -7% Birmingham, Edgbaston 23 -7% Barnsley Central 23 -7% Eastleigh 23 -6% Makerfield 23 -6% Blyth Valley 23 -6% Bognor Regis and Littlehampton 23 -6% Coventry North West 23 -6% South West Hertfordshire 23 -6% Birmingham, Erdington 23 -6% Bolsover 23 -6% South West Norfolk 23 -6% Colchester 23 -6% Eltham 23 -6% Halifax 23 -6% Southport 23 -6% Dewsbury 23 -6% Blackburn 23 -6% Enfield North 23 -5% Leigh 23 -5% Oldham East and Saddleworth 23 -5% Ealing, Southall 23 -4% South Suffolk 24 -4% Sheffield, Hallam 24 -4% Jarrow 24 -4% Epping Forest 24 -4% Manchester, Blackley 24 -4% Wirral West 24 -4% Walsall South 24 -4% Leicester South 24 -4% Welwyn Hatfield 24 -3% Norwich North 24 -3% North Devon 24 -3% Warley 24 -3% Rother Valley 24 -3% Faversham and Mid Kent 24 -3% Westbury 24 -3% Darlington 24 -3% Ilford South 24 -3% North Tyneside 24 -3% Redcar 24 -2% Leeds North East 24 -2% Stockport 24 -2% Exeter 24 -2% Meriden 24 -2% Eddisbury 24 -2% South Ribble 24 -2% Barnsley West and Penistone 24 -2% Taunton 24 -2% Hertsmere 24 -2% Coventry North East 24 -1% South Holland and The Deepings 24 -1% Brighton, Kemptown 24 -1% Basingstoke 24 -1% Tynemouth 24 -1% Nuneaton 24 -1% Dagenham 24 -1% West Suffolk 24 -1% Woodspring 24 -1% Rayleigh 24 -1% Shipley 24 0% North Swindon 24 0% Thurrock 25 0% ENGLAND AVERAGE 25 0% Runnymede and Weybridge 25 0% Middlesbrough South and East Cleveland 25 0% Totnes 25 0% Burton 25 0% Nottingham North 25 0% Hemsworth 25 0% North Durham 25 0% Sunderland South 25 0% Cambridge 25 1% Blaby 25 1% Arundel and South Downs 25 1% Portsmouth South 25 1% Cannock Chase 25 1% Tiverton and Honiton 25 1% Gedling 25 1% Bedford 25 1% South West Surrey 25 1% Wolverhampton South East 25 2% Rutland and Melton 25 2% Stoke-on-Trent South 25 2% Liverpool, West Derby 25 2% New Forest East 25 2% Cheadle 25 2% Isle of Wight 25 2% Stourbridge 25 2% Teignbridge 25 2% Pendle 25 2% Lewes 25 2% Norwich South 25 2% Halesowen and Rowley Regis 25 2% Hemel Hempstead 25 2% Knowsley South 25 3% Birmingham, Yardley 25 3% Beverley and Holderness 25 3% Bradford South 25 3% Derby South 25 3% Hitchin and Harpenden 25 3% Birmingham, Hodge Hill 25 3% Doncaster Central 25 3% North Norfolk 25 3% Luton North 25 3% Chipping Barnet 25 4% Dudley North 25 4% Liverpool, Wavertree 25 4% Bromsgrove 25 4% Uxbridge 26 4% Vauxhall 26 4% Wirral South 26 5% South West Devon 26 5% Horsham 26 5% Hampstead and Highgate 26 5% Poole 26 5% Sutton and Cheam 26 5% Mid Dorset and North Poole 26 6% Shrewsbury and Atcham 26 6% Folkestone and Hythe 26 6% Banbury 26 6% Sheffield, Heeley 26 6% Birmingham, Perry Barr 26 6% Great Yarmouth 26 7% Tewkesbury 26 7% Blackpool North and Fleetwood 26 7% St. Albans 26 7% Waveney 26 7% South Staffordshire 26 7% Wealden 26 7% West Chelmsford 26 8% Yeovil 26 8% Aldershot 26 8% Denton and Reddish 27 8% Worcester 27 8% Rochdale 27 8% Ilford North 27 8% Romford 27 9% Basildon 27 9% West Dorset 27 9% Chesham and Amersham 27 9% Hornsey and Wood Green 27 10% Wansbeck 27 10% Warrington North 27 10% Truro and St. Austell 27 10% South West Bedfordshire 27 10% Boston and Skegness 27 10% Charnwood 27 10% Wellingborough 27 10% Torbay 27 11% Guildford 27 11% Billericay 27 11% Grantham and Stamford 27 11% Newcastle upon Tyne Central 27 11% Sleaford and North Hykeham 27 11% Finchley and Golders Green 27 11% Liverpool, Garston 27 11% Henley 27 12% Blackpool South 28 12% Erith and