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The National Program of Cancer Registries: Enhancing Cancer Incidence Data …

The National Program of Cancer Registries: Enhancing Cancer Incidence Data …. Hannah K. Weir, PhD Division of Cancer Prevention and Control Centers for Disease Control and Prevention. …with Vital Records Data for Cancer Control.

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The National Program of Cancer Registries: Enhancing Cancer Incidence Data …

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  1. The National Program of Cancer Registries: Enhancing Cancer Incidence Data … Hannah K. Weir, PhD Division of Cancer Prevention and Control Centers for Disease Control and Prevention

  2. …with Vital Records Data for Cancer Control Cancer Control: an approach to reducing cancer incidence, morbidity and mortality through prevention, early detection, treatment, rehabilitation and palliation.

  3. CDC’s Cancer Prevention and Control Programs

  4. Model for Cancer Control • Plan Interventions • Prevention • Screening • Treatment & rehabilitation • Palliative Care Measure & Evaluate Cancer Burden Act Implement Interventions

  5. The Cancer Continuum Diagnosis / Stage Death Survival Treatment & Rehabilitation Palliative Care Prevention Early Detection

  6. Cancer Control in Action • If Cancer Control Planners are the “hands” of CC • Plan and implement the interventions) • Vital Records and Cancer Registries are the “eyes” of CC • Measure and evaluate cancer burden

  7. SEER SEER/NPCR (2000+) AK HI Surveillance, Epidemiology, and End Results Program (SEER) • 1971 National Cancer Act • 1973+, 5 States, 4 Metro Areas, 10% population coverage • 1991 added 2 more Metro Areas, 14% population coverage • 2001, added 4 more states, • 26% population coverage

  8. National Program of Cancer Registries (NPCR) • 1992 Cancer Registries Amendment Act • 1995 – 1998 45 states, 3 territories, District of Columbia • 96% population coverage SEER NPCR NPCR/SEER AK HI

  9. What do the ‘eyes” see in the cancer continuum ?

  10. Vital Records - Cancer Deaths Death

  11. Cancer Registries - New Occurrences of Cancer Diagnosis Prevention

  12. United States Cancer Statistics • Combined NPCR and SEER incidence data Increase in population coverage 1999 .. 78% 2002 .. 93% 2000 .. 84% 2003 .. 96% 2001 .. 92% 2004 .. 98% • 100% cancer death data • State, regional, and national incidence and mortality data for whites, blacks, Asians/Pacific Islanders (A/PI), American Indian/Alaska Native (AI/AN), Hispanics, and children www.cdc.gov/cancer/npcr/

  13. United States Cancer Statistics: 2004 Census Region and Division ME NEW ENGLAND NY MIDDLE ATLANTIC PA Seattle-Puget Sound WA NORTHEAST MIDWEST ND MT OR MN PACIFIC WEST NORTH CENTRAL MI ID WI SD Detroit WY MOUNTAIN IA San Francisco-Oakland NE EAST NORTHCENTRAL NV OH UT San José-Monterey CA CO KS IN IL MO WV VA KY Los Angeles AZ NM NC TN OK WEST Atlanta AR SC MS AL SOUTH ATLANTIC EAST SOUTH CENTRAL WEST SOUTH CENTRAL Division GA LA TX State AK State contributing mortality data FL HI SOUTH State contributing incidence and mortality data

  14. Female Breast Cancer (Invasive)SEER Incidence and U.S. Death Rates Incidence Death *Rates are per 100,000 and are age-adjusted to the 2000 U.S. standard population. Source: SEER Cancer Statistics Review, 1975-2004

  15. The Cancer Continuum Diagnosis / Stage Early Detection

  16. Female Breast Cancer Cases Diagnosed at Early Stage 1985–1987 Percentageof Cases < 39.1 39.1–48.1 48.2–55.9 56 & over

  17. Female Breast Cancer Cases Diagnosed at Early Stage 1995–1997 Percentageof Cases < 39.1 39.1–48.1 48.2–55.9 56 & over

  18. Institute of Medicine Reports “ We all want to believe that when people get cancer, they will receive medical care of the highest quality. Even as new scientific breakthroughs are announced, though, many cancer patients may be getting the wrong care, too little care, or too much care, in the form of unnecessary procedures.” (IOM 1999) “NPCR …has great potential to facilitate national, population-based assessments of the quality of cancer care …” (IOM 2000)

  19. The Cancer Continuum Diagnosis Death Survival Treatment & Rehabilitation Palliative Care

  20. All Deaths Incident Cases Linkage between the Registries and State Vital Statistics Offices Cancer Registry Vital Statistics

  21. Deaths Incident Cases … to update vital status

  22. Blanket NPCR-NDI Application • 2006 – application approved to obtain vital status information on cancer patients who move our of state between the time of their diagnosis and their death

  23. Clinical Research vs. Public Health Clinical trials highest achievablesurvival Public health average survival achieved

  24. 100 90 80 70 60 Relative survival (%) 2000-01 50 1996-99 1991-95 40 1986-90 30 20 10 0 0 1 2 3 4 5 Years since diagnosis

  25. “cured” patients Relative Survival and Population “Cure” Mean survival of fatal cases

  26. Cure for more Colorectal Cancers, UK Source: M. Coleman

  27. The “Eyes” and “Hands” of Cancer Control Diagnosis Death Survival Treatment & Rehabilitation Palliative Care Prevention Early Detection

  28. Model for Cancer Control • Plan Interventions • Prevention • Screening • Treatment & rehabilitation • Palliative Care Measure & Evaluate Cancer Burden Incidence Stage at diagnosis Deaths Survival Act Implement Interventions

  29. Important Collaborations between Cancer Registries and Vital Records Hannah Weir HBW4@CDC.GOV (770) 488-3006

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