Transcript Document

Cancer
Healthy Kansans 2010
Steering Committee Meeting
May 12, 2005
Description of the Problem
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Cancer will affect one of every three individuals
during their lifetime.
About 13,000 Kansans were diagnosed with cancer
last year.
Cancer accounts for approximately 22 percent of all
deaths in Kansas.
5,285 Kansans died of cancer in 2003.
Cancer is the second leading cause of death in our
state.
Minorities die of cancer at a greater rate than white
Kansans.
Kansas spends $1.6 billion annually on cancer. 2
Age-Adjusted Death Rate (Per 100,000 Population)
Age-Adjusted Cancer Death Rates By Site Among
Female Residents in Kansas (1998-2002)
45.0
40.9
40.0
37.8
37.8
40.0
37.7
35.0
30.0
28.3
26.4
Colorectal
Lung & Bronchus
Skin Melanoma
Breast
Cervix
26.4
25.4
25.0
22.2
17.6
20.0
17.6
16.9
16.0
15.3
15.0
10.0
5.0
2.3
2.1
1.8
2.3
2.0
3.0
2.8
1.5
2.4
0.0
1998
1999
2000
2001
1.3
2002
Year
Rates are per 100,000 Female Population and age-adjusted to the 2000 U.S. Standard Population. Data
Source: Kansas Vital Statistics database, Center for
Health and Environmental Statistics, Kansas Department of Health & Environment.
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In 2002, age-adjusted cancer death rate (all sites) among females
in Kansas was 160.5/100,000 population, lower than that of the
US 163.1/100,000 population.1
Lung cancer is the leading cause of death among females as well
as males Kansans.2
1. US DHHS/CDC/NCHS, Compressed Mortality File compiled from 1999-2002 on CDC Wonder on-line Database; 2. Kansas Annual Summary of Vital Statistics
3 –
2003, Kansas Department of Health and Environment.
Age-Adjusted Cancer Death Rates By Site Among Male
Residents in Kansas (1998-2002)
Age-Adjusted Death Rate (Per
100,000 Population)
90.0
80.0
76.0
76.9
74.5
76.7
71.1
70.0
60.0
Colorectal
50.0
Lung & Bronchus
40.0
Prostate
31.2
28.5
27.2
30.0
28.6
28.0
24.8
23.5
20.0
23.1
10.0
4.5
4.2
3.4
4.3
2.9
1998
1999
2000
2001
2002
24.7
22.5
Skin Melanoma
0.0
Year
Rates are per 100,000 Male Population and age-adjusted to the 2000 U.S. Standard Population. Data Source: Kansas Vital Statistics database,
Center for Health and Environmental Statistics, Kansas Department of Health & Environment.
In 2002, age-adjusted cancer death rate (all sites) among males in Kansas was
231.8 per 100,000 population, higher than that of female counterparts but lower
than that of the United Stated male residents (238.9 per 100,000).1
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Colon cancer is the third leading cause of death in men as well as in women in
Kansas. The same trend is observed in the United States.2
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1. US DHHS/CDC/NCHS, Compressed Mortality File compiled from 1999-2002 on CDC Wonder on-line Database; 2. Kansas
Annual Summary of Vital Statistics- 2003, Kansas Department of Health and Environment.
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Age-Adjusted Mortality Rates of Cancer (All Sites)
Among White and Black Kansans, 1993-2003.
350
300
259.8
275.0
254.7
288.5
280.0
271.0
262.5
269.8
274.1
241.5
241.0
250
200
196.4
202.6
197.0
196.2
150
191.4
184.5
190.7
187.6
189.7
184.6
183.9
2002
2003
100
Whites
African-Americans
50
0
1993
1994
1995
1996
1997
1998
1999
2000
2001
Year
Adjusted to 2000 US Population. Source: Kansas Information for Communities. Center for Health and Environmental Statistics, KDHE
 Similar
to national trend, African American Kansans have a higher
age-adjusted cancer death rate (all sites).
 In the United States, cancer deaths for men are highest in blacks,
followed by whites, Hispanics, and Asian/Pacific Islanders 1.