Thamesmead 28 12% North East Bedfordshire 28 12% Morley and Rothwell 28 13% Birmingham, Northfield 28 13% Lewisham East 28 13% Worsley 28 14% West Ham 28 14% Copeland 28 14% Dartford 28 14% Erewash 28 14% Kettering 28 15% Ellesmere Port and Neston 28 15% Halton 28 15% Newcastle-under-Lyme 28 15% Castle Point 28 15% Forest of Dean 28 16% Bromley and Chislehurst 28 16% Rossendale and Darwen 29 16% Eastbourne 29 17% Tunbridge Wells 29 17% Worthing West 29 17% Telford 29 17% Hove 29 17% Ryedale 29 17% City of Chester 29 17% Dudley South 29 17% Stalybridge and Hyde 29 18% Bury St. Edmunds 29 18% Rugby and Kenilworth 29 18% Salford 29 19% Staffordshire Moorlands 29 19% Leeds North West 29 19% Mid Norfolk 29 19% Walsall North 29 20% Falmouth and Camborne 29 20% Pontefract and Castleford 29 20% Hyndburn 30 20% Birmingham, Sparkbrook and Small Heath 30 21% Bexleyheath and Crayford 30 21% Broxtowe 30 21% Reading West 30 21% Medway 30 21% East Worthing and Shoreham 30 22% North West Leicestershire 30 22% Twickenham 30 22% Northavon 30 22% North West Cambridgeshire 30 22% Hartlepool 30 23% The Wrekin 30 23% Croydon North 30 23% Central Suffolk and North Ipswich 30 23% Bury South 30 23% Stratford-on-Avon 30 23% Weaver Vale 30 23% North East Hampshire 30 24% Doncaster North 30 24% Kingston upon Hull East 30 24% Loughborough 31 25% South Derbyshire 31 25% Scarborough and Whitby 31 25% Harlow 31 25% Blaydon 31 25% Sedgefield 31 26% North Dorset 31 27% Corby 31 27% Hereford 31 27% North West Hampshire 31 27% Bath 31 28% Gainsborough 31 28% Knowsley North and Sefton East 31 28% North East Derbyshire 31 28% Brighton, Pavilion 31 28% Witney 32 28% Gravesham 32 28% Aylesbury 32 28% North Wiltshire 32 29% Bishop Auckland 32 29% Warwick and Leamington 32 29% Sherwood 32 30% Harrogate and Knaresborough 32 30% Don Valley 32 30% Crewe and Nantwich 32 30% Lichfield 32 30% Plymouth, Devonport 32 30% North Essex 32 31% Stockton North 32 31% Putney 32 32% Louth and Horncastle 33 33% Harborough 33 33% Nottingham South 33 33% Reading East 33 33% Berwick-upon-Tweed 33 33% Carlisle 33 34% Ipswich 33 34% Leominster 33 34% Wansdyke 33 34% Sheffield, Hillsborough 33 35% Liverpool, Walton 33 35% South Norfolk 33 35% Dulwich and West Norwood 33 35% Wentworth 33 35% Woking 33 36% Birkenhead 33 36% Gloucester 34 36% Bootle 34 37% Ashford 34 37% Selby 34 37% Bracknell 34 38% Hastings and Rye 34 38% New Forest West 34 38% Wells 34 38% Wolverhampton South West 34 39% Torridge and West Devon 34 39% Bristol East 34 39% Crosby 34 40% Devizes 35 41% Gosport 35 41% Gillingham 35 41% East Ham 35 42% Brigg and Goole 35 42% Hornchurch 35 43% Congleton 35 43% Bristol West 35 43% Solihull 35 43% Daventry 35 44% Broxbourne 35 44% Hexham 35 44% Barking 35 44% Greenwich and Woolwich 36 46% Leeds Central 36 46% Bolton West 36 47% Saffron Walden 36 47% West Bromwich East 37 49% Newark 37 49% Wigan 37 49% Warrington South 37 50% Maldon and East Chelmsford 37 50% Sunderland North 37 50% Reigate 37 52% Heywood and Middleton 37 53% East Surrey 38 54% Mid Worcestershire 38 54% Brent South 38 54% Canterbury 38 55% Mansfield 38 55% Hayes and Harlington 38 56% Holborn and St. Pancras 39 58% Cleethorpes 39 58% Workington 40 62% Mid Sussex 41 67% Liverpool, Riverside 41 67% South Shields 41 68% West Bromwich West 42 69% Wallasey 44 77% Northampton North 45 82% Bury North 49 98% Leeds West 49 100% Tottenham 57 131%

