Cancer - now the leading cause of death in the UK

Another interesting fact from the UK ONS 2010 mortality report is that Cancer has overtaken circulatory diseases to become the leading cause of death in the UK in both men (narrowly) and women.

Heart Disease falls to 2nd place

There is a sense in which this is understandable, many of the underlying biological pathways involved in hypertension which is a leading predictor and cause of heart disease are becoming well known. Widespread use of statins which reduce plasma cholesterol concentrations, in combination with ACE inhibitors or ARB drugs like Aliskiren (approved 2007 US) should hopefully massively impact those most at risk from severe cardiac events.

The interesting thing here, is that many of the problems such as atheroma and hyperplasia are accumulated problems, and hence the outcome benefits should pan out in the statistics in years to come.

Its also interesting that despite improvements drugs and in understanding the biology, and steps to provide automatic defibrillators in public spaces (@TODO), that the rate of survival of cardiac arrest outside of a hospital is very low, e.g. ~2-10% @todo, and that there is some data that suggests early de-fibrillation with AED and (@todo) continuously early CPR are associated with improved survival rates.

Aliskiren is an Angiotensin II Receptor inhibitor which blocks the final stage of the blood pressure increasing RAS-pathway and was approved by the FDA in 2007, however a brief googling suggests that currently UK trusts are not recommending its use e.g. (Aliskiren (Rasilez® ) is not recommended for use within NHS Wales for the treatment of essential hypertension. [1]) on a cost-performance basis, but it is hopeful that cheaper and similar ARB drugs will be approved that will provide another line of attack against hypertension.

So there seems to be hope that there is even more scope for improvement here over the next 10 years.

Cancer now the number 1 killer of the English & Welsh

I've just spent the week reading articles about Cardiac arrest, hypertension and Heart attacks, and I don't have the same level of comically amateur misunderstanding on the cancer side. So I guess I will just warble and blather a bit and come back and update this section in a month or so when I have covered the cancer topic in S807. @TODO

I suspect that given the absolutely brutal falls in the mortality of heart disease (40 and 38 per cent respectively for men and women) it makes the improvement in cancer mortality look rather tame (15 and 12 per cent). (@todo compare to US, or other eu peer?)

So if you are one of those 15 or 12 percent, then just be pleased about it, and go about your business. However for the others if you were not dead, you might be annoyed to read this statement from the Department of Health regarding the state of Cancer Medicine in the UK;
We also know that, in the outcomes of cancer care, we are failing to achieve our aim. Our record is one of delivering health outcomes which fail to match those achieved by the best-performing countries, or even average-performing countries. 
Although significant improvements have been made in recent decades – and we welcome the work of all those involved in driving these improvements – outcomes for patients in England continue to lag behind those in countries of comparable wealth. The National Audit Office reported recently that almost one in four cancers are detected only when a patient is admitted to hospital as an emergency
Our survival rates for cervical, colorectal and breast cancer are amongst the worst in the Organisation for Economic Co-operation and Development (OECD)
Higher morbidity and mortality in disadvantaged groups and areas are a key driver of our poor average outcomes.
("Improving outcomes: a strategy for cancer", Department of Health, 12 January 2011)

ONS Population estimates Quinary Age groups for UK Consituent countries

ONS Annual Mortality Report 2010

[1] Aliskiren not recommended by NHS Wales for the treatment of essential hypertension.

(charts nicked from the UK report of mortality 2010-uk government office of statistics)

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