Michigan Cancer Registry Update:

Cancer Data and Highlights

MCC Board of Directors MeetingJune 19, 2013

Topics to be Covered

• Cancer registry status• Update on cancer incidence in Michigan• New publication on cancer burden in Michigan• Highlights of a new Web query tool

Twenty-Seven Years of Surveillance Data

Covers the State of Michigan Population-based 1.3 million patients 1.5 million tumors Geocoded pop-based data Complete for 1985-2010 Facilitated 115 research protocols

Collection Methods• Passive Reporting

o Quality Assurance Reviews• Electronic or Paper Reports

o Accept NAACCR formatted files• Reports Initiated by Facilities• Physicians contacted as needed

Information Collected• Basic Identifiers• Patient Demographics• Site, Histology, Stage• Method of Diagnosis• Treatment Information• Supplemental Information

o Mortality Data – Cause and Occupationo Geocoding

Registry Uses

• Basic Statisticso Incidence/Mortality/Survival

• Cluster Investigations• Cohort Studies• Case Finding and Recruiting

Sampling of Current Research

• Suzanna Zick, UofM (National Cancer Institute) o Acupressure for Persistent Cancer Related Fatigue

• Maria Katapodi, UofM (CDC)o Cancer Screening in Breast Cancer Survivors and their Female Relatives

• R.T.I. International (Eli Lilly)o Forteo Post-Approval Surveillance Study: Case Series- Osteosarcoma o Forteo Patient Registry

• Perri Ruckart (DOD)o The Morbidity Study of Former Marines - USMC Base Camp Lejeune

• Kelly Yu – Westat (NCI) o Prostate, Lung, Colorectal and Ovarian (PLCO) Cancer Screening

• HPV Associated Work (CDC)o Surveillanceo Prevalenceo Measuring Vaccine Impact

Recent Trends in the Frequency of Cancer

Incidence and Mortality

• 53,000 invasive cancer cases each year o Number fairly stable over five years through 2010

• 20,000 deaths due to cancer annuallyo Number stable to slightly rising

• Remains second leading cause of deatho Leading cause of death for persons under 75

• Leading cancers are prostate, lung, breast and colono Lung, breast, pancreatic, and colon lead for 50-74

• Leading mortality sites are lung, breast, colon and pancreatic

Important Trends• Lung cancer incidence and mortality rates have

droppedo Mortality rates have declined by 15% from the peak in 1992 and 30 % in maleso Incidence rates have declined by 19% from the peak in 1991 and 32% in maleso Stage distributions are essentially unchangedo Survival at 5 years is improving

• Breast cancer incidence and mortality rates have droppedo Incidence has declined almost 20% and mortality by more than a thirdo Stage at diagnosis continues to improve while survival by stage creeps upo Disparities by race are still evident

• Colon Cancer incidence and mortality are droppingo Incidence has declined 30% and mortality rates have declined 40% since 1985o Stage at diagnosis shows some improvement, shifting to early stageo Survival by stage at diagnosis is not changing