N.B. the data provided by the Office for National Statistics excludes those parliamentary constituencies where fewer than 10 deaths from prostate cancer were recorded in 2007, in order to preserve patient confidentiality.

Further evidence of inequalities in prostate cancer care

3. Today’s figures are further evidence of inequalities of prostate cancer care. Other evidence includes:

 A National Audit Office report in 2005, which found that prostate cancer patients have a worse experience of their treatment compared to other cancers. Prostate cancer patients are more likely than other cancer patients to wait longer for their treatment, have their appointments cancelled, and receive less information than they would like about their condition; and are less likely than other cancer patients to have their treatment discussed, be given information about support groups, and have a named nurse in charge of their care (National Audit Office, Tackling cancer: improving the patient journey, 25 February 2005; available here: http://www.nao.org.uk/publications/nao_reports/04-05/0405288.pdf).

 A previous report by the Prostate Cancer Charter for Action in 2007, which found a threefold variation between different Cancer Networks in the provision of specialist nurses for urological cancers (Prostate Cancer Charter for Action, Because Men Matter: The Case for Clinical Nurse Specialists in Prostate Cancer, 19 November 2007; available here: http://www.prostatecharter.org.uk/lib/docs/because%20men%20matter%20-%20the%20case %20for%20clinical%20nurse%20specialists%20in%20prostate%20cancer.pdf. This audit is set to be repeated by the Prostate Cancer Charter for Action later in 2009.

 A Government audit in 2008, which found that seven of England’s 30 Cancer Networks were not on course to have implemented the National Institute for Health and Clinical Excellence’s Improving Outcomes Guidance on Urological Cancers by the December 2007 deadline (Hansard, 26 February 2008, Col. 1454W; available here: http://www.publications.parliament.uk/pa/cm200708/cmhansrd/cm080226/text/80226w0023.htm# 0802273001787). The importance of NICE’s Improving Outcomes Guidance

4. The NHS has had guidance stipulating how NHS prostate cancer services can eliminate inequalities since 2002. This guidance – called Improving Outcomes in Urological Cancers – sets out the optimal configuration of prostate cancer services, and the most effective technologies which could be used for treatment (NICE, Improving outcomes in urological cancers, 19 September 2002; available here: http://www.nice.org.uk/nicemedia/pdf/Urological_Manual.pdf).

The Government’s Cancer Reform Strategy made clear that this guidance should be implemented, “by the end of 2007”. (Department of Health, Cancer Reform Strategy, 3 December 2007; available here: http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_0 81006?IdcService=GET_FILE&dID=155603&Rendition=Web).

5. A report issued in November 2008 by the Prostate Cancer Charter for Action found that those areas of the country which had failed to implement Improving Outcomes in Urological Cancers in full had – on average – a mortality rate 4% higher than those which had implemented it. Those areas which had failed to implement the guidance in full were the following cancer network areas (Prostate Cancer Charter for Action, To what outcome?, 28 November 2008; available here: http://www.prostatecharter.org.uk/lib/docs/report_final.pdf):

 3 Counties  Anglia  Arden  Greater Manchester and Cheshire  Greater Midlands  Humber and Yorkshire Coast  Kent and Medway  Mount Vernon  Surrey, West Sussex and Hampshire,  Sussex  Thames Valley

The Countdown to Equality

6. In 2008, the Prostate Cancer Charter for Action launched its latest set of actions for Government – the Countdown to Equality – which aimed to:

 Reduce the number of men being diagnosed late with prostate cancer

 Improve the cancer experience of men with prostate cancer to the equal of other cancers

 Level up outcomes across the country so that all patients have an equally good chance of surviving prostate cancer and maintaining their quality of life

 Plan effectively to deliver world-class prostate cancer services in the future

In order to achieve this, the Prostate Cancer Charter for Action called on the Government to:

 Encourage earlier presentation, so that fewer men are diagnosed with prostate cancer that has spread. The Government must move faster on revising the Prostate Cancer Risk Management Programme and then ensuring that it is used appropriately

 Make accurate information available to all patients. The Government must ensure that patients have access to high quality information on all aspects of prostate cancer, including on the quality of NHS services available to them  Increase the provision of clinical nurse specialists. The Government must ensure that services act on the statements in the Cancer Reform Strategy, ending the inequalities in access to clinical nurse specialists

 Fully implement the Improving Outcomes Guidance. The Government must take steps to ensure that every prostate cancer service is compliant with the core minimum standards set out by NICE

The Countdown to Equality is available on the Prostate Cancer Charter for Action’s website, here: http://www.prostatecharter.org.uk/lib/docs/the%20new%20prostate%20cancer%20charter%20for %20action_designed_final.pdf.

The growing burden of prostate cancer

7. Prostate cancer is the most common cancer in men, and is responsible for 25% of newly diagnosed cancer cases (NHS Direct, Cancer of the prostate, 26 February 2008; available here: http://www.nhsdirect.nhs.uk/articles/article.aspx?articleId=82#). It is a major, and growing, disease:

 Each year, almost 30,000 men in England live with prostate cancer (28,886 new registrations in 2005), and this number is set to increase by 7,817 (27%) by 2021 (Hansard, 26 February 2008, Col. 1473W; available here: http://www.publications.parliament.uk/pa/cm200708/cmhansrd/cm080226/text/80226w0027.htm# 0802273001867)

 The hospital costs of treating prostate cancer are set to rise from £60.7 million in 2006 to £82.7 million in 2021 in real terms – an increase of £21.9 million (36%) (Department of Health, Analysis of the Department of Health's cancer reform strategy on projected cancer in-patient costs, broken down by gender and type of cancer, 14 January 2008; available here: http://www.parliament.uk/deposits/depositedpapers/2008/DEP2008-0095.xls).