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 Reportingo Quality Assurance Reviews
• Electronic or Paper Reportso 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
Ag
e-A
dju
ste
d R
ate
pe
r 1
00
,00
0
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
en
t
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
en
t
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
Ag
e-A
dju
ste
d R
ate
pe
r 1
00
,00
0
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
Ag
e-A
dju
ste
d R
ate
pe
r 1
00
,00
0
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 Races
Year of Death
Age
-Adj
uste
d Ra
te p
er 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
45.0
50.0
Death Rates Due to Invasive Cancers of the BreastFemale Michigan Residents
White BlackYear of Death
Ag
e-A
dju
ste
d R
ate
pe
r 1
00
,00
0
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
en
t
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
en
t
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
Ag
e-A
dju
ste
d R
ate
pe
r 1
00
,00
0
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
Ag
e-A
dju
ste
d R
ate
pe
r 1
00
,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, Radia-tion & 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
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