1. United Cancer Statistics: 2001 Incidence and Mortality, DHHS/CDC/NCI 2004
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Age-Adjusted Incidence Rate (Per 100,000
Population)
Age-Adjusted Invasive Cancer Incidence Rates By Primary
Site Among Female Residents in Kansas (1997-2002)
140
128.6
120
132.2
131.8
134.1
126.4
122.0
100
Colorectal
80
Lung & Bronchus
Breas t
Cervical
60
Skin Melanoma
45.8
40
20
0
47.7
45.0
42.2
42.1
46.3
45.7
45.3
44.5
44.4
40.7
11.3
12.5
12.2
13.5
13.5
9.0
7.6
9.4
9.0
9.1
1997
1998
1999
2000
2001
42.2
12.5
6.2
2002
Year
Rates are per 100,000 Female Population and age-adjusted to the 2000 U.S. Standard Population. Data Source: Kansas Cancer Registry
Invasive cancer age-adjusted incidence rate (all sites) among females in Kansas
was essentially stable during 1997 to 2002 (424/100,000 in 2001).1 This incidence
rate was higher than that of females in the United States (405/100,000 in 2001).2
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female Kansans, breast cancer was the most frequently diagnosed cancer
(126.4/100,000 in 2002), but represented the second leading cause of death.1
1. Kansas Cancer Registry Annual Reports, Cancer Incidence and Mortality in Kansas, 1997-2002. University of Kansas Medical Center;
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2. United Cancer Statistics: 2001 Incidence and Mortality, DHHS/CDC/NCI 2004
Age-Adjusted Incidence Rate (Per
100,000 Population)
Age-Adjusted Invasive Cancer Incidence Rates By Primary Site
Among Male Residents in Kansas (1997-2002)
180
164.0
160.2
163.8
161.9
154.3
160
151.0
140
120
Colorectal
100
82.3
81.5
Lung & bronchus
82.4
79.5
79.8
Pros tate
71.8
80
60
64.2
64.6
61.8
19.8
18.3
21.1
19.2
17.1
20.3
1997
1998
1999
2000
2001
2002
60.1
Skin Melanoma
62.5
54.4
40
20
0
Year
Rates are per 100,000 Male Population and age-adjusted to the 2000 U.S. Standard Population. Data Source: Kansas Cancer Registry
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Invasive cancer age-adjusted incidence rate (all sites) among males in Kansas
was also stable during 1997 to 2002 (449/100,000 in 2001).1 In 2001, this
incidence rate was lower than that of all males in the United States
(544.8/100,000).2
African American Kansans experience a higher age-adjusted incidence rate of
prostate cancer (221/ 100,000 male population) compared to White Kansans
(153/100,000 male population).2
1. Kansas Cancer Registry Annual Reports, Cancer Incidence and Mortality in Kansas, 1997-2002. University of Kansas Medical Center;
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2. United Cancer Statistics: 2001 Incidence and Mortality, DHHS/CDC/NCI 2004
Breast Cancer in Kansas
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The most frequently diagnosed cancer among women in
Kansas.
Second leading cause of cancer death among women.
Most common among women ages 65 to 74 years
White females are more often diagnosed with invasive
breast cancer than African-American women.
Women living in household with an income of $20,000
or less, women of Hispanic origin, and women living in
rural areas are at a higher risk for not having a
mammogram within the past 2 years. (KS BRFSS 20012002).
From 1997 to 2002, breast cancer has shown a slight
increase in incidence (from 122.0 to 126.4 cases per
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100,000 female population).
Cervical Cancer in Kansas
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Cervical cancer accounts for about 2% all
cancers.
From 1997 to 2001, 599 new cases of invasive
cervical cancer were diagnosed.
Death rates for cervical cancer is low due to early
detection and screening.
However, women of Hispanic origin are less
likely than others to report that they have
received a Pap smear within the past 2 years.
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Colorectal Cancer in Kansas
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Third leading cause of death among male and
female Kansans.
From 1997-2001, 7,466 Kansans were diagnosed
with colorectal cancer and 2,790 died.
During the same period higher incidence of the
disease was seen among Whites.
