2016 Annual Cancer Program Report

Transcription

1 2016 Annual Cancer Program Report

2 Table of Contents Chairman s Comments..1 Cancer Registry report..2 Tumor Conferences...3 Gender Distribution Compared to State/Nat l Figures County of Residence at Diagnosis....5 Top Ten Sites by Gender. 6 A summary of cancer screenings..7-10

3 On behalf of the Cancer Committee of Baptist Health Floyd, we present to you the annual report that covers data through Our cancer program offers patients a full range of advanced diagnostic and treatment services along with support services via our rehabilitation department, home health services, nutritional support provided by a dedicated dietician, palliative care, pastoral care, psychosocial care provided by a dedicated social worker, support groups, survivorship care program, and patient navigators. We hope you view this program as a resource for education and patient care. Our patients came from 26 surrounding counties in the states of Indiana and Kentucky, as well as Florida, in Lung cancer has been our most commonly diagnosed malignancy, and given our location, we have seen relatively more lung cancer cases in males and females, as compared to the state and national averages. We continue to offer low dose CT screening to detect lung cancers coordinated by our Lung Navigator. We have also seen a higher volume of breast cancers than the rest of Indiana and the U.S. Our Breast Nurse Navigator guides patients through the treatment process and into survivorship in a National Accreditation Program for Breast Centers accredited program. Our incidence of colon cancer for males and females has risen, and is higher than the state and national average. This may be due to our participation in the 80 by 18 Program, an initiative of the National Colorectal Cancer Roundtable, dedicated to eliminating colorectal cancer as a major public health problem. We are working toward a shared goal of screening 80% of adults aged 50 and older by We hope that you will view this report as a valuable resource. Respectfully submitted, David Stapp, M.D. Chairman, Cancer Committee 1

4 Cancer Registry The Cancer Registry is a computerized center responsible for the collection, management, and analysis of data on patients diagnosed with, or treated for, a malignant disease. The registrars collect demographic information including age, gender, race, date of birth, residence, and smoking history. Also collected are: medical history, diagnostic findings including method of diagnosis, primary site, cell type, extent of disease, therapy and follow-up information. The information that is collected is reported, according to federal law and with confidentiality, to the state registry at the Indiana State Department of Health and to the National Cancer Data Base. Data is utilized by local, state, and national cancer agencies in making important health decisions to maximize public health funds for screening and education programs. The information collected is also a valuable tool used by physicians and researchers in the area of etiology, diagnosis, and treatment. The follow-up information collected serves as a reminder to patients and physicians to schedule regular checkups, and provides survival and disease-free intervals. In addition to providing information required by law, the registry also maintains the documentation necessary for cancer program accreditation by the American College of Surgeons Commission on Cancer and accreditation by the American College of Surgeons National Accreditation Program for Breast Centers. The registrars also coordinate Cancer Committee meetings quarterly, conduct site-related quality studies, collaborate with physicians for quality control of registry data, and plan/staff Tumor Conferences. In 2016, there were a total of 744 cases entered into the registry including 673 newly diagnosed cases and 71 cases of recurrent disease. A total of 9,767 newly diagnosed cases have been accessioned since our reference date, January 1, The total percentage of current follow-up since our reference date is 87.36% exceeding our target of 80%, and current follow-up for the most recent five years is 91.67%, exceeding our goal of 90%. The registrars are required to attend continuing education activities. It is the goal of the certified registrars to attend a national or regional meeting at least once every three years. In 2016, the staff attended the first Kentucky and Indiana Regional Cancer Registrars Meeting. This was a cooperative effort between the Kentucky Cancer Registry, the Indiana Cancer Consortium, and the Indiana Cancer Registrars Association. Our staff assisted in the planning for this regional conference. Finally, the Cancer Registry staff is interested in community service and cancer prevention. Staff served on the Floyd County Relay for Life Committee. They provide data for grants to support programs for the underserved/underinsured in our community. The Cancer Registry is located in the Lower Level of the Cancer Center and is staffed by Jill Aemmer, C.T.R.; Shirley Edlin, C.T.R.; and Michele Hoskins, B.A., C.T.R. For more information or to request data, please call or

