Why Yorkshire fares badly when it comes to early deaths from cancer

When it comes to the risk factors likely to lead to increased cancer rates, Yorkshire ticks an awful lot of the wrong boxes.

Pockets of severe social deprivation? Check. Post-industrial landscape? Yes. High rates of alcohol consumption and obesity? Again yes.

“Then you also have to take into account a good helping of old fashioned Yorkshire stoicism,” says Charles Rowett, chief executive of Yorkshire Cancer Research. “It’s that ‘I’ll run it off, work it off attitude’, which means vital symptoms are ignored and GP appointments are only made as a very last resort. Add it all together and it becomes easy to see why early deaths from cancer are higher in this region than elsewhere in the county.”

Latest figures show that between 2010 and 2012, 16,475 people across Yorkshire and the Humber died prematurely from cancer and out of the 13 local authorities - 11 ranked worse than the national average in terms of early death rate. According to Public Health England, if the county as a whole reflected the national average, it would mean 1,000 less deaths each year, but with each area of the region having its own anomalies addressing the issue is difficult.

In Hull, for example, men aged between 65 and 74-years-old are 34 per cent more likely to die from cancer than the national average, while the city’s women face an increased risk of 25 per cent. Then there’s York, which despite being relatively affluent has a higher proportion of over 75s dying from cancer compared to somewhere like Bradford where the figure is below average.

“We suspect that in places like Bradford people end up dying from strokes and heart disease before they can die from cancer, but there is definitely a piece of work to be done to build up a detailed picture of what’s happening out there,” says Charles, who is overseeing a major overhaul in the aims and ambitions of YCR. “We need to know why so many people in Hull are arriving at A&E presenting cancers at a late stage and why the rates of screening in North Yorkshire are lower than they should be.

“The truth is that since the recent NHS reforms services have become more fragmented. We are keen to join those dots and identify not only the problem areas, but the areas where our money can be most effectively spent.”

With a background in business - Charles began his career with Lyons Tetley and has had a succession of senior roles in finance and logistics - the idea is to target YCR’s investment pot into projects which directly address issues specific to the county.

Founded in 1924, historically the charity has funded academic research almost exclusively within the county’s universities and there have been some notable successes. Thanks in part to the three year funding he received from YCR back in the 1970s, Professor V Craig Jordan discovered that tamoxifen - a failed contraceptive drug - was effective in treating breast cancer. His work, which began at the University of Leeds, has been credited with saving thousands of lives and his isn’t the only YCR project of national and international importance.

Elsewhere, research teams have identified a ‘smart bomb’ that has the potential to destroy solid tumours and another project looking at bowel cancer surgery has shown removing more tissue could increase survival rates by 15 per cent - in Yorkshire alone that would mean 3,000 lives saved each year.

Academic research will remain an important part of YCR’s work, but it recognises that it can’t compete with the like of Cancer Research UK and its annual £300m budget and the impact of the Francis Crick Centre. Due to open in London next year, the national centre of excellence will lead the way in developing new ways to treat, diagnose and prevent illnesses like cancer.

The change in direction for YCR has coincided with two substantial legacies coming to fruition. In the next financial year the charity will have an extra £5m to invest and it is now inviting bids for funding across five areas, including understanding health inequalities, improving education, awareness and prevention of cancer, and enhancing screening and early diagnosis methods.

“Every week 554 people in Yorkshire will be told they have cancer and in the next 16 years that is likely to double,” says Charles. “As the population gets older, not only are more people going to get cancer, but more people are going to have to live with it. That’s not something we have any experience of as a society. The impact on the NHS is going to be enormous and anything we can do to both the reduce the risks of people getting cancer and improve the quality of life for those with the disease is vital.”

In the south east £26 is spent per head of population on cancer research, whereas in the north it’s £8. The figures are skewed by the geographical spread of the big clinical trial centres, but YCR admits that some of the projects it has funded have failed to make it beyond the first few years of research.

“There is a real danger that if no more money is forthcoming - and the competition for funding is fierce - that three years of hard work can end up being shelved. To me that doesn’t represent value for money for either the charity or the people of Yorkshire.

“We have done a lot of work in recent months meeting Clinical Commissioning Groups, which replaced the old PCTs, and other health organisations to let them know about our change in direction. It’s an exciting time, because these are people who work on the frontline and for the first time we are really looking to tap into their knowledge.”

The change has already been reflected in the board of trustees. Previously it was staffed entirely by academics, but now it’s more reflective of the society it hopes to serve and alongside the health professionals there’s a chartered accountant, the development manager of Northern Ballet and a couple of entrepreneurs.

While YCR is keen to come up with an investment programme which is tailor-made for Yorkshire, it says lessons could be learnt from Wales, which has a similar population and geography.

“Like Yorkshire, Wales has areas which were one home to heavy industry, big cities as well as large rural and coastal areas and it would be silly not to look at what is working well down there.

“Wales did have a problem in its rural areas with people not attending screening session because of lack of transport. It’s exactly the same in North Yorkshire. They have introduced a mobile screening programme so that the service goes direct to the people who need it most. Something like that has the potential to make a huge difference. Similarly we would like ideas on how to improve breast cancer screening rates among Muslim women, many of whom are uncomfortable with mammograms and therefore stay away.

“We know there are a thousand and one projects which could transform cancer treatment in Yorkshire and obviously we can’t fund them all, but this first wave of funding is about getting that ball rolling.”

YCR is already working closely with St Gemma’s Hospice in Leeds on palliative care and is keen to put in place an infrastructure to make it easier to take research to clinical trial.

“We know cancers patients are often keen to take part in clinical trials even if they know it won’t help them,” adds Charles. “Knowing that it might help others gives many people a sense of control over their situation and a feeling that they are doing something positive. This is a new chapter in the history of the charity, but also in the history of cancer treatment in Yorkshire.”