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Department of Health and Human Services Nevada State Health Department of Health and Human Services Nevada Cancer Systems Overview The Mission of the Health Division is to Promote and Protect the Wellbeing of Nevadans and Visitors to our State by Preventing Disease, Injury and Disability Jim Gibbons, Governor Richard Whitley, MS, Administrator Michael J. Willden, Director Mary Guinan, MD, PhDPhD,, State Health Officer Page 1 of 88 Table of Contents Tab 1: Nevada Central Cancer Registry Tab 2: Nevada Comprehensive Cancer Control Program Tab 3: Nevada State Comprehensive Cancer Plan Tab 4: Statewide and Community Partners Page 2 of 88 For additional information on the programs highlighted in this document, please contact the following: Nevada Central Cancer Registry Alicia Chancellor Hansen, MS Chief Biostatistician Office of Health Statistics and Surveillance Bureau of Health Statistics, Planning and Emergency Response Nevada State Health Division [email protected] (775) 684-4161 Nevada State Comprehensive Cancer Control Program Christine Wood, RDH, BS Chronic and Communicable Disease Manager Bureau of Child, Family and Community Wellness Nevada State Health Division [email protected] (775) 684-5953 Nevada Cancer Council Sheila Baez, RN, MN, AOCNS Chair [email protected] 775-722-8140 American Cancer Society Tom McCoy, JD Nevada Government Relations Director American Cancer Society [email protected] (775) 828-2206 Susan G. Komen for the Cure Stacey A. Gross MPH, CHES Community Programs Manager Southern Nevada Affiliate [email protected] (702) 822-2324 Governor’s Prostate Cancer Task Force Lew Musgrove Chairman [email protected] (702) 227-8028 Page 3 of 88 Nevada Central Cancer Registry Alicia Chancellor Hansen, MS Chief Biostatistician Juanamarie Harris Nevada Central Cancer Registry Program Manager Page 4 of 88 What is a Cancer Registry? “State-based cancer registries are data systems that collect, manage, and analyze data about cancer cases and cancer deaths. In each state, medical facilities (including hospitals, physicians' offices, therapeutic radiation facilities, freestanding surgical centers, and pathology laboratories) report these data to a central cancer registry.” http://www.cdc.gov/cancer/npcr/about.htm Population Based, Retrospective Data Collection Allows for capturing diagnosis, as well as initial treatment information National requirements for reporting Within 24 months from year of diagnosis Registries do not track incidence as diagnoses occur Cannot be used to identify cancer clusters Not real-time data Page 5 of 88 Nevada Central Cancer Registry (NCCR) Established and governed by NRS and NAC 457 Primary purpose Collect, register, and maintain a record of reportable cases of cancer occurring in the state Uses of the data Evaluate the appropriateness of measures for the prevention and control of cancer To conduct comprehensive epidemiological surveys of cancer and cancer related deaths De-identified data reported to Centers for Disease Control and Prevention (CDC) National Program of Cancer Registries (NPCR) and North American Association of Central Cancer Registries (NAACCR) Reporting began in 1995 NCCR Website http://www.health.nv.gov/VS_NVCancerRegistry.htm Page 6 of 88 How Data Is Collected Abstracting State NCCR Cancer Registrars visit facilities and abstract cases Hospitals and Other Facilities Facility Cancer Registrars abstract cases and submit information to the NCCR Pathology Labs Pathology reports sent to NCCR for case finding and supporting information Information from all sources is consolidated Final comprehensive case is reported to NPCR and NAACCR Data sharing with other states Reports received from other state registries of diagnosis and treatment information for Nevada Residents Reports sent to other state registries for their residents who are diagnosed or treated in Nevada Formal written agreements with 11 states, including all surrounding states NPCR Data Exchange Requirements Written agreements Confidentiality Data transmitted securely Page 7 of 88 Page 8 of 88 Cancer Incidence: Consolidated Cases Consolidated Cancer Cases 12,000 10,000 8,000 6,000 4,000 2,000 0 Nevada Central Cancer Registry Calendar Year (CY) 2000-2007 7,265 Total Consolidated Cases CY00 CY01 7,733 10,035 CY02 10,316 CY03 Cases 10,702 CY04 10,695 CY05 10,753 CY06 11,118 CY07 National Standards for Data Quality and Completeness NAACCR Gold Standard Certification for Past 6 Years! Gold Standard Requirements Percent completeness of case ascertainment: At least 95% Percent missing/unknown race: Less than 3% Percent missing/unknown sex, age and county: Less than 2% Percent of cases death certificate only: Less than 3% Duplicate cases: Less than 1 per 1,000 Percent passing quality control