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New approvals, genetic testing, maintenance therapy, and DFS in ovarian cancer
Recent study findings have indicated that women with ovarian cancer may have BRCA1 or BRCA2 mutations despite a negative family history, and current NCCN (National Comprehensive Cancer Network) guidelines endorse genetic testing for all women with epithelial cancer of the ovary. Despite this, recent reports indicate that most women with ovarian cancer are not being tested, particularly those who are elderly or without a family history. In this paper by Daniels and colleagues, the investigators examined targeted versus universal genetic testing to see if the use of a well-regarded risk model (BRCAPRO) based on personal and family history could discriminate among patients with high-grade serous ovarian cancer. Targeted genetic testing in this group might help lower costs and encourage testing for those women who actually have a significant chance of carrying a deleterious gene mutation.
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Recent study findings have indicated that women with ovarian cancer may have BRCA1 or BRCA2 mutations despite a negative family history, and current NCCN (National Comprehensive Cancer Network) guidelines endorse genetic testing for all women with epithelial cancer of the ovary. Despite this, recent reports indicate that most women with ovarian cancer are not being tested, particularly those who are elderly or without a family history. In this paper by Daniels and colleagues, the investigators examined targeted versus universal genetic testing to see if the use of a well-regarded risk model (BRCAPRO) based on personal and family history could discriminate among patients with high-grade serous ovarian cancer. Targeted genetic testing in this group might help lower costs and encourage testing for those women who actually have a significant chance of carrying a deleterious gene mutation.
Click on the PDF icon at the top of this introduction to read the full article.
Recent study findings have indicated that women with ovarian cancer may have BRCA1 or BRCA2 mutations despite a negative family history, and current NCCN (National Comprehensive Cancer Network) guidelines endorse genetic testing for all women with epithelial cancer of the ovary. Despite this, recent reports indicate that most women with ovarian cancer are not being tested, particularly those who are elderly or without a family history. In this paper by Daniels and colleagues, the investigators examined targeted versus universal genetic testing to see if the use of a well-regarded risk model (BRCAPRO) based on personal and family history could discriminate among patients with high-grade serous ovarian cancer. Targeted genetic testing in this group might help lower costs and encourage testing for those women who actually have a significant chance of carrying a deleterious gene mutation.
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Refeeding syndrome in a vegan patient with stage IV gastric cancer: a novel case
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The need for decision and communication aids: a survey of breast cancer survivors
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Cost of palliative external beam radiotherapy (EBRT) use for bone metastases secondary to prostate cancer
Background Evaluations of the costs of palliative external beam radiation therapy (EBRT) for treatment of bone metastases are limited.
Objective To summarize EBRT lifetime care patterns in deceased men with metastatic prostate cancer treated in a cancer hospital in the United States.
Methods A retrospective review of electronic health records identified deceased adult prostate cancer (ICD-9 185.xx) patients with bone metastases (ICD-9 198.5) and who were treated for bone pain and metastasis management with EBRT between January 1, 1995 and December 17, 2012. Common Procedural Terminology codes were used to identify all EBRT episodes (total billed EBRT services; initial and final evaluation) to calculate length of EBRT treatments and per episode costs (2011 US$). Bootstrapping approximated the 95% confidence interval for final cost estimates.
Results 176 men were identified; 19 (10.8%) had bone metastases in >1 site. Eighty-nine men (50.6%) received >1 EBRT episode (range, 1-6; median, 2), with first episode length ranging from 1-44 calendar days (mean, 13.4; SD, 8.4) at a mean cost of $7,084 (SD, $4,028). About 70% of costs were attributable to hospital charges and 30% to physician charges.
Limitations Small sample size limits broad applicability to large populations of men with prostate cancer.
Conclusion Care costs for EBRT constitute one of many costs that should be taken into account when planning for palliative care of prostate cancer and bone metastasis.
Funding Grant from Amgen and support was provided by the Huntsman Cancer Institute for all datasets within the Utah Population Database.
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Background Evaluations of the costs of palliative external beam radiation therapy (EBRT) for treatment of bone metastases are limited.
Objective To summarize EBRT lifetime care patterns in deceased men with metastatic prostate cancer treated in a cancer hospital in the United States.