5 What is a Tumor Conference? Tumor conferences are designed to improve the care of patients with cancer by providing multidisciplinary treatment planning. Twice monthly, a group of physicians including surgeons, medical oncologists, radiation oncologists, radiologists, pathologists, primary care, palliative care or other sub-specialties gather with other health care professionals to discuss the cancer cases seen at Baptist Health Floyd. We offer two types of tumor conferences, a facility-wide multidisciplinary Tumor Board where all types of cancer are discussed, and, a site-specific Breast Conference. These conferences adhere to specific guidelines set by the American College of Surgeons Commission on Cancer and the National Accreditation Program for Breast Centers. The goal is to present at least 15% of the analytic cases, or those cases diagnosed and/or receiving all or part of their care at Baptist Health Floyd. The patient s medical history is given, and radiological studies are reviewed along with pathology slides. There is an opportunity in these conferences for the patient care team to discuss the treatment plan face-to-face while reviewing the nationally accepted treatment guidelines. The following primary cancer sites were discussed at conferences in 2016: Ampulla of vater Duodenum Pancreas Anal canal Esophagus Prostate Anus Gallbladder Pyriform sinus Appendix GE junction Recto-sigmoid Bladder Larynx Rectum Bone marrow Liver Skin Brain Lymph nodes Soft tissue Breast Lung Stomach Cervix Nasopharynx Thyroid Colon Ovary Unknown primary Physicians participating in the 2016 program: Dr. Deepak Azad Dr. Laura Barkley Dr. Douglas Berg Dr. Michael Bousamra Dr. Naveed Chowhan Dr. John Clayton Dr. Kelly Colomb Dr. Yasoda Devabhaktuni Dr. Michael Doyle Dr. Azmi Draw Dr. William Fortner Dr. William Garner Dr. Kendall Goldschmidt Dr. Lanny Gore Dr. Matthew Hennig Dr. Roger Holland Dr. Ajay Kandra Dr. Syed Kazmi Dr. Megan Mezera Dr. Mana Moghadamfalahi Dr. Matthew Nett Dr. Roseline Okeke Dr. David Rankin Dr. Edsel Reed Dr. James Rizzo Dr. David Rodriguez Dr. Jerome Schrodt Dr. David Stapp Dr. Matthew Thurman Dr. Lakshmi Vemavarapu Dr. Andrea Walker Dr. Jeffrey Weiss Dr. Kevin White Dr. Eric Wieman Dr. Brian Worm Dr. Sara Zakel 3

6 2016 Cancers in Females Baptist Health Floyd* Indiana** National*** Breast 33% 28% 30% Lung 21% 15% 12% Colon 10% 6% 6% Endometrium 3% 7% 7% Thyroid 3% 4% 5% 2016 Cancers in Males Baptist Health Floyd* Indiana** National*** Lung 28% 17% 14% Colon 14% 6% 6% Kidney 5% 5% 5% Non-Hodgkin s 5% 4% 5% Lymphoma Urinary bladder 5% 7% 7% The incidence of female breast cancer is stable at our facility as well as in Indiana and nationwide compared to 2015 data. The percentage of lung cancers at Baptist Health Floyd has risen in both males (28% compared to 25% in 2015) and in females (21% compared to 19% in 2015). The rate of male lung cancers is stable in Indiana and the U.S. Female lung cancer is up slightly in Indiana and down slightly in the national data. The percentage of colon cancers at our facility has increased in both sexes (females-10% compared to 8% in 2015) and (males-14% compared to 10% in 2015). This is, perhaps, related to our aggressive screening measures in conjunction with the National Colorectal Cancer Roundtable s 80 by 18 initiative. *Baptist Health Floyd data based on 2016 figures. **State data courtesy of Indiana State Department of Health and is based on 2015 data. ***National data courtesy of CA-A Journal for Clinicians,

7 2016 County of Residence at Diagnosis 0.14% 0.14% 0.14% 0.14% 0.14% 0.27% 0.54% 7.17% 23.14% 37.62% 8.12% 0.27% 3.65% 0.54% 13.40% A total of 95.77% of our patients who have cancer are from Indiana counties; 3.67% of our patients reside in Kentucky; 0.28% of our patients live in Florida; and.28% are documented as out of state, county unknown.