1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 201030.0

50.0

70.0

90.0

110.0

130.0

150.0

170.0

79.6

59.9

100.2

61.5

Incidence Rates of Invasive Cancers of the Lung and BronchusMichigan Residents

White Male White Female Black Male Black Female

Year of Diagnosis

Age-

Adj

uste

d R

ate

per

100,

000

1970

1971

1972

1973

1974

1975

1976

1977

1978

1979

1980

1981

1982

1983

1984

1985

1986

1987

1988

1989

1990

1991

1992

1993

1994

1995

1996

1997

1998

1999

2000

2001

2002

2003

2004

2005

2006

2007

2008

2009

2010

0.0

20.0

40.0

60.0

80.0

100.0

120.0

140.0

Death Rates Due to Invasive Cancers of the Lung and BronchusMichigan Residents

White Male White Female Black Female Black Male

Year of Death

Age

-Adj

uste

d R

ate

per 1

00,0

00

1985

1986

1987

1988

1989

1990

1991

1992

1993

1994

1995

1996

1997

1998

1999

2000

2001

2002

2003

2004

2005

2006

2007

2008

2009

0.0

10.0

20.0

30.0

40.0

50.0

60.0

Trends in Lung Cancer Stage at Diagnosis

Localized RegionalDistant Unknown or Unstaged

Perc

ent

1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 20050.0

10.0

20.0

30.0

40.0

50.0

60.0

70.0

Localized Lung Cancer Survival at 5 Years

White Male White Female Black Male Black Female

Perc

ent

1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 20050.0

5.0

10.0

15.0

20.0

25.0

30.0

35.0

Regional Lung Cancer 5 Year Survival Rates

White Male White Female Black Male Black Female

Perc

ent

Surgery15%

Surgery & Chemotherapy

3%Surgery and Other

Therapy2%

Radiation12%

Chemotherapy14% Radiation & Chemotherapy

19%

Hormone Therapy & in Combination

1%

Unknown9%

None26%

Lung Cancer Treatment Modalities

19851986

19871988

19891990

19911992

19931994

19951996

19971998

19992000

20012002

20032004

20052006

20072008

20092010

80.0

90.0

100.0

110.0

120.0

130.0

140.0

150.0 142.6

116.2

Incidence Rates of Invasive Cancers of the BreastFemale Michigan Residents

Year of Diagnosis

Age

-Adj

uste

d R

ate

per 1

00,0

00

19851986

19871988

19891990

19911992

19931994

19951996

19971998

19992000

20012002

20032004

20052006

20072008

20092010

80.0

90.0

100.0

110.0

120.0

130.0

140.0

150.0

Incidence Rates of Invasive Cancers of the BreastFemale Michigan Residents

White Black

Year of Diagnosis

Age

-Adj

uste

d R

ate

per 1

00,0

00

19701972

19741976

19781980

19821984

19861988

19901992

19941996

19982000

20022004

20062008

20100.0

5.0

10.0

15.0

20.0

25.0

30.0

35.0

40.0 35.1

22.6

Death Rates Due to Invasive Cancers of the BreastFemale Michigan Residents

All RacesYear of Death

Age-

Adju

sted

Rat

e pe

r 100

,000

19701972

19741976

19781980

19821984

19861988

19901992

19941996

19982000

20022004

20062008

20100.0

5.0

10.0

15.0

20.0

25.0

30.0

35.0

40.0

45.0

50.0

Death Rates Due to Invasive Cancers of the BreastFemale Michigan Residents

White BlackYear of Death

Age

-Adj

uste

d R

ate

per 1

00,0

00

1985

1986

1987

1988

1989

1990

1991

1992

1993

1994

1995

1996

1997

1998

1999

2000

2001

2002

2003

2004

2005

2006

2007

2008

2009

0.0

10.0

20.0

30.0

40.0

50.0

60.0

70.0

80.0

Breast Cancer Stage at Diagnosis By Race

Early Stage - WhiteEarly Stage - BlackLate Stage - WhiteLate Stage - Black

Perc

ent

1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 200560.0

65.0

70.0

75.0

80.0

85.0

90.0

Five Year Breast Cancer SurvivalRegional Stage at Diagnosis

Michigan - White SEER - WhiteMichigan - Black SEER - Black

Perc

ent

1985

1986

1987

1988

1989

1990

1991

1992

1993

1994

1995

1996

1997

1998

1999

2000

2001

2002

2003

2004

2005

2006

2007

2008

2009

2010

30.0

40.0

50.0

60.0

70.0

80.0

90.0

100.0

Incidence Rates of Invasive Cancers of the Colon and RectumMichigan Residents

White Male White Female Black Female Black Male

Year of Diagnosis

Age

-Adj

uste

d R

ate

per 1

00,0

00

19701971

19721973

19741975

19761977

19781979

19801981

19821983

19841985

19861987

19881989

19901991

19921993

19941995

19961997

19981999

20002001

20022003

20042005

20062007

20082009

20100.0

5.0

10.0

15.0

20.0

25.0

30.0

35.0

40.0

45.0

50.0

Death Rates Due to Invasive Cancers of the Colon and RectumMichigan Residents

White Male White Female Black Female Black MaleYear of Death

Age-

Adju

sted

Rat

e pe

r 10

0,00

0

19851986

19871988

19891990

19911992

19931994

19951996

19971998

19992000

20012002

20032004

20052006

20072008

20090.0

5.0

10.0

15.0

20.0

25.0

30.0

35.0

40.0

45.0

Trends in Stage at Diagnosis for Colo-rectal Cancer

In Situ Localized Regional Distant Unknown or Not Staged

Perc

ent

Surgery53%

Surgery & Chemotherapy

16%

Surgery, Radi-ation & Chemo-

therapy8%

Radiation1%

Chemotherapy4%

Radiation & Chemotherapy

3%

Hormone Therapy and

Other0.2%

None11%

Unknown4%

Colon Cancer Treatment Modalities

New Ways to Access Data

• Web Site is the portal

o WWW.Michigan.gov/mdch

o Select Statistics and Reports

o Select Cancer Statistics