THE BURDEN OF CANCER IN NEBRASKA: RECENT INCIDENCE AND MORTALITY DATA Presented by: Bryan Rettig, MS Nebraska Dept. of Health & Human Services Division of Public Health May 31, 2017
Nebraska Cancer Registry (NCR): History & Background Established by Unicameral in 1986 Began collecting data statewide in 1987 30 th anniversary this year! 265,000 Nebraska resident cases now on file Funded by portion of state cigarette tax & CDC grant
NCR: History & Background Reportable cases include malignant neoplasms, including cases of carcinoma, sarcoma, melanoma, lymphoma, Hodgkin s Disease, and myeloma Reportable cases exclude precancerous conditions, benign polyps, and benign tumors Benign brain & other central nervous system tumors became reportable in 2004
NCR: History & Background Case data include (but are not limited to): Name, address, Social Security # (if available) Date of birth, race, sex Date of diagnosis Primary site Stage of disease at diagnosis Diagnostic confirmation Type of treatment(s): first course & subsequent Vital status
NCR: History & Background Hospitals required to report (or make available) information on their cancer patients to DHHS Other sources of cases include pathology labs, physician offices, death certificates, and other state cancer registries Collection of data directly from patient or patient s family prohibited
NCR: History & Background The North American Association of Central Cancer Registries (NAACCR) has awarded the NCR its gold standard certificate of data quality for 19 consecutive years (1995-2013) Most recent annual statistical report (2013) is posted on the DHHS website 2014 report will be available soon
Cancer in Nebraska: Some Statistics 47,020 new cases and 17,205 deaths among Nebraska residents during 2010-2014 Mean age at diagnosis: 65.3 years Prevalence: 96,000 Nebraska residents living with cancer in 2015 #1 cause of death among Nebraska residents since 2009 Survival: Current US (SEER) 5-year relative survival rate (for 2009 cases)=69% (49% for 1975-1979 cases)
Nebraska cancer incidence & mortality Number of new cases* and deaths among Nebraska residents, by year of diagnosis/death 10000 9000 8000 7000 6000 5000 4000 3000 2000 1000 0 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 New cases Deaths *invasive cases only
Rate (per 100K population; age-adjusted) Cancer incidence rates, Nebraska and US 600 550 500 450 400 Nebraska US* 350 300 *US data for 2014 not available
Rate (per 100K population; age-adjusted) Cancer mortality rates, Nebraska and US 250 225 200 175 Nebraska US 150 125 100
Nebraska cancer incidence, by primary site Males (N=24,354)* Females (N=22,664)* All Others 39% Prostate 25% All Others 37% Breast 29% NHL 5% Bladder 7% Colorectal 10% Lung 14% Thyroid 4% Endometrium 7% Colorectal 10% Lung 13% *includes all invasive cases diagnosed among Nebraska residents during 2010-2014
Average annual age-adjusted rate (per 100K population) Nebraska cancer incidence & mortality, by race & ethnicity 600 500 400 300 200 100 0 Incidence (2005-2014) Mortality (2005-2014) White African American American Indian Asian PI Hispanic
Lung cancer incidence, mortality, staging, & survival 6,214 diagnoses and 4,486 deaths among Nebraska residents during 2010-2014 Mean age at diagnosis: 70.3 years #1 cause of cancer deaths among Nebraska residents during 2010-2014 (26% of all cancer deaths) 73% of Nebraska cases during 2010-2014 diagnosed at late stage (regional or distant) Survival: Current US 5-year relative survival rate=20% (13% for 1975-1979 cases)
Rate (per 100K population: age-adjusted) Lung cancer incidence rates, Nebraska and US 90 80 70 60 50 Nebraska US* 40 30 *US data not available for 2014
Rate (per 100K population; age-adjusted) Lung cancer mortality rates, Nebraska and US 80 70 60 50 Nebraska US 40 30 20
Average annual age-adjusted rate (per 100K population) Lung cancer incidence & mortality, by race & ethnicity, Nebraska residents 90 80 70 60 50 40 30 20 10 0 Incidence (2005-2014) Mortality (2005-2014) White African American American Indian Asian PI Hispanic
