1. Lung Cancer Morbidity in Baltimore City & Chicago By Calandra Dyson Lyliane Mbah MoniQue Veney Promise Okafor

2. What is Lung Cancer?  A disease in which cancer cells grow out of control in the lungs  Two main types: small cell and non-small cell  Non-small cell is more common than small cell lung cancer (CDC, 2014)

3. Risks  Smoking  Second-hand smoke  Radon exposure  Personal or family history of lung cancer  Radiation therapy to the chest (CDC, 2014)

4. Risks

5. Symptoms  Coughing that gets worse or doesn’t go away  Chest pain  Shortness of breath  Wheezing  Coughing up blood  Feeling very tired all of the time  Weight loss with no known cause (CDC, 2014)

6. Burden on Patient & Family  Effect on individual’s position or the rolewithin their family e.g. Mother assume provider responsibility  Strain in relationship due to role reversal in the long run e.g. caregiver burn out, tensed family dynamics  Emotional burden because of passing away too soon.  Financial instability because of the high cost of treatment and care.

7. Burden on Patient and Family  Effect on individual’s position or the role within their family e.g. Mother assume provider responsibility  Strain in relationship due to role reversal in the long run e.g. caregiver burn out, tensed family dynamics  Emotional burden because of passing away too soon.  Financial instability because of the high cost of treatment and care.

8. Screening and Diagnosis  The only recommended screening test for lung cancer is low-dose computed tomography (low-dose CT scan)  Candidates for screening include people who have a history of heavy smoking, smoke now or have quit within the past 15 years and are between 55 and 80 years old (CDC, 2014)

9. Screening and Diagnosis  Testing to determine how far cancer has spread through the lungs, lymph nodes and the rest of the body includes  MRI  PET scan  CT scan  Radionuclide bone scan  Pulmonary function test  Endoscopic ultrasound  Mediastinoscopy  Anterior mediastinotomy  Lymph node biopsy  Bone marrow aspiration and biopsy

10. Treatment Treatment Depends on 4 factors:  Type of lung cancer  Stage of the cancer  Other present health issues  Patient preferences (American Lung Association, 2015)

11. Treatment continued Treatment approach for NSCLC or SCLC  surgery,  radiation,  chemotherapy  laser therapy (ALA, 2015)

12. Treatment continued Treatment approach specific for NSCLC includes:  Watchful waiting  Targeted therapy  Photodynamic therapy  Cryosurgery  Electrocautery (ALA, 2015)

13. Cancer in Baltimore City Vs Chicago through 2002-2011

14. U.S Census Data for Baltimore City 2000-2010 2000% of Population2010 % of Population Total Population651, 154100%620, 961100% Female Population347, 64753.4328, 71252.9 Male Population303, 68746.6292, 24947.1 Median Age of Total Population 35.0 yearsn/a34.4 yearsn/a White205, 98231.6183, 83029.6 Black or African American 418, 95164.3395, 78163.7 Asian9, 9851.514, 5482.3 American Indian and Alaska Native 2, 0970.32, 2700.4 Native Hawaaian and Other Pacific Islander 2220.02740.0 Hispanic or Latino of Any Race 11, 0611.725, 9604.2 Some Other Race4, 3630.713, 5332.2 (U.S. Census Bureau, 200- 2010)

15. U.S. Census Data for Chicago 2000-2010 2000% of Population2010 % of Population Total Population 2, 896, 016100%620, 961100% Female Population 1, 490, 90953.4328, 71252.9 Male Population 1, 405, 10746.6292, 24947.1 Median Age of Total Population 31.5 yearsn/a32.3n/a White1, 215, 31542.01, 212, 83545.0 Black or African American 1, 065, 00936.8887, 60832.9 Asian125, 9744.3147, 1645.5 American Indian and Alaska Native 10, 2900.413, 3370.5 Native Hawaaianand Other Pacific Islander 1, 7880.11, 0130.0 Hispanic or Latino of Any Race 753, 64426.0778, 86228.9 Some Other Race 452, 25515.6393, 86214.6 (U.S. Census Bureau, 2000- 2010)

