Cancer Tracking The State of the Nation James

Cancer Tracking: The State of the Nation James S. Marks, M. D. , M. P. H. Director Chronic Disease Prevention and Health Promotion

“ If the United States is to reduce the human and financial costs of chronic diseases with effective public health prevention efforts, the first step is to establish a tracking capacity for chronic diseases and environmental exposures. ” Source: Transition Report to the New Administration: Strengthening our Public Health Defense Against Environmental Threats. January 2001, The PEW ENVIROMENTAL HEALTH COMMISSION

• Why cancer tracking is critical. • Why strong cancer registries are needed in every state. • The present and future of cancer registries.

State Cancer Registries PURPOSE: • Is progress occurring? • Are specific populations at higher risk? • Are cancer prevention and control efforts having the expected effect? • Where and how would resources be best used? • Evaluate clusters, quality of care and new interventions.

CDC’s National Program of Cancer Registries • Providing national leadership by helping states and territories: • Fund all 45 states not wholly funded by SEER • Recommend standards for data completeness, timeliness, and quality • Modernize and computerize reporting and data-processing • Develop laws and regulations that promote quality registries

NAACCR*-Certified State Cancer Registries 1997 1998 2000 2002 DC *North American Association of Central Cancer Registries Certification of data from cancers diagnosed 1995, 1996, 1998, 2000 DC

Female Breast Cancer Cases Diagnosed at Early Stage Michigan, 1985– 1987 Percentage of Cases < 39. 1– 48. 1 48. 2– 55. 9 56 & over

Female Breast Cancer Cases Diagnosed at Early Stage Michigan, 1995– 1997 Percentage of Cases < 39. 1– 48. 1 48. 2– 55. 9 56 & over

Patterns of Care Study • Two studies examining four cancer sites: breast, prostate, colon and ovarian. • Compares quality of treatment data reported to NPCR registries with data from medical records • Population-based samples estimate proportion of patients who receive recommended standard of care

What is the Present and Future of Cancer Registries • Trust for America’s Health- “Improving Cancer Tracking Today Saves Lives Tomorrow: Do States Make the Grade? ” is an interim report in establishing systems and great growth in the quality of data. • The future is to use cancer registries for issues of cancer prevention, detection and care. • To serve as a model, as implied in the first Trust For America’s Health report, “America’s Environmental Health Gap: Why the Country Needs a Nationwide Health Tracking Network” for the tracking of critical chronic disease health problems of our time.

The Cancer Weapon America Needs Most “ Although not as glamorous, cancer tabulation can be more important in the fight against cancer than performing an intricate operation or an elegant experiment. A network of cancer registries can be our most potent new weapon against the disease. “ Source: Healey JH. The cancer weapon America needs most. Reader’s Digest June 1992; 140(842): 69– 72.

The Cancer Weapon America Needs Most “ People do not naturally round a cause like cancer record-keeping because no one can point to victims who will suffer without it. Rather, it is our larger understanding of cancer that suffers. And thus, we are all victims. “ Source: Healey JH. The cancer weapon America needs most. Reader’s Digest June 1992; 140(842): 69– 72.