Methods A retrospective review of electronic health records identified deceased adult prostate cancer (ICD-9 185.xx) patients with bone metastases (ICD-9 198.5) and who were treated for bone pain and metastasis management with EBRT between January 1, 1995 and December 17, 2012. Common Procedural Terminology codes were used to identify all EBRT episodes (total billed EBRT services; initial and final evaluation) to calculate length of EBRT treatments and per episode costs (2011 US$). Bootstrapping approximated the 95% confidence interval for final cost estimates.
Results 176 men were identified; 19 (10.8%) had bone metastases in >1 site. Eighty-nine men (50.6%) received >1 EBRT episode (range, 1-6; median, 2), with first episode length ranging from 1-44 calendar days (mean, 13.4; SD, 8.4) at a mean cost of $7,084 (SD, $4,028). About 70% of costs were attributable to hospital charges and 30% to physician charges.
Limitations Small sample size limits broad applicability to large populations of men with prostate cancer.
Conclusion Care costs for EBRT constitute one of many costs that should be taken into account when planning for palliative care of prostate cancer and bone metastasis.
Funding Grant from Amgen and support was provided by the Huntsman Cancer Institute for all datasets within the Utah Population Database.
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Background Evaluations of the costs of palliative external beam radiation therapy (EBRT) for treatment of bone metastases are limited.
Objective To summarize EBRT lifetime care patterns in deceased men with metastatic prostate cancer treated in a cancer hospital in the United States.
Methods A retrospective review of electronic health records identified deceased adult prostate cancer (ICD-9 185.xx) patients with bone metastases (ICD-9 198.5) and who were treated for bone pain and metastasis management with EBRT between January 1, 1995 and December 17, 2012. Common Procedural Terminology codes were used to identify all EBRT episodes (total billed EBRT services; initial and final evaluation) to calculate length of EBRT treatments and per episode costs (2011 US$). Bootstrapping approximated the 95% confidence interval for final cost estimates.
Results 176 men were identified; 19 (10.8%) had bone metastases in >1 site. Eighty-nine men (50.6%) received >1 EBRT episode (range, 1-6; median, 2), with first episode length ranging from 1-44 calendar days (mean, 13.4; SD, 8.4) at a mean cost of $7,084 (SD, $4,028). About 70% of costs were attributable to hospital charges and 30% to physician charges.
Limitations Small sample size limits broad applicability to large populations of men with prostate cancer.
Conclusion Care costs for EBRT constitute one of many costs that should be taken into account when planning for palliative care of prostate cancer and bone metastasis.
Funding Grant from Amgen and support was provided by the Huntsman Cancer Institute for all datasets within the Utah Population Database.
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Effect of ArginMax on sexual functioning and quality of life among female cancer survivors: results of the WFU CCOP Research Base Protocol 97106
Background Problems with sexual functioning are common following therapy for breast and gynecologic cancers, although there are few effective treatments.
Objective To assess the impact of ArginMax, a nutritional supplement comprised of extracts of L-arginine, ginseng, gingko, and damiana, as well as multivitamins and minerals, on sexual functioning and quality of life in female cancer survivors.
Methods This was a 12-week, randomized, placebo-controlled trial of eligible patients who were 6 months or more from active treatment and reporting problems with sexual interest, satisfaction, and functioning after therapy. The participants took 3 capsules of ArginMax or placebo twice daily. Outcome measures were the Female Sexual Function Inventory (FSFI) and the Functional Assessment of Cancer Therapy - General (FACT-G). Assessments were done at baseline, 4, 8, and 12 weeks.
Results 186 patients with a median age of 50 years were accrued between May 10, 2007 and March 24, 2010. 76% of the patients were non-Hispanic white. Most had breast or a gynecologic cancer (78% and 12%, respectively). At 12 weeks, there were no differences between the ArginMax group (n = 96) and placebo (n = 92) group in sexual desire, arousal, lubrication, orgasm, satisfaction or pain. However, FACT-G total scores were significantly better for participants who took ArginMax compared with those who took placebo (least squares [LS] means, 87.5 vs 82.9, respectively; P = .009). The Fact-G subscales that were most affected were Physical (25.37 vs. 23.51, P = .001) and Functional Well-Being (22.46 vs. 20.72, P = .007). Toxicities were similar for both groups.
