Transcript Overview of Incidence Data at the Virginia Cancer Registry

Overview of Incidence Data at the
Virginia Cancer Registry
2000-2004
Carolyn Halbert M.A.,.M.P.H.
Statistical Analysis Coordinator
Virginia Cancer Registry
October 3, 2007
Oh No, Not Data!
Data is not as scary as you may think and can do so
much to help get your job done!
Components of the Surveillance
System
Clinics, free
standing centers
Hospitals
Laboratories
Public health
authorities
Physicians
Central Registry
Fed. Surveillance Pgm.
(CDC NPCR)
Local, Regional, State,
& National Partners
(PH, NAACCR, ACS)
Data Requests
Institutional Review Board Requests
Media requests
Academic
Industry
Not for profit
You!
What can data do for you?
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Strategic planning
-are there enough radiology cases to justify a
new radiologist
Grants?
Certificates of Need ?
Data Caution Statement
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conservative account of the disease in Virginia.
out-of-state data lag time
Underreporting
 rates may be higher in more urbanized areas where
case ascertainment is more complete.
 case reporting may be more complete for certain
racial groups, cancer sites, or diagnosis stages.
Our goal is to be able to provide you with valid and
reliable data with which to understand cancer in
Virginia and to make informed policy decisions.
Suppression Issues
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Rival hospital data
Counts under 11 for geographic areas smaller than the
state
Counts under 6 for state level data
Rates based on counts <15
Rates are per 100,000 and age-adjusted to the 2000
U.S.Census (Industry standard)
Counts vs. Rates
What is the difference
Burden of care-use counts
Use rates for comparisons across
areas but rates can sometimes be
misleading
Now let’s look at the DATA
This is only a small sample of our data or
how we can look at data
Top 5 Cancers among Females in Virginia
(Count and Percent), 2000 – 2004
Breast
23,907
32.6%
Lung & Bronchus
9,760
13.3%
Colon & Rectum
8,496
11.6%
Corpus & Uterus, NOS
4,102
5.6%
Non-Hodgkin Lymphoma
2558
3.5%
Top 5 Cancers among Males in Virginia
(Count and Percent), 2000 – 2004
Prostate
24,443
30.9%
Lung & Bronchus
12,763
16.1%
Colon & Rectum
8,496
10.9%
Urinary Bladder
4,646
5.9%
Melanoma
3305
4.2%
Cancer Site by Gender
Incidence Rates of Selected Cancers by Gender
2000-2004
Virginia Cancer Registry September 2007
Incidence Rates of Selected Cancers by Gender
2000-2004
Virginia Cancer Registry September 2007
Melanoma of
the Skin Male
80
Melanoma of
the Skin
Female
Lung and
Bronchus
Male
Lung and
Bronchus
Female
60
40
20
0
cy2000
cy2001
cy2002
cy2003
cy2004
Rates per 100,000
Rates per 100,000
100
Colon and
Rectum Male
600.0
500.0
Colon and
Rectum
Female
400.0
300.0
All Sites Male
200.0
100.0
All Sites
Female
0.0
cy2000
cy2001
cy2002
Rates are per 100,000 Age Adjusted to 2000 US Census (19 year age group) standard
cy2003
cy2004
Pediatric Cancers By Gender
All Sites Pediatric Cancers 2000-2004
Virginia Cancer Registry September 2007
Rates per 100,000
15.5
15.0
15.0
14.3
14.5
14.0
13.5
13.5
13.0
12.5
0-19
0-19
0-19
Male
Fem ale
Male & Fem ale
Rates are per 100,000 Age Adjusted to 2000 US Census (19 year age group) standard
Pediatric Cancers by Top Sites and
Gender
Top Pediatric Cancers in Virginia 2000-2004
Virginia Cancer Registry September 2007
4
3.7
3.6
3.5
Rates per 100,000
4
3
2.6
2.4
2.2
3
Leukem ia
2
1.4
2
Brain & CNS
1.0
1
0.5
0.5
0.7
0.6
1
0
0-19
0-19
0-19
Male
Fem ale
Male & Fem ale
Rates are per 100,000 Age Adjusted to 2000 US Census (19 year age group) standard
Hodgkin
Lym phom a
NonHodgkin
Lym phom a
Kidney
Health Regions: A Closer Look
Rate per 100,000
Incidence Rates All Cancers 2004 by Health Regions
Virginia Cancer Registry September 2007
500
428.8
379.7
400
477.9
428.8
470.1
428.1
300
200
100
0
N
er
tr h
o
n
w
th
u
o
S
t
es
n
Ea
er
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C
l
ra
t
en
in
irg
V
ia
N
al
n
io
at
Rates are per 100,000 Age Adjusted to 2000 US Census (19 year age group) standard
Ries LAG, Melbert D, Krapcho M, Mariotto A, Miller BA, Feuer EJ, Clegg L, Horner MJ, Howlader N, Eisner
MP, Reichman M, Edwards BK (eds). SEER Cancer Statistics Review, 1975-2004, NCI Bethesda, MD,
http://seer.cancer.gov/csr/1975_2004/, based on November 2006 SEER data submission, posted to the
SEER web site, 2007.
