Transcript (CRC) United States, 1998-2001

Descriptive Epidemiology and Burden of Colorectal Cancer (CRC)
United States, 1998-2001
J
*Missouri
*
Jackson-Thompson ,
RR
†
German ,
F
†
Ahmed ,
SM
±
Lai ,
Cancer Registry/University of Missouri; †Centers for Disease Control and Prevention (CDC) National Program of Cancer Registries; ±Kansas Cancer Registry/University of Kansas;
TABLE 1: Incidence Counts of Invasive Colorectal Cancer by
Registry, United States, 1998-2001, a
• Colorectal cancer (CRC) is one of the most common cancers
and biggest killers worldwide.
• The vast majority of CRC cases and deaths can be prevented
by applying existing knowledge about cancer prevention and
by using recommended screening tests.
8,986
Missouri
13,775
Alaska
858
Montana
2,033
Arizona
9,355
Nebraska
4,280
California
57,402
New Jersey
22,205
Colorado
6,751
New Mexico
2,834
8,896
New York
47,799
District of Columbia
1,375
North Carolina
15,484
• To describe the burden of CRC in the United States (U.S.).
Florida
45,942
Ohio
27,144
Metro Atlanta (Georgia)
3,912
Oklahoma
7,648
Methods:
Hawaii
2,682
Oregon
7,127
Idaho
2,181
Pennsylvania
36,399
Illinois
28,660
Rhode Island
2,957
Indiana
13,783
South Carolina
8,407
Iowa
8,568
Texas
33,128
Kansas
6,215
Utah
2,645
Kentucky
10,050
Vermont
1,395
Louisiana
9,803
Washington
11,290
Maine
3,422
West Virginia
5,133
Massachusetts
16,091
Wisconsin
13,120
Michigan
21,380
Wyoming
970
Minnesota
10,064
TOTAL
542,149
• We used SEER*Stat to analyze CRC data (n=542,149) from 39
states, D.C. and metro Atlanta, representing 88% of U.S.
population, that met high-quality data criteria for 1998-2001.
Invasive Colorectal Cancer for Females by Age and Race/Ethnicity
United States, 1998-2001,
a,b
a,b,c
45%
40%
35%
Connecticut
Purpose:
Comprehensive Cancer Control Branch
United States, 1998-2001,
_______________________________________________________________________________
Registry
Number
Registry
Number
_______________________________________________________________________________
Alabama
††CDC
Invasive Colorectal Cancer for Females by SEER Summary Stage and Race/Ethnicity
Percentage of Cases
Background:
30%
25%
20%
15%
10%
5%
0%
Localized
Regional
Distant
Unstaged
Summary Stage
White
Black
API
Hispanic
Invasive Colorectal Cancer for Males by SEER Summary Stage and Race/Ethnicity
United States, 1998-2001,
a,b,c
45%
600
Results:
40%
• Females are 87% white, 9.5% black and 2% Asian/Pacific Islander
API). Males are 88% white, 8% black, and 2% API.
400
35%
• Race and ethnicity are known for >99% of cases, subsite for 94% of
cases.
300
• For males, median age at diagnosis ranges from 66 (black) to 71 (white);
for females, range is 68 (API and Hispanic) to 75 (white).
200
• Most invasive CRC cases are staged; unstaged cases range from 6.7%
for API males to 11.6% for black females.
100
0
0-19
20-24
25-29
30-34
35-39
40-44
45-49
50-54
55-59
60-64
65-69
70-74
75-79
80-84
>85
Age
White
Black
API
Hispanic
• Diagnosis at localized stage is most likely for white and API males
(36%) and females (34%) and least likely for blacks (30% for each
gender).
30%
Percentage of Cases
500
Rate per 100,000 population
C
††
Friedman
25%
20%
15%
10%
5%
0%
Localized
Regional
Distant
Unstaged
Summary Stage
Invasive Colorectal Cancer for Males by Age and Race/Ethnicity
Table 2: Invasive Colorectal Cancer by Selected Features
United States, 1998–2001, a,b
United States, 1998-2001, a,b
600
___________________________________________________________________________________________________
Feature
Male
Female
Total
(n = 273,195)
( n = 268,954)
(n = 542,149)
___________________________________________________________________________________________________
Rate per 100,000 population
500
400
Overall
66.1 (100)
47.8 (100)
55.6 (100)
White
65.7 (88.1)
47.0 (87.1)
55.1 (87.6)
Black
70.1 (8.3)
53.7 (9.5)
60.2 (8.9)
Asian/Pacific Islander
48.1 (2.2)
35.3 (2.1)
40.9 (2.2)
Other
- (0.6)
- (0.5)
- (0.5)
Unknown
- (0.8)
- (0.8)
- (0.8)
Race
300
200
100
0
20-24
25-29
30-34
35-39
40-44
45-49
50-54
55-59
60-64
65-69
70-74
75-79
80-84
>85
Age
White
Black
API
Hispanic
Non-Hispanic
66.9 (94.8)
48.5 (95.3)
56.4 (95.0)
Hispanic
53.9 (5.2)
36.5 (4.7)
43.8 (4.9)
- (0.0)
- (0.0)
- (0.0)
Proximal colon
25.4 (37.5)
21.7 (46.0)
23.2 (41.8)
Distal colon
17.3 (26.5)
11.5 (23.7)
14.0 (25.1)
Colon, NOS
4.0 (5.8)
3.0 (6.4)
3.4 (6.1)
19.5 (30.2)
11.6 (23.9)
15.1 (27.1)
Unknown
Subsited
NOTE: This project was supported in part by a cooperative
agreement between the Centers for Disease Control and Prevention
(CDC) and the Missouri Department of Health and Senior Services
(DHSS) (#U55/CCU721904-05) and a Surveillance Contract
between DHSS and the University of Missouri.
Rectum
Black
API
Hispanic
Conclusion:
These findings provide valuable information for guiding cancer control
and prevention efforts related to reducing the burden of CRC
(http://www.cdc.gov/cancer/index.htm). Despite the size of the 1998-2001
dataset, the largest CRC dataset analyzed to date, incidence rates could
not be presented for AI/ANs. Rates for populations other than white
and black may be affected by problems in ascertaining race/ethnicity
from basic records (e.g., medical records, death certificates, etc).
Footnotes:
Ethnicity
0-19
White
a Data
are from population-based cancer registries that participate in the National
Program of Cancer Registries (NPCR) and/or the Surveillance, Epidemiology, and End Results (SEER)
Program and meet high quality data criteria (see Table 1 for list of registries). These registries cover
approximately 88% of the U.S. population.
b The data represent incidence rates (% distribution of cases) unless otherwise specified. Rates are per
100,000 persons and are age-adjusted to the 2000 U.S. standard population. Hispanic origin is not
mutually exclusive from race categories (white, black, Asian/Pacific Islander). Rates could not be
calculated for persons of other or unknown race/ethnicity.
c SEER Summary Stage (based on 257,519 male and 254,335 female cases; excludes data for California
outside of Los Angeles, San Francisco-Oakland, and San Jose-Monterey).
d Proximal colon: cecum to splenic flexure (C18.0-C18.5); Distal colon: descending and sigmoid colon
(C18.6-C18.7); Colon, NOS (C18.8-C18.9; C26.0); Rectum (C19.9; C20.9). International Classification
of Diseases for Oncology, 3rd Edition site codes. (Histology codes 9590-9989 excluded.)