Can epidemiological data contribute to improvement in cancer care?

Transcription

1 INSTITUTE OF BIOSTATISTICS AND ANALYSES Faculty of Medicine and Faculty of Science Masaryk University, Brno, Czech Republic Advocacy of comprehensive cancer care and prevention based on recent trends In CRC epidemiology European Colorectal Cancer Days, Brno, April 26 27, 2013 Can epidemiological data contribute to improvement in cancer care?

2 Can epidemiological data help in cancer care management?? Regionally aggregated data / Time trends Prevalence Incidence Mortality Tissue banking Risk Achievable/ Cost - benefit stratification achieved? results evaluation of patients Aggregated Aggregated Outstanding therapeutic financial situation s data demands Spectrum of patients treated Therapeutic procedures Key technologies Results of therapeutic episodes Overall results Specific diagnostic markers Therapeutic strategy Procedures Medication + cost s Toxicity events Complications Risk event s Laboratory data Subjective evaluation, QL DIAGNOSTICS LONGITUDINAL CLINICAL RECORDS RESULTS

3 Where to find the Czech National Cancer Registry? About project News Epidemiological analyses Publications, reports Software SVOD Analytic tools tutorial Incidence and mortality Time trends Regional overview Age analyses Clinical stages Epidemiological analyses International data Comparative standards Comprehensive overview

4 svod.cz interactive analytic tools

5 CRC epidemiology and its information potential I. CRC epidemiological burden

6 Epidemiology of colorectal cancer in the Czech Republic Trends of incidence a mortality Trends in detection of clinical stages Crude rate per,000 inhabitants % 2 nd ed. 3 rd ed. 4 th ed. 5 th ed. 6 th ed. Number of cases per,000 inhabitants incidence mortality %: change between % % Year % % % 20% 0% stages not defined 19 Disease stage at diagnosis: unknown - objective reasons unknown - incomplete records Year Source: Czech National Cancer Registry

7 Epidemiology of colorectal cancer in the Czech Republic Trends of incidence a mortality ASR (E): number of cases per,000 inhabitants age standardized on European age standard % % 2 nd ed. Trends in detection of clinical stages 3 rd ed. 4 th ed. 5 th ed. 6 th ed. ASR (E) % % % stages not defined % 20% incidence mortality %: change between - Year 0% 19 Disease stage at diagnosis: unknown - objective reasons unknown - incomplete records Year Source: Czech National Cancer Registry

8 Regional benchmarking of trends in CRC incidence : Czech Republic : imum in regions : imum in regions PHA: Prague STC: Central Bohemia JHC: South Bohemia PLK: Plzen KVK: Karlovy Vary ULK: Usti nad Labem LBK: Liberec HKK: Hradec Kralove PAK: Pardubice VYS: Vysocina JHM: South Moravia OLK: Olomouc ZLK: Zlin MSK: Moravia-Silesia Number of cases per,000 inhabitants Source: Czech National Cancer Registry PHA STC JHC PLK KVK ULK LBK HKK PAK VYS JHM OLK ZLK MSK

9 Regional profile of CRC incidence and prevalence INCIDENCE PREVALENCE period - at 31/12/ Number of cases per,000 inhabitants 0 20 Number of alive patients per,000 inhabitants Plzen Karlovy Vary Moravia-Silesia Olomouc South Bohemia Hradec Kralove Zlin Vysocina Czech Republic Prague South Moravia Usti nad Labem Liberec Pardubice Central Bohemia Plzen Zlin Vysocina Olomouc South Bohemia Moravia-Silesia South Moravia Pardubice Czech Republic Karlovy Vary Hradec Kralove Prague Liberes Usti nad Labem Central Bohemia Number of cases per,000 inhabitants < 73 Number of alive patients per,000 inhabitants < 4.0 Source: Czech National Cancer Registry

10 CRC epidemiology and its information potential II. CRC prediction of population and therapeutic burden

11 CRC in the Czech Republic: therapeutic burden increases Trends of incidence a mortality Trends of prevalence 000 Number of cases per,000 inhabitants incidence mortality % % Absolute number of alive patients %: change between - Source: Czech National Cancer Registry %

12 CRC in the Czech Republic: predicted burden in 2013 INCIDENCE Colorectal carcinoma Predicted values for 2013 (C18 - C20) Incidence (% CI) Stage I 19 (18; 21) Stage II 1939 (1797; 2081) Stage III 2222 (20; 2373) Stage IV 2177 (2022; 2332) Stage unknown due to objective reasons 3 (237; 483) Stage unknown without reported reason 86 (56; 115) TOTAL 8764 (79; 9534) PREVALENCE Colorectal carcinoma Predicted values for 2013 (C18 - C20) Prevalence (% CI) Stage I (17 843; ) Stage II (16 356; 16 9) Stage III (11 986; ) Stage IV 7557 (7361; 7753) Stage unknown due to objective reasons 2661 (2543; 2779) TOTAL 57 2 (56 089; )

13 Outcome of the care: 5-yr relative survival of CRC patients Colorectal carcinoma (C18 C20) Patients with anti-cancer treatment and with complete information about disease stage 5year relative survival % % % % % % % % 20% 10% Cohort analysis - Cohort analysis - Period analysis - Period analysis - Stage % 77.4% 82.8% 89.4% Stage % 63.9% 67.9% 75.5% Stage % 42.0% 46.9% 55.9% Stage % 10.9% 11.9% 14.6% All stages 48.9% 53.3% 55.3%.8% 0% All stages Stage 1 Stage 2 Stage 3 Stage 4 Period analysis - Period analysis - Cohort analysis - Cohort analysis - Source: Czech National Cancer Registry

14 CRC epidemiology and its information potential III. CRC epidemiology in optimization of cancer care

15 Incidence of CRC in the Czech Republic: detailed view Trend of CRC incidence CRC incidence according to rank of tumors in patient Number of cases per,000 inhabitants % Number of cases per,000 inhabitants Source: Czech National Cancer Registry secondary tumor in patient primary tumor in patient %

16 Epidemiology of colorectal cancer in the Czech Republic Trends in CRC incidence Trend in disease stages CRC as multiple tumor Number of cases per,000 inhabitants primary tumor in patient secondary tumor in patient % % % % % % % % 20% 10% 0% Source: Czech National Cancer Registry 2 nd ed. stages not defined 19 3 rd ed. 4 th ed. Disease stage at diagnosis: unknown - objective reasons 5 th ed. 6 th ed. unknown - incomplete records!

17 Thank you for attention!