Limitations Study results are limited by a lack of data on the participants’ psychological and physical symptoms and sexual partner variables.
Conclusions ArginMax had no significant impact on sexual functioning, but patient quality of life was significantly better at 12 weeks in participants who received ArginMax.
Funding Sponsored by NCI 3 U10 CA081851-12 and The Daily Wellness Company
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Background Problems with sexual functioning are common following therapy for breast and gynecologic cancers, although there are few effective treatments.
Objective To assess the impact of ArginMax, a nutritional supplement comprised of extracts of L-arginine, ginseng, gingko, and damiana, as well as multivitamins and minerals, on sexual functioning and quality of life in female cancer survivors.
Methods This was a 12-week, randomized, placebo-controlled trial of eligible patients who were 6 months or more from active treatment and reporting problems with sexual interest, satisfaction, and functioning after therapy. The participants took 3 capsules of ArginMax or placebo twice daily. Outcome measures were the Female Sexual Function Inventory (FSFI) and the Functional Assessment of Cancer Therapy - General (FACT-G). Assessments were done at baseline, 4, 8, and 12 weeks.
Results 186 patients with a median age of 50 years were accrued between May 10, 2007 and March 24, 2010. 76% of the patients were non-Hispanic white. Most had breast or a gynecologic cancer (78% and 12%, respectively). At 12 weeks, there were no differences between the ArginMax group (n = 96) and placebo (n = 92) group in sexual desire, arousal, lubrication, orgasm, satisfaction or pain. However, FACT-G total scores were significantly better for participants who took ArginMax compared with those who took placebo (least squares [LS] means, 87.5 vs 82.9, respectively; P = .009). The Fact-G subscales that were most affected were Physical (25.37 vs. 23.51, P = .001) and Functional Well-Being (22.46 vs. 20.72, P = .007). Toxicities were similar for both groups.
Limitations Study results are limited by a lack of data on the participants’ psychological and physical symptoms and sexual partner variables.
Conclusions ArginMax had no significant impact on sexual functioning, but patient quality of life was significantly better at 12 weeks in participants who received ArginMax.
Funding Sponsored by NCI 3 U10 CA081851-12 and The Daily Wellness Company
Click on the PDF icon at the top of this introduction to read the full article.
Background Problems with sexual functioning are common following therapy for breast and gynecologic cancers, although there are few effective treatments.
Objective To assess the impact of ArginMax, a nutritional supplement comprised of extracts of L-arginine, ginseng, gingko, and damiana, as well as multivitamins and minerals, on sexual functioning and quality of life in female cancer survivors.
Methods This was a 12-week, randomized, placebo-controlled trial of eligible patients who were 6 months or more from active treatment and reporting problems with sexual interest, satisfaction, and functioning after therapy. The participants took 3 capsules of ArginMax or placebo twice daily. Outcome measures were the Female Sexual Function Inventory (FSFI) and the Functional Assessment of Cancer Therapy - General (FACT-G). Assessments were done at baseline, 4, 8, and 12 weeks.
Results 186 patients with a median age of 50 years were accrued between May 10, 2007 and March 24, 2010. 76% of the patients were non-Hispanic white. Most had breast or a gynecologic cancer (78% and 12%, respectively). At 12 weeks, there were no differences between the ArginMax group (n = 96) and placebo (n = 92) group in sexual desire, arousal, lubrication, orgasm, satisfaction or pain. However, FACT-G total scores were significantly better for participants who took ArginMax compared with those who took placebo (least squares [LS] means, 87.5 vs 82.9, respectively; P = .009). The Fact-G subscales that were most affected were Physical (25.37 vs. 23.51, P = .001) and Functional Well-Being (22.46 vs. 20.72, P = .007). Toxicities were similar for both groups.
Limitations Study results are limited by a lack of data on the participants’ psychological and physical symptoms and sexual partner variables.
Conclusions ArginMax had no significant impact on sexual functioning, but patient quality of life was significantly better at 12 weeks in participants who received ArginMax.