African Americans die of the disease at a higher
rate compared to Whites (30.5/100,000 vs. 19.8
cases per 100,000, age-adjusted).
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Lung Cancer in Kansas
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Lung cancer is the leading cause of cancer death
among both sexes.
From 1997-2001, 8,479 persons were diagnosed
with the disease and 7,401 individuals in Kansas
during that same period died from the disease.
The prognosis for lung cancer is poor; only 14%
of persons with the disease will be alive five
years after diagnosis. Therefore, prevention of
lung cancer is very important.
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Lung Cancer in Kansas - Cont’d
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Tobacco smoking is estimated to account for 87%
of all lung cancer cases and an additional 2% are
attributed to exposure to second hand smoke.
Therefore, tobacco use prevention and control is
very important to reduce lung cancer morbidity
and mortality.
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Prostate Cancer in Kansas
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Invasive prostate cancer is found mainly among
men age 50 or older.
From 1997-2001, about 9,500 persons were
diagnosed with the disease and about 300
individuals die of the disease yearly.
A decline has been seen in the incidence of
prostate cancer, from 164/100,000 male
population in 1997 to 151/100,000 in 2002.
African American men are at a higher risk of
dying of the disease than Whites.
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Skin Cancer in Kansas
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As many as 12,000 new cases of skin cancer are
diagnosed each year.
Data regarding skin cancer are limited. (some
cancers are not reported in registries).
From 1997 to 2001, 2,117 cases of invasive
melanoma were reported. During the same
period, nearly 400 persons died from the disease.
However, melanoma rates remained steady during
the same period (16/100,000 population, ageadjusted).
Young individuals are at high risk for developing
the disease.
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How Are We Addressing This Issue in
Kansas Now?
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Kansas Cancer Partnership
Early Detection Works
Cancer Registry
Patient Navigator Project
Outreach to Minority Groups
 4-Tribes Wellness Coalition Project.
 Heartland American Indian Cancer Coalition.
 Witnessing the Heartland Project among African
American women.
 American Indian Survey Project (BRFSS).
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How Are We Addressing This Issue in Kansas
Now? – Cont’d
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Kansas Cancer Partnership
 Goal: reduce the burden of cancer in Kansas.
 Focus: cancer issues across a continuum of care.
 First step: a comprehensive cancer control plan.
 Current activities: planning for implementation of
strategies recommended in the comprehensive cancer
plan.
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Cancer control has impact on most of the 10 leading
indicators as physical activity, overweight and obesity,
tobacco use, responsible sexual behavior, mental health,
environmental quality, and access to health care.
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Kansas’ Assets for Improving This Health
Issue
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The comprehensive cancer control plan.
Strong data systems and ability to expand
 Kansas Cancer Registry, BRFSS, Vital Statistics (mortality
data), Hospital Discharge data.
Access to cancer information via:
www.preventionworkskansas.com, Tobacco quit line: 1-866-KANSTOP.
Screening services through Early Detection Works (KDHE) and
Susan B. Komen Breast Cancer Foundation.
Local Health Departments: preventive services, support groups.
Numerous partnerships including: Kansas Medical Society, MidAmerica Healthcare Coalition, American College of Surgeons, KU
Med Center, K-State, ACS, Susan B. Komen, and others.
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Barriers or Liabilities That Are Limiting
Progress in Kansas
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Data gaps and linkage problems.
Lack of awareness among the public.
Lack of funding.
Unequal access to prevention and treatment
leading to disparities.
Quality of care needs attention.
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Barriers or Liabilities That Are Limiting
Progress in Kansas – Cont’d
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High prevalence of risk behaviors in the
population.
Incomplete, hard to find, difficult to understand
sources of cancer information.
Screening guidelines are not consistent across
different organizations (USPSTF, ASC, NCI,
etc.).
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Recommendations
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Need for more support, more backing, and more
assistance throughout the implementation process
of the comprehensive cancer control plan.
Strengthen existing partnerships and develop new
ones.
Strong coordination between health professionals/
organizations (clinical and public health), policy
makers and other partners to address cancer
issues in Kansas.
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Gary Doolittle, MD
Chair,
Kansas Cancer Partnership
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