CANCER INCIDENCE IN NEW JERSEY BY COUNTY, 19962000

1
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
  

2
New Jersey State Cancer RegistryBackground

• established by legislation NJSA 262-104
  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

3
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 CDCs National Program of Cancer
  Registries and NCIs Surveillance, Epidemiology,
  and End Results (SEER) program
  
• an active member of NAACCR

4
New Jersey State Cancer RegistryData Quality

• recipient of NAACCRs 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
  
• missing/unknown race -
• death certificate only cases -
• duplicate cases -
• passing an edit program 99 correct
• timeliness data submitted within 24 months

5
New Jersey Cancer Incidence by County, 1996-2000
Data Sources

• data are from the May, 2003 analytic file
• tabulations using SEERStat, 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.

6
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

7
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
  

8
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

9
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
  

10
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.
  

11
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

12
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
  

13
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

14
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.

15
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.

16
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
• Planet does not include stage at diagnosis
• Currently, the 2000 U.S. population standard is
  used nationwide.

17
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