Funding Sponsored by NCI 3 U10 CA081851-12 and The Daily Wellness Company
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Palbociclib and letrozole for ER-positive, HER2-negative advanced breast cancer
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Precision medicine in the making
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Guideline recommends combination therapy for smoking cessation in cancer patients
The National Comprehensive Cancer Network has published a new guideline on smoking cessation for cancer patients that recommends combining pharmacologic therapy with counseling as the most effective approach, along with rigorous review and close follow-ups to prevent relapses.
“Although the medical community recognizes the importance of smoking cessation, supporting patients in ceasing to smoke is generally not done well. Our hope is that by addressing smoking cessation in a cancer patient population, we can make it easier for oncologists to effectively support their patients in achieving their smoking cessation goals,” Dr. Peter Shields, deputy director of the Ohio State University Comprehensive Cancer Center, said in a written statement. Of the estimated 590,000 cancer deaths in 2015, about 170,000, or nearly 30%, will be caused by tobacco smoking. Quitting tobacco improves cancer treatment effectiveness and reduces cancer recurrence, according to the NCCN.
Read the full statement on the NCCN website.
The National Comprehensive Cancer Network has published a new guideline on smoking cessation for cancer patients that recommends combining pharmacologic therapy with counseling as the most effective approach, along with rigorous review and close follow-ups to prevent relapses.
“Although the medical community recognizes the importance of smoking cessation, supporting patients in ceasing to smoke is generally not done well. Our hope is that by addressing smoking cessation in a cancer patient population, we can make it easier for oncologists to effectively support their patients in achieving their smoking cessation goals,” Dr. Peter Shields, deputy director of the Ohio State University Comprehensive Cancer Center, said in a written statement. Of the estimated 590,000 cancer deaths in 2015, about 170,000, or nearly 30%, will be caused by tobacco smoking. Quitting tobacco improves cancer treatment effectiveness and reduces cancer recurrence, according to the NCCN.
Read the full statement on the NCCN website.
The National Comprehensive Cancer Network has published a new guideline on smoking cessation for cancer patients that recommends combining pharmacologic therapy with counseling as the most effective approach, along with rigorous review and close follow-ups to prevent relapses.
“Although the medical community recognizes the importance of smoking cessation, supporting patients in ceasing to smoke is generally not done well. Our hope is that by addressing smoking cessation in a cancer patient population, we can make it easier for oncologists to effectively support their patients in achieving their smoking cessation goals,” Dr. Peter Shields, deputy director of the Ohio State University Comprehensive Cancer Center, said in a written statement. Of the estimated 590,000 cancer deaths in 2015, about 170,000, or nearly 30%, will be caused by tobacco smoking. Quitting tobacco improves cancer treatment effectiveness and reduces cancer recurrence, according to the NCCN.
Read the full statement on the NCCN website.
Assessing the impact of a targeted electronic medical record intervention on the use of growth factor in cancer patients
Background Patients receiving chemotherapy are at risk for febrile neutropenia following treatment. The American Society of Clinical Oncology (ASCO) and National Comprehensive Cancer Network (NCCN) recommend screening patients for risk of febrile neutropenia and risk stratification based on likelihood of febrile neutropenia events. The impact of the implementation of an electronic medical record (EMR) system on physician compliance with growth factor support guidelines has not been studied.
Objective To investigate whether implementation of automated orders in EMRs can improve adherence to national guidelines in prophylactic G-CSF use in chemotherapy patients.
Methods A retrospective chart review of cancer patients receiving chemotherapy from January 1, 2007 to August 1, 2008 (pre-EMR) and January 1, 2011 to December 31, 2011 (post-EMR) was conducted. Institutional adherence to ASCO and NCCN guidelines for G-CSF after the implementation of automatic electronic orders for pegfilgrastim in patients who received a high-risk chemotherapy regimen were examined. The results were compared with a similar study that had been conducted before the implementation of the EMR system.