Drilling Down a Bit More
Who Gets Prostate Cancer?
Age Adjusted Incidence Rates by Race-Prostate
Virginia Cancer Registry September 2007
Rates per 100,000
300
250
237.3
253.5
244.2
231.8
212.2
200
150
149.6
153.8
Male White
144.1
136.5
124.7
100
50
0
2000
2001
2002
2003
2004
Rates are per 100,000 Age Adjusted to 2000 US Census (19 year age group) standard
Male Black
Who Gets Breast Cancer?
Rates per 100,000
Age Adjusted Incidence Rates
by Race-Female Breast
Virginia Cancer Registry September 2007
150
Female White
100
Female Black
50
Female Other
0
2000
2001
2002
2003
2004
Rates are per 100,000 Age Adjusted to 2000 US Census (19 year age group) standard. Other includes Asian,
Pacific Islander, American Indian, Alaskan Native, other and unknown
Who gets Lung Cancer?
Rates per 100,000
Age Adjusted Incidence Rates
by Race and Sex -Lung & Bronchus
Virginia Cancer Registry September 2007
120
100
80
60
40
2000
2001
20
2002
0
White Black
Other White Black Other White
Male & fem ale
Male
Black Other
Fem ale
Rates are per 100,000 Age Adjusted to 2000 US Census (19 year age group)
standard. Other includes Asian, Pacific Islander, American Indian, Alaskan
Native, other and unknown
2003
2004
Who Gets Colon Cancer?
Rates per 100,000
Age Adjusted Incidence Rates
by Race & Sex- Colorectal
Virginia Cancer Registry September 2007
80
60
2000
40
2001
20
2002
0
2003
White Black Other White Black Other White Black Other
Male & fem ale
Male
Fem ale
Rates are per 100,000 Age Adjusted to 2000 US Census (19 year age group) standard. Other includes Asian,
Pacific Islander, American Indian, Alaskan Native, other and unknown
2004
Rate (per 100,000)
Cancer Incidence Rates by Age by
Selected Site, VA, 2000-2004
2500
Breast (Female)
2000
Prostate (Male)
1500
Lung &
Bronchus
Colon & Rectum
1000
500
All Sites
0
0-19 2029
3039
4049
5059
6069
7079
Age at diagnosis (in years)
80+
Rate (per 100,000)
Stage at Diagnosis by Race,
All Sites 2000-2004
220
200
180
160
140
120
100
80
60
40
20
0
All races
186.2
182.8
177.3
White
Black
103.4
94 92.8
96.8
84.982.3
87.4
71.1
63.3
Localized
Regional
Distant
Unstaged
Age-Specific Cancer Mortality Rates
Selected sites VA, 2000-2004
2000
1800
All sites
Rate per 100,000)
1600
Breast
1400
1200
Colon
1000
Lung
800
Prostate
600
400
200
0
<5
5-14 15-24 25-34 35-44 45-54 55-64 65-74 75-84 85+
Age at Death (in years)
Source: VDH Division of Health Statistics
Now let’s look over the years
Trends : All Sites
Rates per 100,000
Age Adjusted Cancer Incidence Rates
All Sites by Race 1995-2004
Virginia Cancer Registry June 2007
700
600
500
400
300
200
100
0
White
Black
Other**
Total
1995 1996 1997 1998 1999 2000 2001 2002 2003 2004
Rates are per 100,000 Age Adjusted to 2000 US Census (19 year age group) standard. Other includes Asian, Pacific Islander, American
Indian, Alaskan Native, other and unknown
Trends : Breast and Cervical
Breast and Cervical Cancer Incidence Rates
Commonwealth of Virginia
1995-2004
Rate per 100,000
150
100
128.4 128
113.5 119.5 121.5
128.2
119.8 122.1 118.3 121.6
