11 th Annual Arizona Tribal Collaborative Conference Building - PowerPoint PPT Presentation

11 th Annual Arizona Tribal Collaborative Conference “Building Bridges for Cancer Care and Collaboration” Arizona Cancer Data May 3, 2018

O VERVIEW A RIZONA D ATA – A MERICAN I NDIAN • Introduction to the Arizona Cancer Registry • How information collected • Incidence • Mortality • Comparisons to national and local data • Websites

Arizona Cancer Reporting Introduction – State Reporting • Authority to collect cancer information: – 1988: A.R.S. §36-133 Statute – 1992: A.A.C. Title 9 Chapter 4 Rules • Who we are? – Population-based surveillance system that collects, manages, and analyzes information on the incidence and survival of Arizona residents diagnosed with cancer. • Where do the cases come from? – Hospitals, free-standing clinics, physicians, pathology laboratories, data exchanges, and death certificates.

Arizona Cancer Reporting Indian Facilities & Cancer Reporting • 3-way agreement – New Mexico Tumor Registry (NMTR) / IHS / AZ – NMTR travels into Arizona for data collection • Data linkages with CDC funded Breast & Cervical Cancer Early Detection Programs

Arizona Cancer Reporting Challenges & Opportunities • Tribally-Operated 638 Facilities • Completeness of data • Misclassification of American Indians

National Programs NAACCR – Certification of Data

Arizona Cancer Reporting Physician Reporting – Melanoma Task Force A Comparison of the Reporting Source* - Physician and Hospital Case Reports Invasive and In Situ Melanoma, 2010-2015 3000 2507 2500 2162 1952 Case Count 2000 1721 1243 1321 1500 1254 1202 1208 1040 1050 1000 755 500 0 2010 2011 2012 2013 2014 2015 Diagnosis Year Physicians & Clinics Hospitals *An average of 65 cases per year received from other states, death certificates, and pathology labs were excluded from the reports received analysis.

Arizona Cancer Reporting Physician Reporting – Melanoma Task Force Arizona, U.S.*, and SEER** Invasive & In Situ Age Adjusted Melanoma Rates For Diagnosis Year 2010 -2015 25.0 per 100,000 Persons 20.0 Age Adjusted Rate 15.0 10.0 5.0 0.0 2010 2011 2012 2013 2014 2015 AZ Invasive Melanoma 16.1 19.9 19.4 19.9 21.9 23.8 U.S Invasive Melanoma 19.9 20.5 20.5 21.0 21.4 AZ Insitu Melanoma 9.4 11.9 15.5 16.8 17.6 20.9 SEER Insitu Melanoma 18.5 19.3 19.8 20.5 21.4 23.3 Diagnosis Year * United States Cancer Statistics: 1999 - 2014 Incidence, WONDER Online Database. United States Department of Health and Human Services, Centers for Disease Control and Prevention and National Cancer Institute; 2016. Accessed at http://wonder.cdc.gov/cancer-v2014.html on Apr 19, 2018. ** Surveillance, Epidemiology, and End Results (SEER) Program (www.seer.cancer.gov) SEER*Stat Database: Incidence - SEER 9 Regs Research Data, Nov 2017 Sub (1973-2015) <Katrina/Rita Population Adjustment> - Linked To County Attributes - Total U.S., 1969-2016 Counties, National Cancer Institute, DCCPS, Surveillance Research Program, released April 2018, based on the November 2017 submission.

Arizona Cancer Reporting CDC National Program of Cancer Registries • IHS Linkage Required – The central cancer registry links with IHS at least every five years. Central cancer registries with IHS Contract Health Service Delivery Area counties link their records with patient registration records from IHS annually.

Arizona Cancer Reporting Data Linkage with IHS Comparison of Age Adjusted Incidence Rates of All Invasive Cancer 2010-2015 in American Indians IHS Link vs. No IHS Link 350.0 322.6 302.0 295.5 295.6 283.8 per 100,000 persons 300.0 256.5 Age Adjusted Rate 286.8 250.0 263.2 263.5 263.2 244.8 200.0 218.1 150.0 100.0 50.0 0.0 2010 2011 2012 2013 2014 2015 Diagnosis Year AZ American Indian - With IHS Link AZ American Indian - No IHS Link

N ATIONAL O RGANIZATIONS

CDC N ATIONAL P ROGRAM OF C ANCER R EGISTRIES Forty-six states, the District of Columbia, Puerto Rico, the U.S. Pacific Island Jurisdictions, and the U.S. Virgin Islands receive funding through CDC’s National Program of Cancer Registries (NPCR).

NCI SEER P ROGRAM Nine States, 6 Metro Areas

C ANCER I NCIDENCE

Comparison of Arizona and U.S.* Age Adjusted Incidence Rates For All Race/Ethnicity and American Indians of All Invasive Cancer 2010-2015 500.0 450.0 per 100,000 persons Age Adjusted Rate 400.0 350.0 300.0 250.0 200.0 150.0 100.0 50.0 0.0 2010 2011 2012 2013 2014 2015 Arizona All Race/Ethnicity Rate 406.0 406.8 391.4 387.8 388.7 379.9 U.S. All Race/Ethnicity Rate NA 464.7 463.7 450.0 445.7 436.6 Arizona American Indian Rate 322.6 295.5 295.6 302.0 283.8 256.5 U.S. American Indian Rate 301.3 299.2 284.8 291.8 274.0 NA Diagnosis Year * United States Cancer Statistics: 1999 - 2014 Incidence, WONDER Online Database. United States Department of Health and Human Services, Centers for Disease Control and Prevention and National Cancer Institute; 2016. Accessed at http://wonder.cdc.gov/cancer-v2014.html on Apr 24, 2018