Results The number of regimens that included guideline-driven growth factor usage and nonusage was 75.6% in the post-intervention arm, compared with 67.5% in the pre-intervention arm. This is a statistically significant difference between the pre-EMR and post-EMR compliance with national guidelines on growth factor usage (P = .041, based on chi-square test). The post-EMR implementation data of 1,042 individual new chemotherapy regimens showed correct use of G-CSF in 89.13% high-risk chemotherapy regimens and 58.74% intermediate-risk regimens, with risk factors and incorrect usage in 26.23% of intermediate-risk regimens without risk factors and 19.34% of low-risk regimens. The appropriateness of use in high- and low-risk regimens was the most compliant, because growth factor was built into chemotherapy plans of high-risk regimens and omitted from low-risk regimens.
Limitations This project was limited by a change in EMR systems at West Virginia University hospitals on January 1, 2009. All pre-EMR data was collected before 2009 and could not be further collected once the project began in 2013.
Conclusions Appropriateness of growth factor usage can be improved when integrated into an EMR. This can improve compliance and adherence to national recommendations. Further development and understanding of EMR is needed to improve usage to meet national guidelines, with particular attention paid to integration of risk factors into EMR to improve growth factor usage compliance.
Funding NIH Research Funding Development Grant, WVU office of research and graduate education
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Background Patients receiving chemotherapy are at risk for febrile neutropenia following treatment. The American Society of Clinical Oncology (ASCO) and National Comprehensive Cancer Network (NCCN) recommend screening patients for risk of febrile neutropenia and risk stratification based on likelihood of febrile neutropenia events. The impact of the implementation of an electronic medical record (EMR) system on physician compliance with growth factor support guidelines has not been studied.
Objective To investigate whether implementation of automated orders in EMRs can improve adherence to national guidelines in prophylactic G-CSF use in chemotherapy patients.
Methods A retrospective chart review of cancer patients receiving chemotherapy from January 1, 2007 to August 1, 2008 (pre-EMR) and January 1, 2011 to December 31, 2011 (post-EMR) was conducted. Institutional adherence to ASCO and NCCN guidelines for G-CSF after the implementation of automatic electronic orders for pegfilgrastim in patients who received a high-risk chemotherapy regimen were examined. The results were compared with a similar study that had been conducted before the implementation of the EMR system.
Results The number of regimens that included guideline-driven growth factor usage and nonusage was 75.6% in the post-intervention arm, compared with 67.5% in the pre-intervention arm. This is a statistically significant difference between the pre-EMR and post-EMR compliance with national guidelines on growth factor usage (P = .041, based on chi-square test). The post-EMR implementation data of 1,042 individual new chemotherapy regimens showed correct use of G-CSF in 89.13% high-risk chemotherapy regimens and 58.74% intermediate-risk regimens, with risk factors and incorrect usage in 26.23% of intermediate-risk regimens without risk factors and 19.34% of low-risk regimens. The appropriateness of use in high- and low-risk regimens was the most compliant, because growth factor was built into chemotherapy plans of high-risk regimens and omitted from low-risk regimens.
Limitations This project was limited by a change in EMR systems at West Virginia University hospitals on January 1, 2009. All pre-EMR data was collected before 2009 and could not be further collected once the project began in 2013.
Conclusions Appropriateness of growth factor usage can be improved when integrated into an EMR. This can improve compliance and adherence to national recommendations. Further development and understanding of EMR is needed to improve usage to meet national guidelines, with particular attention paid to integration of risk factors into EMR to improve growth factor usage compliance.
Funding NIH Research Funding Development Grant, WVU office of research and graduate education
Click on the PDF icon at the top of this introduction to read the full article.
Background Patients receiving chemotherapy are at risk for febrile neutropenia following treatment. The American Society of Clinical Oncology (ASCO) and National Comprehensive Cancer Network (NCCN) recommend screening patients for risk of febrile neutropenia and risk stratification based on likelihood of febrile neutropenia events. The impact of the implementation of an electronic medical record (EMR) system on physician compliance with growth factor support guidelines has not been studied.
Objective To investigate whether implementation of automated orders in EMRs can improve adherence to national guidelines in prophylactic G-CSF use in chemotherapy patients.
