ABSTRACT

1
Expanding the Use of Surveillance Data the
colorectal cancer monograph project, chapter
one J Jackson-Thompson, MSPH, PhD, Missouri
Cancer Registry University of
Missouri-Columbia, Columbia, MO

• ABSTRACT
• Background
• In late 2003, a group of Centers for Disease
  Control and Prevention/National Program of Cancer
  Registries (CDC/NPCR) staff and faculty/staff
  affiliated with a number of CDC/NPCR and
  National Cancer Institute/Surveillance,
  Epidemiology and End Results (NCI/SEER)
  registries began discussing preparation of a
  monograph on colorectal cancer (CRC).
• It was felt that research and general
  communities would have great interest in a
  compilation of articles on CRC, utilizing
  high-quality data from a national database.
• Objectives
• To present an overview of the project, with a
  focus on the introductory chapter and
• To present some findings.
• Methods
• Invasive cases of CRC for diagnosis years
  1998-2001 were used for most analyses
• 39 states, the District of Columbia and SEER
  Atlanta met publication criteria for data
  quality.
• CDC/NPCR staff carried out the analyses reported
  here.
• Rates are per 100,000 and age-adjusted to the
  2000 U.S. (19 age groups) standard.
• Results
• A total of 542,149 cases were included,
  representing 89 of the U.S. population.

• Chapter 1 Descriptive Epidemiology of Colorectal
  Cancer in the United States, 1998-2001
• Lead Author J. Jackson-Thompson, MSPH, PhD
• (Missouri Cancer Registry)
• Co-authors Robert R. German, DrPH, MPH Ahmed
  Faruque, MD, PhD, MPH
• Sue-Min Lai, PhD, MS, MBA Carol Friedman, DO
• Purpose of the CRC Monograph
• Excluding cancers of the skin, CRC is one of the
  most common cancers in the United States
• Overall, CRC ranks third in incidence for both
  U.S. men (after prostate and lung cancers) and
  women (after breast and lung cancers).
• CRC is the second leading cause of death from
  cancer in the U.S.
• We chose to focus on CRC because
• It is a common cancer
• CRC incidence rates could be reduced through
  diet and lifestyle changes
• CRC is amenable to screening (e.g.,
  sigmoidoscopy, colonoscopy, etc.) and
• Mortality rates could be lowered by more
  widespread use of screening, leading to earlier
  diagnosis and treatment.

CRC Incidence is Declining, 1998-2001
542,149 CRC cases (89 U.S. population coverage)

• CRITERIA FOR INCLUSION OF CANCER INCIDENCE DATA
• Case ascertainment 90 complete, i.e., each
  registrys data includes at least 90 of the
  expected, unduplicated cases
• 5 of cases are death certificate only (DCO)
  cases, i.e., ascertained solely on the basis of a
  death certificate
• 3 of cases missing information on sex
• 3 of cases missing information on age
• 5 of cases missing information on race
• 97 of registrys records passed a set of
  single-field computerized edits.
• Criteria are for all cancer sites combined.

Geographic Coverage of CRC Monograph
Source NPCR and SEER high-quality data, 1998-2001

• CRC Monograph Collaborators
• NPCR- and SEER-funded cancer registries
• National Cancer Institute
• Centers for Disease Control and Prevention
• American Cancer Society
• ORC Macro

• Expected Uses of the CRC Monograph
• Monograph will provide high quality, national
  population-based data that can be used in the
  control of CRC.
• Population subgroups can be identified and
  targeted for informed decision making, screening
  practices, treatment therapies, etc.
• Intended Publication supplement to the
  journal CANCER
• Expected Publication Date May 2006

This project was supported in part by a
cooperative agreement between the Centers for
Disease Control and Prevention (CDC) and the
Missouri Department of Health and Senior Services
(DHSS) (U55/CCU721904-04) and a Surveillance
Contract between DHSS and the University of
Missouri.
I gratefully acknowledge the technical assistance
of MCR staff Nancy Cole, CTR Gentry White, MS
and Dr. Chetan Wasekar.

• For further details about the CRC Monograph,
  contact
• Ahmed Faruque, MD, PhD (CDC) fba5_at_cdc.gov
• Robert R. German, DrPH (CDC) rrg1_at_cdc.gov
• J. Jackson-Thompson, PhD (MCR)
  jacksonthompsonj_at_health.missouri.edu

Thanks to the co-authors of Chapter One for their
support Robert R. German, DrPH, MPH and Faruque
Ahmed, MD, PhD, MPH (CDC/NPCR) Sue-Min Lai, PhD,
MS, MBA (Kansas Cancer Registry KU) and Carol
Friedman, DO (CDC/NPCR).
Related 2005 NAACCR poster Case Completeness and
Data Quality in the National Program of Cancer
Registries (NPCR). Lead author KK Thoburn, NY
State Cancer Registry. (Originally a chapter in
the monograph, this will now be published
separately.)