2015 Cancer Annual Report

Transcription

1 2015 Cancer Annual Report Using data from 2014 Franciscan St. Elizabeth Health Cancer Registry The Franciscan St. Elizabeth Health Cancer Registry is accredited by the American College of Surgeons Commission on Cancer and is staffed by a certified cancer registrar. The Registry maintains cancer data and follow-up on patients diagnosed and/or treated at Franciscan St. Elizabeth Health. This data is reported to both the Indiana State Department of Health Cancer Registry and the American College of Surgeons National Cancer Data Base. In 2014, there were 457 (174 male/283 female) analytic cases accessioned. These cases were used in the statistical analysis of the 2015 Franciscan St. Elizabeth Health Cancer Annual Report data. The top four diagnoses for men were lung, prostate, colorectal and bladder. The top four diagnoses for women were breast, lung, colorectal and endometrium. The Franciscan St. Elizabeth Health Cancer Registry currently maintains follow-up on approximately 6,385 patients. Lifetime follow-up is collected on all analytic cases to compare treatment outcomes and survival rates. The Registry consistently maintains a lost-to-follow-up rate of 10 percent or less as mandated by the American College of Surgeons Commission on Cancer. Studies completed in 2014: NHL & HD Age/Stage Comparison with NHL & HD Survival Comparison Dr. Kazumi Chino NHL & HD Treatment Within NCCN Guidelines Comparison Dr. Kazumi Chino Lafayette Oncologists Adherence to Current Therapy Utilizing Personalized Targeted Therapy in Advanced Lung, Colorectal, and Melanoma Cancers Dr. Mario Contreras Charla J. Dark, CTR, Manager, Cancer Registry

2 Franciscan St. Elizabeth Health Cancer Cases Diagnosed 2014 * National comparison of selected cancer sites * Estimated numbers of new cases from The American Cancer Society Cancer Facts & Figures 2014 Franciscan St. Elizabeth Health Indiana National Breast % 4, % 232, % Lung % 5, % 224, % Prostate % 4, % 233, % Colorectal % 3, % 136, % Bladder % 1, % 74, % Corpus Uteri % 1, % 52, % Melanoma % 1, % 76, % All others % 13, % 635, % TOTAL CASES % 35, % 1,665, % SELECTED CANCER SITE NEW CANCERS 2014 BREAST 14.0% 28.0% 12.9% LUNG 13.5% 20.4% 15.6% PROSTATE 14.0% 4.6% 12.3% COLORECTAL 8.2% 9.4% 8.5% BLADDER 4.5% 5.3% 4.5% CORPUS UTERI 3.2% 4.4% 3.0% MELANOMA 4.6% 3.9% 4.4% Franciscan St Elizabeth 2014 ACS Projected Figures IN 2014 ACS Projected Figures National 2014

3 Franciscan St. Elizabeth Health Cancer Deaths 2014 * National comparison of selected cancer sites * Estimated Numbers of New Cases from: The American Cancer Society Cancer Facts & Figures 2014 Franciscan St. Elizabeth Health Indiana National Breast % % 40, % Lung % 4, % 159, % Prostate % % 29, % Colorectal % 1, % 50, % Pancreas % % 39, % All others % 5, % 266, % TOTAL CASES % 13, % 585, % SELECTED CANCER SITE DEATHS 2014 BREAST 6.9% 12.0% 6.4% LUNG 27.2% 28.0% 31.0% PROSTATE 5.7% 5.0% 4.3% COLORECTAL 8.6% 9.1% 8.2% PANCREAS 5.7% 6.8% 6.3% ALL OTHERS 45.5% 39.4% 43.8% Franciscan St Elizabeth 2014 ACS Projected Figures IN 2014 ACS Projected Figures National 2014