16. Morbidity Rate: Baltimore City vs.Chicago in 2010 Baltimore City, MD 5,114 _______ x100,000 = 823.5 620,961 0.82% Chicago, IL 15,973 _______ x100,000 = 2572.3 620,961 2.57%

17. Reference  References  American Lung Association (ALA), 2015. Lung cancer: Making Treatment decision. Retrieved on March 18, 2015 from http://www.lung.org/lung-disease/lung-cancer/treating-lung-cancer/preparing-for-treatment/making-treatment- decisions.html  Center for Cancer Surveillance and Control Maryland Department of Health and Mental Hygiene. Retrieved on March 18, 2015 from http://phpa.dhmh.maryland.gov/cancer/SitePages/surv_data-reports.aspx  Centers for Disease Control and Prevention. (2013). How did cause of death contribute to racial differences in life expectancy in the United States in 2010? (NCHS Data Brief Number 125). Washington, DC: Government Printing Office.  Division of Cancer Prevention and Control, Centers for Disease Control and Prevention. (2014). How is Lung Cancer Diagnosed and Treated? Retrieved from http://www.cdc.gov/cancer/lung/basic_info/diagnosis_treatment.htm  Division of Cancer Prevention and Control, Centers for Disease Control and Prevention. (2014). What are the Risk Factors? Retrieved from http://www.cdc.gov/cancer/lung/basic_info/risk_factors.htm  Division of Cancer Prevention and Control, Centers for Disease Control and Prevention. (2014). What Screening Tests are There? Retrieved from http://www.cdc.gov/cancer/lung/basic_info/screening.htm  Division of Cancer Prevention and Control, Centers for Disease Control and Prevention. (2014). What are the Symptoms? Retrieved from http://www.cdc.gov/cancer/lung/basic_info/symptoms.htm

18. Reference  Division of Cancer Prevention and Control, Centers for Disease Control and Prevention. (2014). What is Lung Cancer? Retrieved from http://www.cdc.gov/cancer/lung/basic_info/what-is-lung-cancer.htm  Heron, M. (2013). Deaths: Leading causes for 2010 (National Vital Statistics Reports Vol 62 No 6). Retrieved from National Vital Statistics Reports: http://www.cdc.gov/nchs/data/nvsr/nvsr62/nvsr62_06.pdf.  Illinois Department of Public Health. Cancer in Illinois Statistics. Retrieved on March 20, 2015 from http://app.idph.state.il.us/EpiStudies/public/genericdb/code/GenericList.asp  National Cancer Institute at the National Institutes of Health. (2014). Non-Small Cell Lung Cancer Treatment. Retrieved from http://www.cancer.gov/cancertopics/pdq/treatment/non-small-cell-lung/Patient/page2  United States Census Bureau. (2000). General Population and Housing Characteristics, Baltimore City. Retrieved from http://factfinder.census.gov/faces/tableservices/jsf/pages/productview.xhtml?pid=DEC_10_DP_DPDP1&prodType=table  United States Census Bureau. (2010). General Population and Housing Characteristics, Baltimore City. Retrieved from http://factfinder.census.gov/faces/tableservices/jsf/pages/productview.xhtml?pid=DEC_10_DP_DPDP1&prodType=table  United States Census Bureau. (2000). General Population and Housing Characteristics, Chicago. Retrieved from http://factfinder.census.gov/faces/tableservices/jsf/pages/productview.xhtml?pid=DEC_10_DP_DPDP1&prodType=table  United States Census Bureau. (2010). General Population and Housing Characteristics, Chicago. Retrieved from http://factfinder.census.gov/faces/tableservices/jsf/pages/productview.xhtml?pid=DEC_10_DP_DPDP1&prodType=table  World Health Organization [WHO]. (2003). Lung Cancer.