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Cancer Surveillance in Shanghai

Cancer Surveillance in Shanghai. Ying Zheng, MD, MS Shanghai Cancer Registry Shanghai Municipal Center for Disease Prevention and Control NAACCR Annual Meeting Denver, Colorado, June, 2008. General Information of the Cancer Registries in Mainland of China.

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Cancer Surveillance in Shanghai

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  1. Cancer Surveillance in Shanghai Ying Zheng, MD, MS Shanghai Cancer Registry Shanghai Municipal Center for Disease Prevention and Control NAACCR Annual Meeting Denver, Colorado, June, 2008

  2. General Information of the Cancer Registries in Mainland of China • First Cancer Registry in China was established at Linxian county in Henan province in 1959. • The Linxian County had one of the highest incidence rate of esophageal cancer in the world. • “Hard of swallowing disease” had been an endemic disease for generations in the Linxian county.

  3. Cancer Registries in China in Recent 20 Years Data source: The National Office for Cancer Prevention, Control and Research of China (NOCPCR)

  4. Mainland China 48 Cancer registries Covered 20 provinces 75.27Million (5.96%) 129,300Km2 (1.38%) 27 registries affiliate with hospitals or Institutes 21 in CDC Data source: NOCPCR

  5. 19 20 18 16 14 12 12 Registry 10 8 6 6 4 4 2 0 ICD-9 ICD-10 ICD-O-2 ICD-O-3 New Cases Coding in 2003 in Mainland China Data source: NOCPCR

  6. Percentage of Microscopically Verified Cases in Mainland China, 2003 Data source: NOCPCR

  7. Cancer Registry Data of Mainland China • Low population coverage • Quality of data unbalanced and unstable > Lack of quality control - Missing Reports - Inaccurate discharge diagnoses > Lack of stable financial support > Lack of technical support > Lack of training • Data interpretation and further mining

  8. Some Facts about Shanghai (2005) • Area: 6340.5 square kilometers • Administrative divisions: 18 districts and 1 county • Population : 13.60 million 50.25% Male, 49.75% Female • Age over 60: 19.58% Data source: Shanghai Municipal Statistics Bureau

  9. Three Leading Causes of Death in Shanghai Others Cardiovascular & Cerebrovascular 24% disease 34% Respiratory disease 11% Cancer 31%

  10. Cancer Registry in Shanghai - History • 1960’s > Established by Shanghai Municipal Health Bureau through the Cancer Registry Amendment Act > Cancer Reporting Procedure in Shanghai was issued > Date collection system only covered the 9 urban districts > Supported by research funds

  11. Cancer Registry in Shanghai - History • 1980’s > Establish network • > Budget from the government • 2001.12 • > Shanghai Cancer Registry was expanded to cover • all administrative divisions (18 districts and 1 county) • > Budget: $400,000/year

  12. Cancer Registry Network Report 175 Hospitals 19 District CDC Municipal CDC Data Input Check Coding Death Certificate check Administration Technical support Case consolidation 207 Community Health Service Center Home care Regular follow-up

  13. Information System for Cancer Registry and Patient Follow-up • Cancer registry database: over 360,000 cases recorded • Patient follow-up > All patient are active followed until death > Active follow-up: home visit or telephone visit at least once a year > The first visit happens within 1-2 months after diagnosed normally

  14. Cancer Registry in Shanghai - Quality Assurance • Registration guidelines (IACR) • Registrar training: • - Disease classification (ICD-10, ICD-0-2) • - Cancer related terminology • - Cancer diagnosis and treatment • - Computer and network skill • - Epidemiology and statistics • Quality control audit

  15. Cancer Registry in Shanghai – Data Application • Annual report and a recent 30 year report • Reports, educational materials • CI5 • Urban area, about 6.5 M

  16. Cancer Registries of China in CI5

  17. Cancer Registry in Shanghai – Data Application Cancer epidemiology researches • Case control studies on lung cancer, breast cancer, endometrial cancer for the urban Chinese women. • The Shanghai Breast Cancer Study > 1500 pairs of cases and controls > 5000 breast cancer cases cohort since 2002 • Provide cancer information for other studies > The Shanghai Women’s Health Study > The Shanghai Men’s Health Study

  18. 2005 Shanghai Cancer Incidence, Male 1 Rate are per 100,000 and adjusted using World population standard. 2 US rates are for 2000-2004.

  19. 2005 Shanghai Cancer Incidence, Female 1 Rate are per 100,000 and adjusted using World population standard. 2 US rates are for 2000-2004.

  20. 2005 Shanghai Cancer Mortality, Male 1 Rate are per 100,000 and adjusted using World population standard. 2 US rates are for 2000-2004.

  21. 2005 Shanghai Cancer Mortality, Female 1 Rate are per 100,000 and adjusted using World population standard. 2 US rates are for 2000-2004.

  22. Age-adjusted (Word Standard) Cancer Incidence Rates by Gender, Shanghai Urban,1973-2005

  23. Age-adjusted (Word Standard) Cancer Incidence Rates of Selected Cancers, Shanghai Urban,1973-2005. Male

  24. Age-adjusted (Word Standard) Cancer Incidence Rates of Selected Cancers, Shanghai Urban,1973-2005. Male

  25. Age-adjusted (Word Standard) Cancer Incidence Rates of Selected Cancers, Shanghai Urban,1973-2005. Female

  26. Age-adjusted (Word Standard) Cancer Incidence Rates of Selected Cancers, Shanghai Urban,1973-2005. Female

  27. Shanghai Cancer Survivors • Prevalence, 2006-12-31 • Total 178, 813 (1.3%) • Male 79,288 (1.2%) • Female 99,525 (1.5%) • Home or telephone visit, 2006 • Total 153 465 in 209708 (73.2%)

  28. Anatomic Site Distribution of Cancer Survivors by Sex, Shanghai, 2006 All sites 79288 99525 Site Cases % Site Cases % Stomach 12488 15.75 Breast 29098 29.24 Lung 9182 11.58 Colon 8521 8.56 Colon 7842 9.89 Stomach 7352 7.39 Rectum 6303 7.95 Thyroid gland 6143 6.17 Bladder 5564 7.02 Rectum 5748 5.78 Prostate 4614 5.82 Lung 4642 4.66 Liver 3847 4.85 Corpus uteri 4597 4.62 Kidney 2960 3.73 Brain, CNS 4372 4.39 Brain, CNS 2833 3.57 Ovary 4073 4.09 Nasopharynx 2570 3.24 Cervix uteri 2861 2.87

  29. Contact me: Ying Zheng yzheng@scdc.sh.cn 86-21-62758710*1418 86-21-62087109

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