4 Franciscan St. Elizabeth Health County of Residence at Diagnosis Benton 27 5% 17 4% 19 4% Carroll 20 4% 20 4% 26 6% Cass 8 2% 8 2% 9 2% Clinton 31 6% 25 5% 23 5% Fountain 22 4% 10 2% 25 6% Jasper 25 5% 21 5% 20 4% Montgomery 22 4% 32 7% 36 8% Newton 12 2% 15 3% 10 2% Pulaski 11 2% 6 1% 2 0% Tippecanoe % % % Warren 4 1% 9 2% 13 3% White 57 12% 59 13% 44 10% Other Counties/State 13 NA 14 NA 10 NA TOTAL CASES % % % COUNTY OF RESIDENCE AT DIAGNOSIS BENTON CARROLL CASS CLINTON FOUNTAIN JASPER MONTGOMERY NEWTON PULASKI TIPPECANOE WARREN WHITE

5 NHL & HD Treatment within NCCN Guidelines Comparison Franciscan St. Elizabeth Lafayette National Cancer Data Base The treatment of NHL continues to evolve, and is complicated since some lymphomas are more aggressive (diffuse large B cell) than others (follicular) while still falling into the category of NHL. Generally, there is not a large role for surgery in the treatment of NHL, other than the occasional need for splenectomy and other individual circumstances. Likewise radiation therapy is frequently reserved for bulky disease or sometimes for lymphoma limited to a single site. There is no role for hormonal therapy. The backbone of NHL treatment is with chemotherapy and immunotherapy with targeted agents. At Franciscan St. Elizabeth Health, 4.6% of patients were treated with surgery alone, vs. 7.0% of patients nationally. 4.6% of our patients received radiation alone, vs. 2.3% of patients nationally. 1.5% of our patients received surgery and radiation, vs. 1% nationally. 24.6% of patients locally received surgery with chemotherapy, vs. 6.5% nationally. 4.6% of patients locally received chemotherapy and radiation, vs. 4.5% nationally. 33.8% of our patients received chemotherapy alone, vs. 29.0% nationally. Interestingly, though no patients received hormonal therapy as part of their treatment for NHL, 15.5% of patients did nationwide. 4.6% of patients here had some other form of treatment not included above, vs. 11.4% of patients nationally. And 21.5% of patients locally had no treatment at all, vs. 22.9% of patients nationwide. A higher proportion of patients treated locally had some form of surgery involved with their treatment (30.7% of our patients vs 16.8% of patients nationally). It may be that our patients who just had excisional biopsies as part of their diagnosis are being counted as having surgery as part of treatment. Per the NCCN guidelines, the backbone of treatment HD is with chemotherapy (ABVD or Stanford V regimens). In Stage I/II disease, chemotherapy is generally to be followed with limited field radiation. Like other lymphomas, there is not a formal role for surgery in the treatment of HD, though it may prove helpful in individual circumstances. Likewise, we are not aware of any defined role for a hormonal therapy in lymphomas in general. In comparing the way patients at Franciscan St. Elizabeth Health were treated for HD in to treatments received by patients nationwide in the same time period, local physicians adhered much closer to the NCCN guidelines. 45.5% of local patients received some combination of surgery and chemotherapy, 9.1% received chemotherapy and radiation, 18.2% received chemotherapy alone, and 18.2% received surgery, chemotherapy and radiation. 9.1% of our local patients did not have any treatment. By comparison, nationally 4.1% of patients received surgery alone, 11.1% received surgery and chemotherapy, 16.5% received chemotherapy and radiation, 39.2% received chemotherapy alone, 6.0% received surgery, chemotherapy and radiation, and 11.4% received no treatment. Additionally, 4% of patients nationwide received chemotherapy with hormonal therapy, and 7.4% received other therapy. Treatment FSEH Lafayette NCDB S 4.0% 7.0% R 4.0% 2.0% S/R 1.0% 1.0% S/C 28.0% 7.0% R/C 5.0% 6.0% C 32.0% 30.0% S/X/C 3.0% 1.0% S/C/H 0.0% 2.0% C/H 0.0% 12.0% Other 4.0% 11.0% None 20.0% 21.0% Totals In summary, though our numbers are small, it appears that patients with lymphomas in this community are being treated appropriately according to the NCCN guidelines.