edits: 100% CDC NPCR In compliance with grant reporting requirements Goals 24 month completeness: 95% 12 month completeness: 90% Percent passing quality control edits: 100% Page 9 of 88 Linkages With Other Programs State Office of Vital Records Case finding Death Certificate Only Cases Survival Information Demographic information updates Grant requirement Hospital Discharge Data Case finding Supporting Information Women’s Health Connection (WHC) – Breast and Cervical Cancer Early Detection Program Benefits both programs Case finding for NCCR Treatment information for WHC Grant requirement Indian Health Services – US Department of Health and Human Services Improve estimates of cancer incidence among American Indian / Alaska Natives (AI/ANs) Improve the quality of cancer surveillance data for AI/ANs in NPCR registries Supports CDC goal to eliminate racial and ethnic health disparities Cancer incidence data for AI/ANs included in United States Cancer Statistics (USCS) annually Grant requirement Page 10 of 88 Value of the Data Identify areas where Nevada differs from the rest of the country Identify burden of disease and disparities Allows prevention programs to target interventions Information for policy development Evaluation of program outcomes Due to consistent high quality of Nevada data, information is included in nationally published statistics Research Page 11 of 88 Accessing Cancer Data Report on Cancer in Nevada: 2000-2004 http://www.health.nv.gov/CD_CancerReport2000-2004.htm CDC NPCR http://www.cdc.gov/cancer/npcr/ United States Cancer Statistics (USCS) http://apps.nccd.cdc.gov/uscs/ NAACCR http://www.naaccr.org/ Cancer in North America CINA+ Online http://www.cancer-rates.info/naaccr/ CINA Publications http://www.naaccr.org/index.asp?Col_SectionKey=11&Col_ContentID=50 National Cancer Institute (NCI) Surveillance, Epidemiology and End Results (SEER) Program http://www.seer.cancer.gov/ Page 12 of 88 Data for Research NAACCR Research Program Compiling a “multi-registry aggregated database from all NAACCR member registries” Researchers can submit proposals and request the use of the data Research proposals are evaluated “to determine scientific merit and provide constructive criticism to improve research designs.” Website: http://www.naaccr.org/index.asp?Col_SectionKey=11&Col_C ontentID=379 Page 13 of 88 Future Plans Future Linkages National Death Index Social Security Death Index Web enabled reporting for facilities Geocoding of data Build infrastructure Information technology Data analysis Data quality control Page 14 of 88 Lung Cancer and Smoking Lung Cancer Incidence From 2000 to 2005, the incidence of invasive lung and bronchus cancer in Nevada declined from 85.2 to 70.6 per 100,000 (age-adjusted rate) Ranking improved from 3rd highest to 24th highest Source: United States Cancer Statistics (USCS) Page 15 of 88 Smoking Prevalence Adults Who Are Current Smokers In 1998, Nevada had Nevada BRFSS: 1998-2007 the 2nd highest smoking rate in the 35 nation 30 25 30.4% 20 In 2007, Nevada had % 15 the 16th highest 10 smoking rate in the 5 nation 0 21.5% 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 From 1998-2007, Nevada experienced the largest decrease in prevalence (8.9%) Of the 50 States and the District of Columbia Sources: Morbidity and Mortality Weekly, Volume 58, No. 9, March 13, 2009; Behavioral Risk Factor Surveillance System Page 16 of 88 Women, Lung Cancer, and Smoking Lung Cancer In 2005, Nevada ranked 24th overall for Lung Cancer Incidence Male Incidence: ranked 31st Female Incidence: ranked 9th Source: United States Cancer Statistics (USCS) This indicates a need to target prevention efforts towards women Smoking Prevalence In 1998, 28.0% of women smoked In 2007, 19.5% of women smoked Source: Behavioral Risk Factor Surveillance System (BRFSS) Although smoking prevalence among women has declined, lung cancer incidence remains high compared to other states Page 17 of 88 Comparison of Nevada Cancer Incidence Rates to National Rates: 2001-2005 Source: USCS Page 18 of 88 Colon and Rectum Cancer and Screenings Colon and Rectum Cancer Incidence Rate for 2001-2005 49.7 per 100,000 people (age-adjusted) Ranked 37th highest Slightly less than national rate of 51.6 per 100,000 Source: USCS Colorectal Cancer Screenings Rate for 2004 46.7% Also, slightly less than national prevalence of 53.5% Source: BRFSS Screening rates are lower than national, but so are cancer rates Why? This example reveals a need for further investigation Page 19 of 88 Comparison of Nevada Colorectal Cancer Screening Rates to National Rates: 2004 Respondents who ever had a colonoscopy or sigmoidoscopy Source: Behavioral Risk Factor Surveillance System Page 20 of 88 Future Opportunities Further focused data analysis
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