Methods A retrospective chart review of cancer patients receiving chemotherapy from January 1, 2007 to August 1, 2008 (pre-EMR) and January 1, 2011 to December 31, 2011 (post-EMR) was conducted. Institutional adherence to ASCO and NCCN guidelines for G-CSF after the implementation of automatic electronic orders for pegfilgrastim in patients who received a high-risk chemotherapy regimen were examined. The results were compared with a similar study that had been conducted before the implementation of the EMR system.
Results The number of regimens that included guideline-driven growth factor usage and nonusage was 75.6% in the post-intervention arm, compared with 67.5% in the pre-intervention arm. This is a statistically significant difference between the pre-EMR and post-EMR compliance with national guidelines on growth factor usage (P = .041, based on chi-square test). The post-EMR implementation data of 1,042 individual new chemotherapy regimens showed correct use of G-CSF in 89.13% high-risk chemotherapy regimens and 58.74% intermediate-risk regimens, with risk factors and incorrect usage in 26.23% of intermediate-risk regimens without risk factors and 19.34% of low-risk regimens. The appropriateness of use in high- and low-risk regimens was the most compliant, because growth factor was built into chemotherapy plans of high-risk regimens and omitted from low-risk regimens.
Limitations This project was limited by a change in EMR systems at West Virginia University hospitals on January 1, 2009. All pre-EMR data was collected before 2009 and could not be further collected once the project began in 2013.
Conclusions Appropriateness of growth factor usage can be improved when integrated into an EMR. This can improve compliance and adherence to national recommendations. Further development and understanding of EMR is needed to improve usage to meet national guidelines, with particular attention paid to integration of risk factors into EMR to improve growth factor usage compliance.
Funding NIH Research Funding Development Grant, WVU office of research and graduate education
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CDC: Cancer incidence and survival improve; racial disparities persist
Numerous states have achieved Healthy People 2020 goals for colorectal and cervical cancer incidence, and the proportion of persons with cancer who survive at least 5 years after diagnosis has reached 65%, but racial disparities in survival persist, according to a Centers for Disease Control and Prevention report.
An analysis of data from the U.S. Cancer Statistics for 2011 – the most recent data available – showed that a total of 1,532,066 invasive cancers were reported to cancer registries in the United States that year (annual incidence rate, 451 per 100,000 persons). Invasive cancers were considered all cancers except in situ cancers (excluding situ cancers in the urinary bladder) and basal and squamous cell cancers.
Incidence rates were higher for men than for women (508 vs. 410 per 100,000), and were highest among blacks (458 per 100,000). The 5-year survival rate, calculated for cases diagnosed between 2003 and 2010, was similar among men and women at 65%, but lower among blacks (60%) for every cancer site, S. Jane Henley of the National Center for Chronic Disease Prevention and Health Promotion, CDC, Atlanta and her colleagues reported in the March 13 issue of the Morbidity and Mortality Weekly Report.
Survival was highest among those diagnosed before age 45 years (81%) and decreased with increasing age.
The most common cancer reported was prostate cancer (128 per 100,000 men), followed by female breast cancer (122 per 100,000 women), lung and bronchus cancer (61 per 100,000 persons), and colon and rectum cancer (40 per 100,000 persons). Together these cancers accounted for half of those diagnosed in 2011, and 5-year relative survival in patients diagnosed with these cancers was highest for prostate cancer (97%) and breast cancer (88%), the investigators said (MMWR 2015;63:237-42).
Survival was intermediate for colorectal cancer (63%) and lowest for lung cancer (18%).
The cervical cancer incidence rate was 7.5 per 100,000 the authors noted.
A geographic breakdown shows that incidence ranged from 374 per 100,000 persons in New Mexico to 509 per 100,000 persons in Washington, D.C.
“Healthy People 2020 targets were reached in 37 states for incidence of colorectal cancer and in 28 states for incidence of cervical cancer,” they wrote, noting that this report is the first to include incidence rates in Puerto Rico; those rates were lower for all cancer sites, compared with the states and the District of Columbia (339 per 100,000 persons) – a finding that reflects screening practices and risk factors that may differ from in the states.
The inclusion of survival data is also a first and provides a basis for tracking progress.
“Cancer incidence and survival data can guide the planning and evaluation of cancer prevention and control programs,” the authors said, adding that such data can also assist in long-term planning for cancer diagnostic and treatment services, and help public health officials set priorities for allocating health resources.
