The national program of cancer registries enhancing cancer incidence data
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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

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

…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.


Cdc s cancer prevention and control programs

CDC’s Cancer Prevention and Control Programs


Model for cancer control

Model for Cancer Control

  • Plan Interventions

  • Prevention

  • Screening

  • Treatment & rehabilitation

  • Palliative Care

Measure &

Evaluate

Cancer Burden

Act

Implement Interventions


The cancer continuum

The Cancer Continuum

Diagnosis / Stage

Death

Survival

Treatment &

Rehabilitation

Palliative Care

Prevention

Early

Detection


The national program of cancer registries enhancing cancer incidence data

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


Surveillance epidemiology and end results program seer

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


National program of cancer registries npcr

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


What do the eyes see in the cancer continuum

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


Vital records cancer deaths

Vital Records - Cancer Deaths

Death


Cancer registries new occurrences of cancer

Cancer Registries - New Occurrences of Cancer

Diagnosis

Prevention


United states cancer statistics

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/


The national program of cancer registries enhancing cancer incidence data

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


Female breast cancer invasive seer incidence and u s death rates

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


The cancer continuum1

The Cancer Continuum

Diagnosis / Stage

Early

Detection


Female breast cancer cases diagnosed at early stage

Female Breast Cancer Cases Diagnosed at Early Stage

1985–1987

Percentageof Cases

< 39.1

39.1–48.1

48.2–55.9

56 & over


Female breast cancer cases diagnosed at early stage1

Female Breast Cancer Cases Diagnosed at Early Stage

1995–1997

Percentageof Cases

< 39.1

39.1–48.1

48.2–55.9

56 & over


Institute of medicine reports

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)


The cancer continuum2

The Cancer Continuum

Diagnosis

Death

Survival

Treatment &

Rehabilitation

Palliative Care


Linkage between the registries and state vital statistics offices

All

Deaths

Incident

Cases

Linkage between the Registries and State Vital Statistics Offices

Cancer Registry

Vital Statistics


To update vital status

Deaths

Incident

Cases

… to update vital status


Blanket npcr ndi application

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


Clinical research vs public health

Clinical Research vs. Public Health

Clinical trialshighest achievablesurvival

Public healthaverage survival achieved


The national program of cancer registries enhancing cancer incidence data

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


The national program of cancer registries enhancing cancer incidence data

“cured” patients

Relative Survival and Population “Cure”

Mean survival of fatal cases


Cure for more colorectal cancers uk

Cure for more Colorectal Cancers, UK

Source: M. Coleman


The eyes and hands of cancer control

The “Eyes” and “Hands” of Cancer Control

Diagnosis

Death

Survival

Treatment &

Rehabilitation

Palliative Care

Prevention

Early

Detection


Model for cancer control1

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


Important collaborations between cancer registries and vital records

Important Collaborations between Cancer Registries and Vital Records

Hannah Weir

[email protected]

(770) 488-3006


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