Female breast cancer incidence, mortality, staging, & survival 6,547 invasive and 1,376 in situ diagnoses among Nebraska women during 2010-2014 Mean age at diagnosis: 62.9 years 1,168 deaths among Nebraska women during 2010-2014 (#2 cause of female cancer deaths) 70% of Nebraska cases during 2010-2014 diagnosed at early stage (localized or in situ) Survival: Current US 5-year relative survival rate=91% (75% for 1975-1979 cases)
Rate (per 100K female population; age-adjusted) Female breast cancer incidence rates, Nebraska and US 150 140 130 120 Nebraska US* 110 100 *US data not available for 2014
Rate (per 100K female population; age-adjusted) Female breast cancer mortality rates, Nebraska and US 35 30 25 20 15 Nebraska US 10 5 0
Average annual age-adjusted rate (per 100K female population) Female breast cancer incidence & mortality, by race & ethnicity, Nebraska residents 140 120 100 80 60 40 20 0 Incidence (2005-2014) Mortality (2005-2014) White African American American Indian Asian PI Hispanic
Colorectal cancer incidence, mortality, staging, & survival 4,550 diagnoses and 1,714 deaths among Nebraska residents during 2010-2014 Mean age at diagnosis: 68.8 years 52% of Nebraska cases during 2010-2014 diagnosed at late stage (regional or distant) Prognosis improving: Current US 5-year relative survival rate=66% (50% for 1975-1979 cases)
Rate (per 100K population; age-adjusted) Colorectal cancer incidence rates, Nebraska and US 80 70 60 50 40 30 Nebraska US* 20 10 0 *US data not available for 2014
Rate (per 100K population; age-adjusted) Colorectal cancer mortality rates, Nebraska and US 30 25 20 15 10 Nebraska US 5 0
Average annual age-adjusted rate (per 100K population) Colorectal cancer incidence & mortality, by race & ethnicity, Nebraska residents 70 60 50 40 30 20 10 0 Incidence (2005-2014) Mortality (2005-2014) White African American American Indian Asian PI Hispanic
Prostate cancer incidence, mortality, staging, & survival 5,981 diagnoses and 914 deaths among Nebraska men during 2010-2014 Mean age at diagnosis: 67.2 years 74% of Nebraska cases during 2010-2014 diagnosed at early (localized) stage Prognosis excellent: Current US 5-year relative survival rate over 99% (69% for 1975-1979 cases)
Rate (per 100K male population: age-adjusted) Prostate cancer incidence rates, Nebraska and US 200 175 150 125 100 Nebraska US* 75 50 *US data not available for 2014
Rate (per 100K male population; age-adjusted) Prostate cancer mortality rates, Nebraska and US 50 40 30 20 Nebraska US 10 0
Average annual age-adjusted rate (per 100K male population) Prostate cancer incidence & mortality, by race & ethnicity, Nebraska residents 250 200 150 100 50 0 Incidence (2005-2014) Mortality (2005-2014) White African American American Indian Asian PI Hispanic
Other cancers incidence & mortality Top primary sites among Nebraska residents during 2010-2014 (after lung, female breast, colorectal & prostate): Primary Site # Diagnoses Primary Site # Deaths Bladder 2,190 Pancreas 1,111 NHL 2,112 Leukemia 738 Melanoma 2,064 NHL 645 Kidney & RP 1,730 Brain & CNS 515 Leukemia 1,486 Liver & IBD 512 Endometrium 1,471 Esophagus 486
Other cancers incidence & mortality rate trends, Nebraska, 2005-2014 Urinary bladder Liver & intrahepatic bile duct Endometrium Leukemia No change NHL Pancreas Kidney & renal pelvis Melanoma -20% -15% -10% -5% 0% 5% 10% 15% 20% 25% Incidence Mortality
Other cancers survival 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% US (SEER) 5-year relative survival rates, by year of diagnosis 2009 1975-9
Cancer incidence, mortality & survival in Nebraska: conclusions Positive: Overall cancer incidence and mortality rates declining Large rate declines for colorectal and prostate cancers Survival rates good for many sites & improving Negative: Cancer will remain #1 cause of death Incidence rates increasing for some sites Aging population means that the number of new cases and deaths will not decline & may increase
CONTACT INFORMATION Bryan Rettig Nebraska Dept. of Health & Human Services Division of Public Health Phone: 402-471-0553 E-mail: Bryan.Rettig@nebraska.gov