1. Mapping Cancer Incidence David Grkovic Joe Pascarosa Andrew Waters Faculty Advisor: Dr. Cynthia Klevickis NPR

2. Introduction About 1 in 3 Americans will get some type of cancer at some point in their life. Half of all cancer cases diagnosed are fatal. Early detection can be critical to the survival of cancer patients. Awareness, awareness, awareness!

3. Introduction Our senior project involved gathering data from the Virginia Cancer Registry to produce interactive cancer maps. These maps show cancer statistics within the different regions in Virginia.

4. Introduction These maps provide geographical representation important in epidemiology From our geographical analysis, we hypothesized possible correlations between cancer incidence and various demographics and environmental concerns.

5. Introduction We created a web page where people can view our maps, interpretations, and statistics from the Virginia Cancer Registry.

6. Introduction Clip from NPR about cancer.

7. Health Districts Virginia-35 Health Districts Gather health-related statistics and report to Virginia Department of Health (VDH) Within the VDH, there is the Virginia Cancer Registry (VCR) VCR divides cancer statistics between individual health districts

8. Disclaimer This project was put together by undergraduate college students at James Madison University. It is by no means a comprehensive list of correlations linking cancer from certain health districts to certain environmental causes. The possible causes for a high level of cancer incidence in certain health districts are listed in red and described briefly in their appropriate spots. Most of the information on environmental concerns comes from the EPA Superfund site, and all of the environmental concerns listed are real problems. We make no claim, however, that they are absolutely linked to high levels of cancer incidence, but list them merely as possibilities.EPA Superfund site

9. Time Lag Cancer data takes 3-4 years to get reported to Virginia Cancer Registry Patient’s file must be complete Hospital takes time to send it to Virginia Cancer Registry

10. Age-adjusted Cancer Rate Cancer rates based on 100,000 people, 1970 Census Bureau Population Data –If town has old population, higher cancer incidence –If town has young population, lower cancer incidence –More people in Virginia today, but most current generation not most likely to have cancer at young age

11. Cancer Statistics Two sets of data: 1993-1997, and 1998 Each health district’s statistics compared to state and national averages Purposes for two sets of data: a) If 1998 has a high increase over the average from 1993-1997, it could be due to standard deviation, but b) could also be because something changed over the time period causing these extra cancers

12. Not All Cancer Cases End Up Being Reported Some die without seeking medical treatment –don’t know they have cancer –don’t have the money to be treated Some travel outside state to be treated Some hospitals’ record-keeping incomplete Not all medical facilities report to Virginia Cancer Registry

13. Not All Cancer Cases End Up Being Reported National Goal: have 95% of cancer cases reported Virginia:1997: 87.7%1998: 93% Since Virginia below standard, compare statistics to National data instead of state- level data

14. Confidentiality Protection Since on World Wide Web, confidentiality protection important Cannot use many demographics –Age –Race –Gender –Detailed whereabouts –Any other personal information

15. The Virginia Cancer Registry a division of the State Health Department that collects and analyzes information about the occurrence of cancer in Virginia VCR has collected data and information regarding cancer incidence in Virginia since 1970 became a population-based registry in 1990 when reporting of newly diagnosed cancer cases became mandatory under Code of Virginia Section 32. 1- 70 (Cancer Incidence in Virginia 1998)

16. Cancer Registry Goals provision of data for the planning and evaluation of cancer control activities provision of community-based information regarding cancer incidence promotion of cancer research education of allied health professionals about cancer reporting and data

17. Application of Incidence Maps The application cancer incidence data to thematic maps provides a geographic perspective to cancer research The resultant thematic maps can be a highly useful aid for recognition of regional trends in cancer incidence More efficient recognition of trends in cancer incidence leads to more expedient action towards remediation of possible causes

18. Virginia Cancer Maps Incidence by Anatomical Site

19. All Sites

20. Female Breast Cancer

21. Prostate Cancer

22. Colorectal Cancer

23. Lung and Bronchus Cancer

24. Urinary Bladder Cancer

25. Environmental Causes of Cancer Cancer caused by a WIDE range of things Some causes may be environmental in nature Workplace-depending on occupation, higher exposure to pollutants over shorter periods of time Pollutants at home-lower exposure to pollutants over longer periods of time

26. Correlation between Cancer and Environmental Factors Three sets of data (health district, state, national) were analyzed for each health district and each specific cancer site within each health district Health districts with high levels of cancer stand out (when compared to state and national averages) Look for high level of cancer incidence for certain sites on the body

27. Correlation between Cancer and Environmental Factors (cont.) Look at possible causes for that type of cancer Look at individual health district’s industrial and environmental history Do any of the causes for the specific kind of cancer match up with environmental problems in the health district?

28. Accessing your health district http://www.isat.jmu.edu/users /klevicca/cancer_database/hea lthdistricts/healthdistricts.ht mlhttp://www.isat.jmu.edu/users /klevicca/cancer_database/hea lthdistricts/healthdistricts.ht ml

29. Reporting Cancer Clusters Do you think you are part of a cancer cluster? Report it to the Virginia Health Department http://www.vdh.state.va.us/lhd/02.htm

30. Interactive Web Page Questions? Navigate through our web page Answer questions on the quiz

31. Special Thanks Dr. Cindy Klevickis