Transcript WEIR_NAPHSIS 2006 - National Association for Public Health

National Program of
Cancer Registries
Hannah K. Weir, PhD
Cancer Surveillance Branch
Centers for Disease Control
and Prevention, Atlanta, Georgia
Outline of Presentation



Overview of cancer surveillance in the US
How registries use vital statistics data
Why cancer registry data in combination with
vital statistics data is important to cancer
control
Outline of Presentation



Overview of cancer surveillance in the US
 SEER
 NPCR
How registries use state vital statistics data
Why cancer registry data in combination with vital
statistics data is important to cancer control
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
Publish CSR
Conducting surveillance
research
SEER
SEER/NPCR
(2000+)
AK HI
National Program of Cancer Registries
(NPCR)





1992 Cancer Registries
Amendment Act
1994+ first awards
1998, 45 states, 3
territories, District of
Columbia; 96%
population coverage
2001 NPCR-Cancer
Surveillance System
Publish USCS
SEER
NPCR
NPCR/SEER
AK HI
As of 1998, a Cancer Registry
in Every State…
Seattle/Pu
get Sound
Detroit
San
Francisco/
Oakland
San Jose/
Monterey
IA
N
J
UT
CA
C
T
KY
Los
Angel
es
NM
Atlanta
LA
HAWAII
ALASKA
*National
REPUBLIC
OF PALAU
Program of Cancer Registries (CDC)
Epidemiology, and End Results
Program (NCI)
†Surveillance,
NPCR*
SEER`
†
NPCR/SEER
PUERT
O
VIRGIN
RICO
ISLAND
S
NPCR-Funded Cancer Registries


State health departments receive support for populationbased registry and report their data to CDC annually
State law with regulations
 protection of staff at CCR and facilities
 protection of confidential data
 reporting from facilities
 reporting from health care providers
 access to medical records
 data in standard format
 access to data by researchers
 use of data for cancer control
Outline of Presentation



Overview of cancer surveillance in the US
How registries use state vital statistics data
 To find incident cases
 To update vital status and cause of death
Why cancer registry data in combination with vital
statistics data is important to cancer control
Linkage between the Registries and
State Vital Statistics Offices
Cancer Registry
Incident
Cases
Vital Statistics
All
Deaths
… to update vital status and identify…
Incident
Cases
Cancer
Deaths
… Death Certificate–Only (DCO) cases
Cancer Registry
Incident
Cases
Cancer
Deaths
Vital Statistics
DCO
National Death Index
To obtain vital statistics information on patients
who move out of state between the time of their
diagnosis and death
NPCR – NDI
application approved
April 2006
Outline of Presentation



Overview of cancer surveillance in the US
How registries use vital statistics data
Why cancer registry data in combination with vital
statistics data is important to cancer control

Surveillance

Incidence based mortality

Survival
Survivorship

“The reason for collecting, analyzing and
disseminating information on a disease is
to control that disease. Collection and
analysis should not be allowed to
consume resources if action does not
follow.”
Cancer Prevention and Control
Program
o
m
p
r
e
h
e
n
s
i
v
e
C
a
n
c
e
r
C
o
n
t
r
o
l
C
Nationwide Surveillance
United States Cancer Statistics:
2002 Incidence and Mortality




State, regional, and national
data
Rates for whites, blacks,
Asians/Pacific Islanders
(A/PI), Hispanics, and
children
Covers 100% US population
for mortality
And increasing incidence
1999 ….. 78%
2000 ….. 84%
2001 ….. 92%
2002 ….. 93%
2003 ….. 95% (not published)
Incidence-based Mortality

Understand the role of
incidence and survival
on mortality trends
(e.g.. the role of PSA in
prostate cancer
incidence and mortality)
Survival Studies

Clinical trials - highest achievable survival

Population-based - survival achieved
Cancer survival (5-years) in Europe
and USA: patients diagnosed 1985-89
NHL
Hodgkins
Prostate
Ovary
Uterus
Cervix
Melanoma
Breast
Lung
Rectum
Colon
Stomach
0
20
40
Europe
60
80
100
SEER
Gatta et al., 2000
Relative survival and population “cure”
“cured” patients
Survivorship Studies


Prevalence (i.e., number of patients alive with a
history of cancer) – information used for health
care planning
Long term effects of treatment (e.g., childhood
and young adult cancers)
Summary


Together cancer registry and vital statistics data
play an important role cancer control
NPCR and NAPHSIS should work together to
ensure balance between…..
Data Use
Data Protection
Hannah K Weir
[email protected]
770 488-3006