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9 Standard 1.8 Monitoring Community Outreach in Cancer Related HCI Events 2016 Individual Event Report Summary Date: January 1, 2016 December 31, 2016 Event Name: Colon Cancer Screening Program Screening Type: Occult Blood Screening Kits Location: Kits provided at various locations in our region Target Population: Adults, at risk individuals Number Screened YTD: 29 How was the need determined for this outreach activity? Floyd County, Indiana, has a high risk of deaths related to colon cancer. Information for this can be found at the Floyd County Health Needs Assessment, floydfoundation.org List the nationally accepted, evidence based guidelines that directed this activity. The CDC recommends annual FOBT (fecal occult blood testing) for adults over the age of Discuss the mechanism in place to ensure follow up of all positive findings identified through the activity. All participants are mailed their results along with a letter recommending follow up with their primary care physician. They are given a number to call if they do not have a primary physician. Evaluate the effectiveness of access and referral processes. Occult blood screening kits are available at many of Baptist Health Floyd s community events. In addition, they can be picked up for free at the front desk of our Cancer Center. What is the overall summary of this event? Year to date, 29 people have participated in this free screening. There were 6 with a positive result. 7

10 Standard 1.8 Monitoring Community Outreach in Cancer Related HCI Events Dates: January 1, 2016 December 31, 2016 Event Name: Lung Cancer CT Cancer Screenings Screening Type: Cat Scan of lungs for those who qualify Location: Baptist Health Floyd Cancer Center 2016 Lung Cancer Screening Program Target Population: Smokers or ex smokers who have quit within the last 15 years, age (private insurance or selfpay age 55 80), have a 30 pack year history of smoking, and have no signs or symptoms of lung problems or lung cancer Number Screened: 131 How was the need determined for this outreach activity? Floyd County has high number of deaths related to lung cancer according to the community health needs assessment (found at floydfoundation.org). This screening is intended to catch early stage lung disease among those who are at a high risk for developing lung cancer. List the nationally accepted, evidence based guidelines that directed this activity. The National Cancer Institute promotes lung cancer screenings. Studies have shown a 20% reduction in lung cancer deaths among those who received early screenings. See Discuss the mechanism in place to ensure follow up of all positive findings identified through the activity. Participants are responsible for their own follow up. Results are forwarded to their family physician or physician of preference. All results are discussed with patient same day of service. A Radiologist will discuss directly with any patient with positive results. All patients are given a copy of report for their records same day service. Evaluate the effectiveness of access and referral processes. Participants learn of this screening through a multitude of media methods, including the community newsletter, which reaches over 100,000 households. Medical records are kept as are any normal medical procedures. The patients physician has access to these. In 2016, the lung cancer screening program has been overseen by Mindi Burch, the Lung Health Navigator for Baptist Health Floyd. We expect to see an increase in the numbers of those screened as well as a more comprehensive follow up process in place for the patients. Number of Patients with confirmed malignant diagnosis: 3 Number of follow up appointments with Dr. Kandra or primary care physician : 28 8

11 Standard 1.8 Monitoring Community Outreach in Cancer Related HCI Events 2016 Individual Event Report Summary Date: January 1, 2016 December 31, 2016 Event Name: Community Skin Cancer Screenings Screening Type: Skin Cancer Screenings provided by certified Dermatologists Location: Floyd County: YMCA, Baptist Health Floyd Cancer Center Target Population: adults Number Screened: 94 How was the need determined for this outreach activity? According to the National Cancer Institute, non melanoma skin cancer is the most common cancer in the United States. These screenings were provided to help detect early cancer as well as heighten awareness and education regarding skin cancer prevention. List the nationally accepted, evidence based guidelines that directed this activity. The National Cancer Institute as well as the American Academy of Dermatology both recommend skin cancer screenings provided by certified dermatologists. Discuss the mechanism in place to ensure follow up of all positive findings identified through the activity. When a dermatologist documents that a screening patient should receive a biopsy or further evaluation or treatment, the patient must sign the following statement, I understand that I have a possible cancerous or precancerous condition that requires a follow up examination. I also understand that it is my responsibility to arrange for a follow up examination with a dermatologist of my choice, and that any follow up examination or treatment that I may receive is not sponsored, endorsed, or guaranteed by the American Academy of Dermatology. We have a 100% completion rate for patient s signing this statement when required. Evaluate the effectiveness of access and referral processes. All patients, regardless of screening outcome, are given a list of contact information for all area certified dermatologists. 9

12 What is the overall summary of this event? Results from the two 2016 skin cancer screenings indicate how effective this event is for the region. Total Screened 94 Possible Basal Cell Carcinoma 5 Possible Squamous Cell Carcinoma 3 Possible Melanoma 1 Biopsy Recommended 21 10