Transcript Belgian Cancer Registry - Belgian Breast Meeting

Update on the Belgian Cancer Registry,
breast cancer data...
Belgian Breast Meeting 3-4/10/2008
Liesbet Van Eycken
Overview
• Introduction, history of the BCR
• Breast Cancer Incidence - Mortality
– Europe
– Belgium
– Flanders
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History cancer registration in Belgium
1955 Obligatory
health insurance
‘social disease’
1950
1960
1983
NKR-RNC
1970
1980
1994
AKR/LIKAR
1990
2003
“KB MOC - KB normen onco basiszorg en progr”
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2002
CIV
IACR
Flemish
Network
2000
2005: -STOP NCR
Belgian Cancer Registry
• Founded 1/7/2005
– Collaboration between physicians,
autorities and health insurances
• 12/2006: Health Law, art. 39:
‘Kankerregister- Registre du Cancer’
– Autorisation to use the national number
– Description of data transfer and pathways
• Clinical pathway (moc – non moc)
• Pathology and Hematology pathway
• Cancer Plan March 2008
– All cancers MOC
– Data manager funding in the hospital
– ...
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Actual Data sources Belgian Cancer Registry
Hospitals: Oncol Care
MOC – non-MOC
Pathology labs
Haematology
Health Insurances
Belgian Cancer Registry
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CANCER IN EUROPE, 2006
• 3.191.600 new cancer cases
– 53% males
– 47% females
• 1.703.000 cancer deaths
– 56% males
– 44% females
Ferlay J et al, Ann Onc 2007, doi:10.1093/annonc/mdl498
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Cancer incidence and mortality, estimates 2006
EUROPE
• Incidence (n)
• Mortality (n)
– Total: 3.191.600
– Total: 1.703.000
–
–
–
–
–
–
–
–
Breast: 429.900
Colorectal: 412.900
Lung: 386.300
Prostate: 346.000
Lung: 334.800
Colorectal: 207.000
Breast: 131.900
Stomach: 118.200
Ferlay J et al, Ann Onc 2007, doi:10.1093/annonc/mdl498
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2004, Breast Cancer, Belgium: 9.406 new cases
Borstkanker in België, 2004
Absolute aantallen
Aantallen / 100.000
500,0
1400
450,0
1200
400,0
1000
350,0
300,0
800
250,0
600
200,0
150,0
400
100,0
200
50,0
0
0,0
00-
05-
10-
15-
20-
25-
30-
35-
40-
45-
50-
55-
60-
Leeftijdscategorie
Absolute aantallen
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Aantallen / 100.000
65-
70-
75-
80-
85+
Breast Cancer, 2004
Belgium
9.406
Flemish Region
5.374
57%
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Walloon region
3.101
33%
Brussels region
931
10%
Breast Cancer, Age standardised incidence, 2004
Wallonië
breast
Brussel
Vlaanderen
0
20
40
60
80
100
ESR (n/100,000)
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120
140
160
180
Breast cancer, 2004, Age specific incidence
700,0
600,0
n/100,000
500,0
400,0
Flemish Region
Walloon Region
Brussels Region
300,0
200,0
100,0
0,0
00- 05- 10- 15- 20- 25- 30- 35- 40- 45- 50- 55- 60- 65- 70- 75- 80- 85+
age
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Reasons?
• Methodology?
– Check (Wall-Bxl)
• Administrative procedures?
• Prevalent cases?
• Result check: >3.000 cases: change of 2,2% !
•
•
•
•
Influence screening programs (timing)?
Risk factors?
Next years?
...
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Breast Cancer: evolution of age stand. incidence rates
Flemish Region
Flanders: evolution of age standardised incidence rates (3 age categories)
450
400
ESR (Aantallen / 100.000)
350
300
250
200
150
100
50
0
1997
1998
1999
2000
2001
2002
Jaar
0-49
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50-69
70+
alle leeftijden
2003
2004
2005
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Flemish Region, Breast Cancer:
evolution of incidence and mortality per age category
<50 y
50-69y
Borstkanker in Vlaanderen,
Leeftijdscategorie 0-49
Mortaliteit versus incidentie
ESR
(N/100.000)
ESR
(N/100.000)
70+
Borstkanker in Vlaanderen,
Leeftijdscategorie 50-69
Mortaliteit versus incidentie
ESR
(N/100.000)
450
450
450
400
400
400
350
350
350
300
300
300
250
250
250
200
200
200
150
150
150
100
100
100
50
50
50
0
0
2000
2001
2002
2003
2004
0
2000
2001
Jaar
Incidentie
Borstkanker in Vlaanderen,
Leeftijdscategorie 70+
Mortaliteit versus incidentie
2002
2003
2004
2000
2001
Jaar
Mortaliteit
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Incidentie
2002
2003
Jaar
Mortaliteit
Incidentie
Mortaliteit
2004
Breast cancer mortality, Flemish Region, 1994-2004
40-69 years: breast cancer is the most important cause of death
Direct Gestandaardiseerde sterfte door borstkanker. Vlaams Gewest.
Betrouwbaarheidsintervallen
gestandaardiseerd cijfer (1/100.000 inw.)
BG
50
ASR
48
OG
46
Linear
(ASR)
44
42
40
y = -0,7776x + 47,125
R2 = 0,7776
38
36
34
32
30
1994
1995
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1996
1997
1998
1999
2000
2001
2002
2003
2004
Flemish Region, breast cancer:
5y relative survival per stage
Borstkanker in Vlaanderen:
Relatieve overleving per stadium, 1997-2001
100%
90%
80%
70%
60%
50%
40%
30%
20%
10%
0%
0
12
24
36
48
Maand
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I
II
III
IV
X
60
Breast Cancer, all ages, flemish region: stage distribution
Breast Cancer, all ages: stage distribution, 1997-2005
100%
90%
ESR (Aantallen / 100.000)
80%
70%
60%
50%
40%
30%
20%
10%
0%
1997
1998
1999
2000
2001
2002
Jaar
IV
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III
II
I
2003
2004
2005
Breast Cancer, 50-69 years, flemish region: stage distribution
Breast cancer, 50-69 years: stage distribution, 1997-2005
100%
90%
ESR (Aantallen / 100.000)
80%
70%
60%
50%
40%
30%
20%
10%
0%
1997
1998
1999
2000
2001
2002
Jaar
IV
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III
II
I
2003
2004
2005
Europe: 5-year relative survival, 1995-1999
Eurocare-4
F. Berrino
et al. 2007
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Europe, breast cancer: 5-year relative survival, 1995-1999
Eurocare-4
F. Berrino
et al. 2007
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5 year relative survival, all cancers, 1995-1999
TNEH
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Conclusion
• Breast Cancer
– High incidence in Belgium
– Differences in incidence in the Belgian regions
• Further investigations!
• TNM evolution?
– Mortality decreasing over time
– Survival data comparable with the European results
• Up to a cancer registry for Belgium with useful
data for health care workers, autorities, research,
etc...
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Thank you! And...
Thank you Cancer Registry team!
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