Though limited by potential systematic misclassification of race and ethnicity, by the possibility that cancer reporting was delayed thus leading to underestimation of certain cancers, and by the fact that relative survival rates were calculated only for white and black racial groups due to lack of accurate life tables for other racial/ethnic groups, the findings are nonetheless important for helping public health officials to monitor cancer incidence, mortality, and survival and to identify populations that might benefit most from targeted prevention and control efforts, they said.
The findings can also help guide the planning of health care allocation and support services and track progress toward Healthy People 2020 goals, they added.
Dr. Lisa Richardson, the director of the CDC’s Division of Cancer Prevention and Control further stressed the value of monitoring cancer incidence and survival rates in a statement.
“These data are an important reminder that a key to surviving with cancer is making sure everyone has access to care from early diagnosis to treatment. We know, for example, that early detection of colorectal cancer has had the largest impact on long-term survival rates,” she said.
Numerous states have achieved Healthy People 2020 goals for colorectal and cervical cancer incidence, and the proportion of persons with cancer who survive at least 5 years after diagnosis has reached 65%, but racial disparities in survival persist, according to a Centers for Disease Control and Prevention report.
An analysis of data from the U.S. Cancer Statistics for 2011 – the most recent data available – showed that a total of 1,532,066 invasive cancers were reported to cancer registries in the United States that year (annual incidence rate, 451 per 100,000 persons). Invasive cancers were considered all cancers except in situ cancers (excluding situ cancers in the urinary bladder) and basal and squamous cell cancers.
Incidence rates were higher for men than for women (508 vs. 410 per 100,000), and were highest among blacks (458 per 100,000). The 5-year survival rate, calculated for cases diagnosed between 2003 and 2010, was similar among men and women at 65%, but lower among blacks (60%) for every cancer site, S. Jane Henley of the National Center for Chronic Disease Prevention and Health Promotion, CDC, Atlanta and her colleagues reported in the March 13 issue of the Morbidity and Mortality Weekly Report.
Survival was highest among those diagnosed before age 45 years (81%) and decreased with increasing age.
The most common cancer reported was prostate cancer (128 per 100,000 men), followed by female breast cancer (122 per 100,000 women), lung and bronchus cancer (61 per 100,000 persons), and colon and rectum cancer (40 per 100,000 persons). Together these cancers accounted for half of those diagnosed in 2011, and 5-year relative survival in patients diagnosed with these cancers was highest for prostate cancer (97%) and breast cancer (88%), the investigators said (MMWR 2015;63:237-42).
Survival was intermediate for colorectal cancer (63%) and lowest for lung cancer (18%).
The cervical cancer incidence rate was 7.5 per 100,000 the authors noted.
A geographic breakdown shows that incidence ranged from 374 per 100,000 persons in New Mexico to 509 per 100,000 persons in Washington, D.C.
“Healthy People 2020 targets were reached in 37 states for incidence of colorectal cancer and in 28 states for incidence of cervical cancer,” they wrote, noting that this report is the first to include incidence rates in Puerto Rico; those rates were lower for all cancer sites, compared with the states and the District of Columbia (339 per 100,000 persons) – a finding that reflects screening practices and risk factors that may differ from in the states.
The inclusion of survival data is also a first and provides a basis for tracking progress.
“Cancer incidence and survival data can guide the planning and evaluation of cancer prevention and control programs,” the authors said, adding that such data can also assist in long-term planning for cancer diagnostic and treatment services, and help public health officials set priorities for allocating health resources.
Though limited by potential systematic misclassification of race and ethnicity, by the possibility that cancer reporting was delayed thus leading to underestimation of certain cancers, and by the fact that relative survival rates were calculated only for white and black racial groups due to lack of accurate life tables for other racial/ethnic groups, the findings are nonetheless important for helping public health officials to monitor cancer incidence, mortality, and survival and to identify populations that might benefit most from targeted prevention and control efforts, they said.
The findings can also help guide the planning of health care allocation and support services and track progress toward Healthy People 2020 goals, they added.
