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CANCER INCIDENCE IN NEW JERSEY BY COUNTY, 1996-2000. for the Comprehensive Cancer Control Plan County Needs Assessments August 2003 Prepared by: Cancer Surveillance Program Cancer Epidemiology Services New Jersey Department of Health & Senior Services.
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CANCER INCIDENCE IN NEW JERSEY BY COUNTY, 1996-2000 for the Comprehensive Cancer Control Plan County Needs Assessments August 2003 Prepared by: Cancer Surveillance Program Cancer Epidemiology Services New Jersey Department of Health & Senior Services
New Jersey State Cancer RegistryBackground • established by legislation – NJSA 26:2-104 et.seq. • a central cancer registry (i.e. population-based incidence registry) • all cases of cancer diagnosed October 1978 to the present (about 40,000 a year) • except cervical cancer in situ diagnosed after 1994 and certain skin carcinomas • hospitals, clinical laboratories, physicians, dentists must report cases • reporting agreements with New York, Delaware, Pennsylvania, Florida, Maryland, North Carolina
New Jersey State Cancer Registry Background (cont.) • includes identifiers, demographic characteristics, medical information, vital status for each case • cancer information is coded using the International Classification of Disease for Oncology (ICD-O), 2nd edition • follows data standards of the North American Association of Central Cancer Registries (NAACCR) • participates in CDC’s National Program of Cancer Registries and NCI’s Surveillance, Epidemiology, and End Results (SEER) program • an active member of NAACCR
New Jersey State Cancer RegistryData Quality • recipient of NAACCR’s Gold Standard (highest possible) for 1995 through 2000 data • Gold Standard is based on: • completeness of case ascertainment – > 95% • missing/unknown age at diagnosis, gender, county – each < 2% • missing/unknown race - < 3% • death certificate only cases - < 3% • duplicate cases - < 1 per 1000 • passing an edit program – > 99% correct • timeliness – data submitted within 24 months
New Jersey Cancer Incidence by County, 1996-2000 – Data Sources • data are from the May, 2003 analytic file • tabulations using SEER*Stat, a statistical software package distributed by NCI • 1996-1999 populations estimates from NCI • 2000 populations from U.S. Census Bureau Note: NJSCR follows the SEER multiple primary rules; thus a patient with cancer can be counted more than once if diagnosed with two or more primary cancers.
New Jersey Cancer Incidence by County, 1996-2000 – Hispanic Algorithm • used the NAACCR Hispanic Identification Algorithm (NHIA) • auguments the cases reported as Hispanic • based on: • birthplace • marital status • race • surname match to the 1990 U.S. Census Hispanic surname list
County Cancer Incidence Tables and Figures – General Information • includes the 7 cancers in the CCCP – breast, cervix, colorectal, lung & bronchus, melanoma, oral cavity & pharynx, prostate • include incidence rates and stage at diagnosis by race, ethnicity, and age group for: • men and women for colorectal, lung & bronchus, oral cavity & pharynx cancers and melanoma of the skin • women only for breast, cervical cancer • men only for prostate cancer • except stage at diagnosis is not included for lung & bronchus cancer
County Cancer Incidence Tables and Figures – General Information (cont.) • incidence rates were calculated for invasive cancers only • incidence rates are per 100,000 population and age-adjusted to the 2000 U.S. population standard • percents diagnosed by stage include invasive and in situ cases except for cervical cancer • for the percents diagnosed by stage the in situ and localized stages are combined except for breast cancer Note: invasive cancers are localized, regional, and metastatic stages; in situ cancers are not considered invasive
County Cancer Incidence Tables and Figures – General Information (cont.) • race categories are white, black, and all races (includes other than white and black races and unknown race) • ethnic category is Hispanic (non-Hispanic is not shown) • race and ethnicity are not mutually exclusive • age groups are 15-39, 40-49, 50-64, 65-74, 75 and over (the 0-14 age group was not included due to very small numbers statewide) • counts, and rates based on counts, fewer than 5 are suppressed due to unreliability
County Tables & GraphsCancer Incidence • use to determine opportunities for prevention activities (and screening activities for colorectal cancer) • within the county compare rates among the different gender, the different race and ethnic groups and the different age groups • compare the county rates to the New Jersey rates • be cautious with rates based on small numbers: • the number of people affected is small • the rates are not reliable Note: Corresponding incidence graphs for men and women are on the same scale.
County Tables & GraphsCancer Incidence by Race and Ethnicity • table includes incidence counts and rates for each year and 1996-2000 combined • separate table and graphs for each gender where applicable • table includes all races, whites, blacks, Hispanics for the county and New Jersey • first line graph shows annual incidence rates for whites and blacks in the county and New Jersey (if data for blacks is suppressed then all races is shown instead) • second line graph shows annual incidence rates for Hispanics in the county and New Jersey
County Tables & GraphsCancer Incidence by Age Group • separate table and graphs for each gender where applicable (New Jersey is shown separately) • table includes incidence counts and rates for each year and 1996-2000 combined • table includes five age-groups for the county • line graph shows annual incidence rates by age group
County Tables & GraphsStage at Diagnosis • use to determine screening needs – distant stage is the most important stage to note • within the county compare percent diagnosed at the distant stage among the different race and ethnic groups and the different age groups • compare the percent diagnosed at the distant stage in the county with New Jersey • be cautious with percents based on small numbers: • the number of people affected is small • the percents are not reliable
County Tables & GraphsStage at Diagnosis by Race and Ethnicity • separate table and charts for each gender where applicable (New Jersey is shown separately) • table includes the number and percent of cases diagnosed at each stage for 1996-2000 combined • table includes all races, whites, blacks, Hispanics for the county • pie charts show the percent diagnosed by stage for all races, whites, blacks, and Hispanics • the dark pie slice is the distant stage, the stage with the lowest survival rate Note: Read the pie chart clockwise.
County Tables & GraphsStage at Diagnosis by Age Group • separate tables and graphs for each gender where applicable (New Jersey is shown separately) • table includes the number and percent of cases diagnosed at each stage for 1996-2000 combined • table includes five age-groups for the county (New Jersey is shown separately) • pie charts show the percent diagnosed by stage for each age group • the dark pie slice is the distant stage, the stage with the lowest survival rate Note: Read the pie chart clockwise.
County Tables & GraphsComparison with Other Data Sources • Healthy New Jersey 2010: • this county data is more recent • age-adjusted rates computed using the 1970 U.S. population standard so cannot compare with these county data rates* • Cancer Control Planet: • this county data is more recent • Planet suppresses counts <16 • Planet does not include stage at diagnosis *Currently, the 2000 U.S. population standard is used nationwide.
County Tables & GraphsGroup Exercise • three groups (by color of your folder) • each group has one cancer type for one county • discuss the data (e.g. compare incidence and stage at diagnosis among the genders, races, ethnicity and with New Jersey) • agree upon two or three prevention/early detection activities and the target population(s) for each based on the data • if time enough, each group report its findings