A LL R ACES A MERICAN I NDIAN A RIZONA A GE A DJUSTED R ATE A GE A DJUSTED R ATE 113.4 1. Prostate 63.7 1. Female Breast I NCIDENCE - 50.0 2. Female Breast 60.2 2. Lung & Bronchus T OP T EN 82.2 3. Colorectal 27.2 3. Prostate I NVASIVE 34.2 4. Kidney & Renal Pelvis 26.7 4. Colorectal 20.0 5. Uterus Total 25.3 5. Melanoma C ANCER 19.1 6. Lung & Bronchus 19.7 6. Bladder S ITES , 18.1 7. L iver&IntrahepaticBileDuct 15.6 7. Lymphoma D IAGNOSIS 16.6 15.5 8. Ill Defined&Unspecified 8. Ill Defined&Unspecified 9. Lymphoma 12.5 15.3 9. Thyroid Y EARS 10.Stomach 10.4 11.8 10.Leukemia 2010-2015

M ALES A RIZONA F EMALES I NCIDENCE – A GE -A DJUSTED R ATE A GE -A DJUSTED R ATE 1. Breast 60.2 1. Prostate 63.7 T OP T EN 2. Uterus Total 25.3 2. Kidney/Renal Pelvis 37.6 I NVASIVE 3. Colorectal 22.9 3. Colorectal 32.3 C ANCER S ITES 4. Kidney/ Renal Pelvis 18.0 4. Lung and Bronchus 22.3 5. Thyroid 14.6 5. Liver and Intrahepatic Bile FOR 20.5 Duct 6. Lung and Bronchus 18.1 A MERICAN 6. Ill-Defined and Unspecified 17.7 7. Ovary 12.9 7. Lymphoma 13.4 I NDIAN BY 13.5 8. Ill-Defined and Unspecified 8. Stomach 14.7 S EX , 9. Lymphoma 11.5 9. Myeloma 10.7 10. Liver and Intrahepatic Bile D IAGNOSIS 11.5 10.Leukemia 9.8 Duct Y EARS 2010- 2015

F EMALE B REAST C ANCER T ELLING THE STORY “D EEP D IVE ”

Female Breast Cancer Invasive and In Situ Case Count by Diagnosis Year, 2011-2015 5000 4626 4693 4506 4212 4194 4000 Case Count 3000 2000 990 957 1036 953 927 1000 0 2011 2012 2013 2014 2015 Diagnosis Year In Situ Invasive

Female Breast Cancer Percent of Early/Late Stage by Diagnosis Year, 2011-2015 100.0% 3.6% 5.3% 5.6% 6.1% 6.9% 25.2% 25.8% 24.5% 26.8% 80.0% 25.2% Percent of Early/Late Stage 60.0% 40.0% 71.2% 69.3% 68.6% 67.9% 67.8% 20.0% 0.0% 2011 2012 2013 2014 2015 Diagnosis Year Early Late Unknown *Early Stage = In Situ and Local SEER Summary Stage 2000; Late Stage= Regional and Distant SEER Summary Stage 2000. Note: The sum of the percent of Early/Late Stage for each diagnosis year does not equal 100% due to rounding.

Invasive Female Breast Cancer Incidence Age Adjusted Rate by Race/Ethnicity, 2011-2015 150.0 per 100,000 Females Age Adjusted Rate 125.7 113.0 120.0 106.3 90.0 77.3 74.1 58.0 60.0 30.0 0.0 White Non- White Black American Asian & All Races Hispanic Hispanic Indian Pacific Islander Race/Ethnicity Note: 282 invasive cases had other or unknown race.

Percent of Female Breast Cancer Cases Diagnosed in Late Stage* by Race/Ethnicity, 2011-2015 40.0% 33.9% Percent of Cancer Cases 30.2% 30.1% 30.0% 25.3% 25.5% 24.6% 20.0% 10.0% 0.0% White Non- White Black American Asian & All Races Hispanic Hispanic Indian Pacific Islander Race/Ethnicity

Female Breast Cancer ER, PR, HER2 Assay Combination by Race/Ethnicity, 2011-2015 70.0% 60.0% 50.0% Percent of Cases 40.0% 30.0% 20.0% 10.0% 0.0% Triple Negative Triple Positive All Other ER,PR,HER2 NA/Unk. ER, PR, & HER2 Assay Combination Value White Non-Hispanic White Hispanic Black American Indian Asian & Pacific Islander Note: 286 cases with an other or unknown race are excluded from the analysis.

Percent Female Breast Cancer Cases Diagnosed In Late Stage* Race/Ethnicity by Age Group, 2011-2015 50.0% Percent of Cases 40.0% 30.0% 20.0% 10.0% 0.0% Less than 40 65 years and 40-49 years 50-64 years years older White Non-Hispanic 4.4% 14.3% 36.9% 44.4% White Hispanic 12.1% 23.0% 39.5% 25.4% Black 12.7% 20.0% 45.4% 21.9% American Indian 6.5% 25.3% 38.2% 30.0% Asian & Pacific Islander 14.2% 24.1% 41.4% 20.4% Age Group *Late Stage = Derived SEER Summary Stage 2000 Regional and Distant Stages. Percent of cases are derived from the total of invasive and in situ cases. The sum of the percent of cases by age group does not equal 100% due to rounding. Note: 65 late stage cases had other or unknown race/ethnicity.

C OLORECTAL