Cervix
Uteri
50
0
Breast
9.3
10.1
9.1
8.4
9
7.6
7.7
7.3
6.4
6.3
1995 1996 1997 1998 1999 2000 2001 2002 2003 2004
Year
Rates are per 100,000 Age Adjusted to 2000 US Census (19 year age group) standard
Trends: Colon & Rectum
80
Wh male
60
Wh female
40
Bk male
20
04
20
03
20
02
20
01
20
00
Tot female
19
99
Tot male
19
98
0
19
97
Bk female
19
96
20
19
95
Rates per 100,000
Age Adjusted Cancer Incidence Rates
by Gender & Race-Colon
Virginia Cancer Registry June 2007
Rates are per 100,000 Age Adjusted to 2000 US Census (19 year age group) standard
Trends: Melanoma
30
25
20
15
10
5
0
Wh Male
Wh Female
Wh Total
19
95
19
96
19
97
19
98
19
99
20
00
20
01
20
02
20
03
20
04
Rates per 100,000
Age Adjusted Cancer Incidence Rates
by Gender-Melanoma 1995-2004
Virginia Cancer Registry June 2007
Rates are per 100,000 Age Adjusted to 2000 US Census (19 year age group) standard
Data on the web
http://www.vahealth.org/cdpc/cancer/02
data.asp
We still have a long road ahead ..
Cancer Risk Factors
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Behavioral risk factors: tobacco use, physical
inactivity, overweight, diet and alcohol use, lack of
preventive screening
Other risk factors: environmental carcinogens,
occupational factors, family history, environmental
pollution, ultraviolet radiation, and socioeconomic
status have all been linked to cancer.
Viruses (HPV, Hepatitis)
Respondents to
Virginia Behavioral Risk Factor Surveillance System
(BRFSS)
2000-2002
25
24.6
22.5
21.4
20
15
10
19.1
14.4
13.3
10.8
5
0
Smoke
no pap
no
daily or
smear 3 mamogram
'some days' years
2 years
Centers for Disease Control and Prevention (CDC). Behavioral Risk Factor Surveillance System Survey Data.
Atlanta, Georgia: U.S. Department of Health and Human Services, Centers for Disease Control and
Prevention,
[
2000
2002
Data Analysis for Case
Ascertainment
Table 2: Sources of Data by Population*
# cases
% cases by region
Non-Appalachian Source MD Office
397
1.01%
Appalachian Source MD Office
102
2.65%
Non-Appalachian Source DCO
517
1.33%
92
2.39%
Appalachian Source DCO
Physician offices and DCO’s are greater sources of data in
Appalachia than in non- Appalachia by population percent
*Cancer Surveillance in Appalachian Virginia: Evaluating Data Quality and Enhancing Case Finding
Carolyn Halbert M.A., M.P.H., Jim Martin Ph.D., Virginia Cancer Registry
Virginia Department of Health Poster Presentation NAACCR 2007
Final Thoughts
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The data are truly useful to a variety of people.
The data are used to answer many kinds of questions:
scientific research, public health policy, and disease
surveillance.
Our results are only as good as your data. We value
working with you.
Almost at 3 years of certification
Data collection and use are improving and
growing…especially thanks to your efforts
Thank you Cancer Registrars!
Our Partners
Questions??
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[email protected]
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804 864 7861