1. CANCER INCIDENCE IN NEW JERSEY BY COUNTY, 1996-2000 for the Comprehensive Cancer Control Plan County Needs Assessments August 2003 Prepared by: Cancer Surveillance Program Cancer Epidemiology Services New Jersey Department of Health & Senior Services

2. New Jersey State Cancer Registry Background established by legislation – NJSA 26:2-104 et.seq. a central cancer registry (i.e. population- based incidence registry) all cases of cancer diagnosed October 1978 to the present (about 40,000 a year) except cervical cancer in situ diagnosed after 1994 and certain skin carcinomas hospitals, clinical laboratories, physicians, dentists must report cases reporting agreements with New York, Delaware, Pennsylvania, Florida, Maryland, North Carolina

3. New Jersey State Cancer Registry Background (cont.) includes identifiers, demographic characteristics, medical information, vital status for each case cancer information is coded using the International Classification of Disease for Oncology (ICD-O), 2 nd edition follows data standards of the North American Association of Central Cancer Registries (NAACCR) participates in CDC’s National Program of Cancer Registries and NCI’s Surveillance, Epidemiology, and End Results (SEER) program an active member of NAACCR

4. New Jersey State Cancer Registry Data Quality recipient of NAACCR’s Gold Standard (highest possible) for 1995 through 2000 data Gold Standard is based on: –completeness of case ascertainment – > 95% –missing/unknown age at diagnosis, gender, county – each < 2% –missing/unknown race - < 3% –death certificate only cases - < 3% –duplicate cases - < 1 per 1000 –passing an edit program – > 99% correct –timeliness – data submitted within 24 months

5. New Jersey Cancer Incidence by County, 1996-2000 – Data Sources data are from the May, 2003 analytic file tabulations using SEER*Stat, a statistical software package distributed by NCI 1996-1999 populations estimates from NCI 2000 populations from U.S. Census Bureau Note: NJSCR follows the SEER multiple primary rules; thus a patient with cancer can be counted more than once if diagnosed with two or more primary cancers.

6. New Jersey Cancer Incidence by County, 1996-2000 – Hispanic Algorithm used the NAACCR Hispanic Identification Algorithm (NHIA) auguments the cases reported as Hispanic based on: –birthplace –marital status –race –surname match to the 1990 U.S. Census Hispanic surname list

7. County Cancer Incidence Tables and Figures – General Information includes the 7 cancers in the CCCP – breast, cervix, colorectal, lung & bronchus, melanoma, oral cavity & pharynx, prostate include incidence rates and stage at diagnosis by race, ethnicity, and age group for: –men and women for colorectal, lung & bronchus, oral cavity & pharynx cancers and melanoma of the skin –women only for breast, cervical cancer –men only for prostate cancer –except stage at diagnosis is not included for lung & bronchus cancer

8. County Cancer Incidence Tables and Figures – General Information (cont.) incidence rates were calculated for invasive cancers only incidence rates are per 100,000 population and age-adjusted to the 2000 U.S. population standard percents diagnosed by stage include invasive and in situ cases except for cervical cancer for the percents diagnosed by stage the in situ and localized stages are combined except for breast cancer Note: invasive cancers are localized, regional, and metastatic stages; in situ cancers are not considered invasive

9. County Cancer Incidence Tables and Figures – General Information (cont.) race categories are white, black, and all races (includes other than white and black races and unknown race) ethnic category is Hispanic (non-Hispanic is not shown) race and ethnicity are not mutually exclusive age groups are 15-39, 40-49, 50-64, 65-74, 75 and over (the 0-14 age group was not included due to very small numbers statewide) counts, and rates based on counts, fewer than 5 are suppressed due to unreliability

10. County Tables & Graphs Cancer Incidence use to determine opportunities for prevention activities (and screening activities for colorectal cancer) within the county compare rates among the different gender, the different race and ethnic groups and the different age groups compare the county rates to the New Jersey rates be cautious with rates based on small numbers: –the number of people affected is small –the rates are not reliable Note: Corresponding incidence graphs for men and women are on the same scale.

11. County Tables & Graphs Cancer Incidence by Race and Ethnicity table includes incidence counts and rates for each year and 1996-2000 combined separate table and graphs for each gender where applicable table includes all races, whites, blacks, Hispanics for the county and New Jersey first line graph shows annual incidence rates for whites and blacks in the county and New Jersey (if data for blacks is suppressed then all races is shown instead) second line graph shows annual incidence rates for Hispanics in the county and New Jersey

12. County Tables & Graphs Cancer Incidence by Age Group separate table and graphs for each gender where applicable (New Jersey is shown separately) table includes incidence counts and rates for each year and 1996-2000 combined table includes five age-groups for the county line graph shows annual incidence rates by age group

13. County Tables & Graphs Stage at Diagnosis use to determine screening needs – distant stage is the most important stage to note within the county compare percent diagnosed at the distant stage among the different race and ethnic groups and the different age groups compare the percent diagnosed at the distant stage in the county with New Jersey be cautious with percents based on small numbers: –the number of people affected is small –the percents are not reliable

14. County Tables & Graphs Stage at Diagnosis by Race and Ethnicity separate table and charts for each gender where applicable (New Jersey is shown separately) table includes the number and percent of cases diagnosed at each stage for 1996-2000 combined table includes all races, whites, blacks, Hispanics for the county pie charts show the percent diagnosed by stage for all races, whites, blacks, and Hispanics the dark pie slice is the distant stage, the stage with the lowest survival rate Note: Read the pie chart clockwise.

15. County Tables & Graphs Stage at Diagnosis by Age Group separate tables and graphs for each gender where applicable (New Jersey is shown separately) table includes the number and percent of cases diagnosed at each stage for 1996-2000 combined table includes five age-groups for the county (New Jersey is shown separately) pie charts show the percent diagnosed by stage for each age group the dark pie slice is the distant stage, the stage with the lowest survival rate Note: Read the pie chart clockwise.

16. County Tables & Graphs Comparison with Other Data Sources Healthy New Jersey 2010: –this county data is more recent –age-adjusted rates computed using the 1970 U.S. population standard so cannot compare with these county data rates* Cancer Control Planet: –this county data is more recent –Planet suppresses counts <16 –Planet does not include stage at diagnosis *Currently, the 2000 U.S. population standard is used nationwide.

17. County Tables & Graphs Group Exercise three groups (by color of your folder) each group has one cancer type for one county discuss the data (e.g. compare incidence and stage at diagnosis among the genders, races, ethnicity and with New Jersey) agree upon two or three prevention/early detection activities and the target population(s) for each based on the data if time enough, each group report its findings