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

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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.

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CDCs Cancer Prevention and Control Programs
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Model for Cancer Control

• Plan Interventions
• Prevention
• Screening
• Treatment rehabilitation
• Palliative Care

Measure Evaluate Cancer Burden
Act Implement Interventions
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The Cancer Continuum
Diagnosis / Stage
Death
Survival
Treatment Rehabilitation
Palliative Care
Prevention
Early Detection
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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

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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

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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
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What do the eyes see in the cancer continuum ?

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Vital Records - Cancer Deaths
Death
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Cancer Registries - New Occurrences of Cancer
Diagnosis
Prevention
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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/
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United States Cancer Statistics 2004 Census
Region and Division
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 NORTH CENTRAL
NV
OH
UT
San José-Monterey
CA
CO
KS
IN
MO
IL
WV
VA
KY
Los Angeles
AZ
NM
NC
TN
OK
WEST
Atlanta
AR
SC
AL
MS
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
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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
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(No Transcript)
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The Cancer Continuum
Diagnosis / Stage
Early Detection
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Female Breast Cancer Cases Diagnosed at Early
Stage
19851987
Percentageof Cases
lt 39.1
39.148.1
48.255.9
56 over
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Female Breast Cancer Cases Diagnosed at Early
Stage
19951997
Percentageof Cases
lt 39.1
39.148.1
48.255.9
56 over
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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)

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The Cancer Continuum
Diagnosis
Death
Survival
Treatment Rehabilitation
Palliative Care
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Linkage between the Registries and State Vital
Statistics Offices
Cancer Registry
Vital Statistics
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to update vital status
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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

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Clinical Research vs. Public Health
Clinical trials highest achievable
survival Public health average survival achieved
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100
90
80
70
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Relative survival ()
2000-01
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1996-99
1991-95
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1986-90
30
20
10
0
1
2
3
4
5
0
Years since diagnosis
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Relative Survival and Population Cure
Mean survival of fatal cases
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Cure for more Colorectal Cancers, UK
Source M. Coleman
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The Eyes and Hands of Cancer Control
Diagnosis
Death
Survival
Treatment Rehabilitation
Palliative Care
Prevention
Early Detection
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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
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Important Collaborations between Cancer
Registries and Vital Records

• Hannah Weir
• HBW4_at_CDC.GOV
• [phone]