Cancer Center

Cancer Registry Report— 2003 Data & Activity

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main page The Cancer Registry is a system to monitor all types of cancer diagnosed and/or treated here at Erlanger. The data we maintain is a critical element in the evaluation of cancer care. Information maintained in the Registry includes: Demographics, Medical History, Diagnostic Findings, Cancer Identification, Treatment, and Lifetime Follow-Up Data. All the data is collected in compliance with the American College of Surgeon’s Commission on Cancer (ACoS-CoC) Standards, and the Tennessee Cancer Registry (TCR).

Registry data contributes to staging, treatment planning, and continuity of care for the cancer patient. The Registry is a valuable resource for research investigations. Accurate and complete data allows for optimal cancer program and administrative planning to allocate hospital resources. The security of confidential patient information is maintained in the Registry database through established procedures. The Erlanger Cancer Committee supervises the Registry and ensures accurate and timely abstracting, staging, follow-up, and reporting.

The EHS Cancer Registry has a reference date of January 1, 1983, with a current database of 21,184 (as of 2003 accession year). During 2003 the Registry submitted data to the TCR and the National Cancer Data Base (NCDB). Over 30 reports of Registry data statistics and analysis were prepared by the Registry. Annual lifetime Follow-Up on all analytic patients is conducted on a monthly basis. More than 5,000 cases are currently under active follow-up with an average follow-up rate of 90-percent (90%). The Registry is staffed by two Certified Tumor Registrar’s and one Registry Assistant. The responsibilities of the Registry include but are not limited to the following as an integral part of the Erlanger Cancer Program: Maintain Cancer Registry Database; State and National reporting; Lifetime patient follow-up; Outcomes analysis; Cancer Conferences; CoC liaison to the Cancer Committee; Partnership with American Cancer Society.

Statistical summary of registry data for 2003 is displayed in CHARTS #1-7, with a site-specific analysis of Prostate Cancer in CHARTS #8-10:

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CHART-1
Class of Case Distribution: For the Year 2003, EHS accessioned 1056 cases. 83% of the cases were analytic which includes patients first diagnosed and/or first treated at EHS and required to be accessioned by the Commission on Cancer. 17% were non-analytic, these cases include patients treated here subsequently and cases required by the Tennessee Cancer Registry but not by the CoC.

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CHART-2
Distribution of Primary Sites – Analytic Cases 1999-2003: Since 1999 there’s been an increase of incidence in six top sites at EHS: Colon/Rectum, Lung, Leukemia, Uterus, Ovary, Brain/CNS. 5 top sites have shown a decline: Melanoma, Breast, Prostate, Bladder, and Unknown Primary. The top 5 sites of incidence at EHS in 2003 were Lung, Breast, Colon/Rectum, Brain/CNS, and Uterus. The Male top five sites: Lung, Colon/Rectum, Brain/CNS, Prostate, and Oral Cavity. The Female top five sites: Breast, Lung, Colon Rectum, Uterus, and Brain/CNS.

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CHART-3
Ten Leading Sites By Sex: Comparison of national statistics with EHS. Of notice is the percentage of Prostate cancer rates at EHS showing nearly one-fourth that of the national statistics for estimated new cases. Lung cancer at EHS has a 10% higher rate than the national data for Male incidence, and a 3% higher rate for Female. EHS Male Colo-Rectal rates are higher than national by 3%, and Female rates are actually lower than national by 4%. The percentage of Uterine incidence at EHS is 3% higher than national rates.

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CHART-4
AJCC Stage By First Course of Treatment - Summary of patterns of treatment for patients at EHS: 483 received definitive surgery, 302 received radiation, 339 received chemo, 6 received other treatment, and 112 received none or unknown if pt received treatment.

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CHART-5
Analytic Cases by Stage/Sex - The majority of Female incidence of cancer was diagnosed at Stage I, of which 38% were Breast cases. 22% of Female incidence was diagnosed at Stage II, and 23% at Stage III. Stage IV represents 16% of Female incidence, of which 30% were Lung cases. The lowest incidence was diagnosed at Stage 0.
By comparison only 15% of Male cases were diagnosed at Stage I, of which Colon/Rectum and Lung were each 20%. The majority of Male cases were diagnosed at Stage III and Stage IV, 28% each. Almost half of the Stage III & IV Male cases were Lung, at 48% and 40% respectively. As with Female incidence, the lowest percentage of Male incidence of cancer was diagnosed at Stage 0.

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CHART-6
Annual Cancer Caseload 1998-2003 and Trend in Yearly Cancer Cases – Compared to 1998, the 2003 annual caseload increased by 7%. The trend of cases by Class per year shows the majority of cases accessioned continue to be Class-1 “First diagnosed and treated here”, with minimally alternating increases and decreases annually. Class-2 “First diagnosed elsewhere, treated here” cases are on the rise in 2003, as are the non-reportable cases.

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CHART-7
2003 Cases by County – Over 50% of cancer cases seen at EHS are from within Hamilton County. Georgia cases contribute the next largest population at 21%, with Walker County alone at 8% (3% higher than any of the remaining TN counties). The next highest percentage of cases at approximately 5% each are from Bradley, Marion and Rhea counties. Alabama cases and Sequatchie County represent about 2% each, and the remaining TN counties as well as Other States are at 1% or less.

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CHART-8
Prostate Cases 2000-2003 by AJCC Stage - The greatest rate of incidence of Prostate cancer at EHS is diagnosed at Stage II for all four years, 2000 to 2003. There was a greater percentage of Stage III diagnosed in 2001 compared to the other 3 years, and also Stage IV percentage was higher in 2002.

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CHART-9
Prostate Cases First Course Tx – EHS vs NCDB - First course of treatment for Prostate cancer patients at EHS showed an increase in the percentage of Radiation in 2003 compared to 2001, and a decrease in Surgery with Radiation showing the higher percentage over Surgery for both years. The national rate (NCDB) of Radiation is just below the rate of Surgery. Radiation and Surgery combined treatment at EHS had a reduced rate in 2003, with the national rate as it's lowest of the four treatments.

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CHART-10
Prostate Five Year Survival – EHS vs NCDB - Compared with the national rates (NCDB), EHS shows a higher percentage of survival for Stage II and III Prostate cancer cases. The survival rate for Stage IV is approximately the same at EHS compared to NCDB. Stage I shows a less than 10% lower survival rate at EHS.

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