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

*North American Association of Central Cancer Registries Certification of data from cancers diagnosed 1995, 1996, 1998, 2000

NAACCR*-Certified State Cancer Registries

1997 1998

2000 2002

DCDC

DCDC

Female Breast Cancer Cases Diagnosed at Early Stage

Michigan, 1985–1987

Percentageof Cases

< 39.1

39.1–48.1

48.2–55.9

56 & over

Female Breast Cancer Cases Diagnosed at Early Stage

Michigan, 1995–1997

Percentageof Cases

< 39.1

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 rally 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.