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New release of Ontario cancer incidence data: Update for APHEO

New release of Ontario cancer incidence data: Update for APHEO. Diane Nishri Staff Scientist, Prevention & Surveillance November 16, 2012. Outline. SEER*Stat Cancer registration in Ontario Ontario cancer incidence & mortality data What’s new for this release?

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New release of Ontario cancer incidence data: Update for APHEO

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  1. New release of Ontario cancer incidence data: Update for APHEO Diane Nishri Staff Scientist, Prevention & Surveillance November 16, 2012

  2. Outline • SEER*Stat • Cancer registration in Ontario • Ontario cancer incidence & mortality data • What’s new for this release? • Improvements/changes to incidence data & populations • Questions?

  3. SEER*Stat • Software created and maintained by the US National Cancer Institute • Produces statistics useful for studying the impact of cancer on a population. Sessions available are: • Frequencies • Rates • Survival & Limited-duration prevalence • Designed to work with SEER data, but adaptable to any cancer registry anywhere • CCO has been making Ontario cancer data available through SEER*Stat for over 10 years

  4. SEER*Stat • Current version: 7.1.0; previously distributed version was 6.6.2 • Most of the enhancements were for survival • A complete revision history is included in the readme.txt installation file • New variable: Lymphoma subtype recode

  5. The Ontario Cancer Registry • Cancer registration reliant on administrative records created by others: • CIHI Hospital data • Pathology reports • Regional cancer centre records • Death certificates • Computerized record linkage • Automated medical logic (“Case Resolution”) • Uses the International Classification of Diseases for Oncology (ICD-O), which has three editions to date

  6. What’s new for this release? • Incidence and mortality data now available for 2008 and 2009 • Ontario level data from 1981 • PHU, CD and LHIN level from 1986 • Improved assignment of ICD-O-3 morphologies to cases • Most important for lymphomas and leukemias • Update to case resolution logic has resulted in new cases

  7. Assignment of ICD-O-3 morphologies • Most morphologies have not changed across the three versions of ICD-O • In previous releases, the case morphologies were converted forward to ICD-O-3 • For this release, morphologies on sourcerecords were examined to try to determine the best morphology • Some codes from ICD-O-1 were reused in ICD-O-3

  8. Myelodysplastic syndromes & other disorders • Cancer registries were not required to collect data on these 12 diseases under ICD-O-2. • When ICD-O-3 coding began in the early 2000s, these cancers became reportable. However, the OCR’s logic continued to reject records with a morphology starting with 998. • The logic has finally been fixed. However, SEER*Stat automatically excludes these cases from routine analyses. To include them, you must uncheck the “Select only malignant behaviour” box on the Selection tab.

  9. Myelodysplastic syndromes & other disorders • Due to other data issues, these cancer are still under-registered • They are included under “Miscellaneous” in SEER Site Recode • Frequency of these cancers in the OCR, 2000-09

  10. Hodgkin lymphoma, Non-Hodgkin lymphoma and Leukemia • As a result of the improved histology assignment, leukemia incidence rates have increased since 2000 • Lymphoma incidence rates, both Hodgkin and non-Hodgkin, have decreased slightly • In general, hematopoietic morphologies have shifted to more specific codes • Work is still in progress to determine whether incidence trends by subgroups are now reliable

  11. Skin cancer • Basal and squamous cell carcinoma of the skin are not registered in Ontario • Melanoma of the skin is defined by topography (C44.n Skin) and morphology (8720-8790) • Melanoma can occur in other body sites, such as the eye • Other common non-epithelial skin cancers include dermatofibrosarcoma and Merkel cell carcinoma • Kaposi sarcoma commonly occurs in the skin, but is included in its own category based on morphology (9140)

  12. Population data • In July 2009, Statistics Canada changed its census undercount adjustment method, and the official provincial population counts back to 1971 were revised downwards • Stat Can only revised sub-provincial level population back to 1996 • This means that for 1986-1995, the rates differ slightly between the Ontario and PHU/CD/LHIN files due to the different populations

  13. Obtaining the new OCR data • Due to enhanced Privacy considerations, a new form is being finalized for requesting the new release of incidence & mortality data • New internal procedures for secure distribution of DVDs are also being worked out • Expected to be in place in 2-3 weeks • Beth Theis will post details on the APHEO LISTSERV as soon as everything is ready

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