Dr. Lisa Richardson, the director of the CDC’s Division of Cancer Prevention and Control further stressed the value of monitoring cancer incidence and survival rates in a statement.
“These data are an important reminder that a key to surviving with cancer is making sure everyone has access to care from early diagnosis to treatment. We know, for example, that early detection of colorectal cancer has had the largest impact on long-term survival rates,” she said.
Numerous states have achieved Healthy People 2020 goals for colorectal and cervical cancer incidence, and the proportion of persons with cancer who survive at least 5 years after diagnosis has reached 65%, but racial disparities in survival persist, according to a Centers for Disease Control and Prevention report.
An analysis of data from the U.S. Cancer Statistics for 2011 – the most recent data available – showed that a total of 1,532,066 invasive cancers were reported to cancer registries in the United States that year (annual incidence rate, 451 per 100,000 persons). Invasive cancers were considered all cancers except in situ cancers (excluding situ cancers in the urinary bladder) and basal and squamous cell cancers.
Incidence rates were higher for men than for women (508 vs. 410 per 100,000), and were highest among blacks (458 per 100,000). The 5-year survival rate, calculated for cases diagnosed between 2003 and 2010, was similar among men and women at 65%, but lower among blacks (60%) for every cancer site, S. Jane Henley of the National Center for Chronic Disease Prevention and Health Promotion, CDC, Atlanta and her colleagues reported in the March 13 issue of the Morbidity and Mortality Weekly Report.
Survival was highest among those diagnosed before age 45 years (81%) and decreased with increasing age.
The most common cancer reported was prostate cancer (128 per 100,000 men), followed by female breast cancer (122 per 100,000 women), lung and bronchus cancer (61 per 100,000 persons), and colon and rectum cancer (40 per 100,000 persons). Together these cancers accounted for half of those diagnosed in 2011, and 5-year relative survival in patients diagnosed with these cancers was highest for prostate cancer (97%) and breast cancer (88%), the investigators said (MMWR 2015;63:237-42).
Survival was intermediate for colorectal cancer (63%) and lowest for lung cancer (18%).
The cervical cancer incidence rate was 7.5 per 100,000 the authors noted.
A geographic breakdown shows that incidence ranged from 374 per 100,000 persons in New Mexico to 509 per 100,000 persons in Washington, D.C.
“Healthy People 2020 targets were reached in 37 states for incidence of colorectal cancer and in 28 states for incidence of cervical cancer,” they wrote, noting that this report is the first to include incidence rates in Puerto Rico; those rates were lower for all cancer sites, compared with the states and the District of Columbia (339 per 100,000 persons) – a finding that reflects screening practices and risk factors that may differ from in the states.
The inclusion of survival data is also a first and provides a basis for tracking progress.
“Cancer incidence and survival data can guide the planning and evaluation of cancer prevention and control programs,” the authors said, adding that such data can also assist in long-term planning for cancer diagnostic and treatment services, and help public health officials set priorities for allocating health resources.
Though limited by potential systematic misclassification of race and ethnicity, by the possibility that cancer reporting was delayed thus leading to underestimation of certain cancers, and by the fact that relative survival rates were calculated only for white and black racial groups due to lack of accurate life tables for other racial/ethnic groups, the findings are nonetheless important for helping public health officials to monitor cancer incidence, mortality, and survival and to identify populations that might benefit most from targeted prevention and control efforts, they said.
The findings can also help guide the planning of health care allocation and support services and track progress toward Healthy People 2020 goals, they added.
Dr. Lisa Richardson, the director of the CDC’s Division of Cancer Prevention and Control further stressed the value of monitoring cancer incidence and survival rates in a statement.
“These data are an important reminder that a key to surviving with cancer is making sure everyone has access to care from early diagnosis to treatment. We know, for example, that early detection of colorectal cancer has had the largest impact on long-term survival rates,” she said.
FROM MORBIDITY AND MORTALITY WEEKLY REPORT
Key clinical point: Incidence rates are declining for some cancers, and survival is improving.
Major finding: The 5-year survival rate is 65% among persons with invasive cancer.
Data source: The U.S. Cancer Statistics for 2011.
Disclosures: The study was funded and conducted by the Centers for Disease Control and Prevention.
