2007 Oncology Services Annual Report

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  • Our observances of ethnicity by sex appeared to correlate with published data. Fresno County statistics (#5), breakouts Hispanic or Latino which they note can be of any race, comprising 47.6% of the county demographic.
  • Adenocarcinoma was the most common histology diagnosed during the study period. Of note, the portion of signet ring adenocarcinoma has increased over the observed duration. During the 5 year interval 2002-2006 we noted an observed increase of carcinoids.
  • Slightly higher percentage of Men had a personal history of at least one other primary cancer diagnosis.
  • One case 4 modalities was combined into Tri and category labeled Multi. Note, N/A and Unknown numbers not included total displayed N=450.
  • ‘87-91 stg I= 13/stg II= 22; ‘92-96 stg I= 14/stg II= 26; ‘97-01 stg I= 14/stg II= 13; ‘02-06 stg I= 15/stg II= 15.
  • Source: NCDB website numbers utilized. Trinity (12 facilities) & NCDB (1337 facilities)
  • Sources: SAMC Cancer Registry; NCDB (1337 facilities)
  • The most common site for both Men and Women was with the lower 1/3 of the esophagus. Interestingly, the predominant site observed for Men with Stomach Cancer was Gastric Cardia indicating that Men appear to have a propensity for cancers in this common locale. ?????
  • No gender bias identified.
  • Numbers for N/A and Unknown are not included. Total displayed N=450.
  • 2007 Oncology Services Annual Report

    1. 1. 2007 Oncology Services Annual Report Li Liu, MD Ellen Malek, CTR July 2008 1987-2006 SAMC Esophagus & Stomach Cancers 20 Year Review Saint Agnes Medical Center Cancer Registry 1303 East Herndon Avenue Fresno, CA 93720 559 450-3570 www.samc.com ®
    2. 2. 1987-2006 SAMC Analytic Stomach Cancer  There were 544 cases of Stomach Cancer diagnosed and/or treated at Saint Agnes Medical Center during the 20 year period.  97% were diagnosed by positive histology.  58% were Men and 42% were Women.  Median age at diagnosis was 72.  The most common site of Stomach Cancer diagnosed for Men was Stomach Cardia (29%) and the most common site for Women was Gastric Antrum (21%).  An overall 5% increase incidence of Stomach Cancer was observed at SAMC (#1). Although, SEER data show historical rate trends (1975-2005) for Stomach Cancer Nationally are falling (minus 1.6%) (#2).  For the years 2000-2004 CDC National Cancer Institute data (#3) showed an average annual count of 61 cases of Stomach Cancer diagnosed in Fresno County. SAMC Cancer Registry data (#1) indicated that close to half (28) of that average annual number of Stomach Cancer were seen at SAMC.  In California, cancer rates are considerably lower for persons of Asian/Pacific Inlanders and Hispanic ethnicity; however, both these group have a substantially higher rate of Stomach Cancer (#4) which appears to be reflected in our data and, noted in particular contrast to our data seen further in this report for Cancer of the Esophagus.
    3. 3. 1987-2006 Analytic Stomach Cancer Incidence by 5 Year Interval N=544 73 70 86 86 52 62 50 65 125 132 136 151 0 20 40 60 80 100 120 140 160 1987-1991 1992-1996 1997-2001 2002-2006 Year numberofcases Male Female Overall
    4. 4. 1987-2006 SAMC Analytic Stomach Cancer Ethnicity by Sex N=544 66% 54% 61% 22% 9.5% 16% 12% 1.5% 8% 4% 0.9 0.4 1% 0 10 20 30 40 50 60 70 percent White Hispanic Asian Black Other Male Female Overall
    5. 5. 1987-2006 SAMC Analytic Stomach Cancer Histology by 5 Year Intervals N=544 0 20 40 60 80 100 120 140 numberofcases 1987-1991 1992-1996 1997-2001 2002-2006 Year Carcinoma in-situ Squamous Cell CA Adenocarcinoma signet ring Sarcoma Carcinoid Neuroendocrine Other
    6. 6. 1987-2006 SAMC Analytic Stomach Cancer Personal History of Multiple Primaries N=544 83.5% Stomach Cancer only 80% Stomach Cancer only 20% 2 or more primaries 16.5% 2 or more primaries Male Female
    7. 7. 1987-2006 SAMC Analytic Stomach Cancer Stage by Combined Treatment Modalities N=544 5% 3% 26% 100% 75% 50% 44% 46% 21% 30% 25% 14% 7% 23%25% 6% 0% 20% 40% 60% 80% 100% 120% Stage 0 Stage I Stage II Stage III Stage IV None Single Bi Tri N=8 N=81 N=65 N=105 N=191
    8. 8. 1987-2006 SAMC Stomach Cancer Treatment ~ Surgery Only 23% 29% 25% 34% 25% 17% 27% 20% 1987-1991 1992-1996 1997-2001 2002-2006 Year Stage I Stage II/III N=125 N=132 N=136 N=151
    9. 9. 1998-2000 Analytic Stomach Cancer National Cancer Data Base 5 Year Survival Comparison ~ All Stages SAMC 25% N=64 NCDB 18% N=29,490 (1337 facilities)
    10. 10. Analytic Stomach Cancer National Cancer Data Base 5 Year Survival Comparison ~ Stage II/III Combined SAMC, 32% 1998-2002 N=32 NCDB, 20% 1998-2000 N=10,081
    11. 11. 1987-2006 SAMC Analytic Esophagus Cancer  244 cases of esophageal cancer were accessioned into the Saint Agnes Cancer Registry over the 20 year period.  98% were diagnosed by positive histology.  74% were Men and 26% were Women.  Median age at diagnosis was 70.  Data showed a 10.7% observed overall increased incidence of esophageal cancer diagnosed and/or treated at the medical center (#1).  Of these, 54% were diagnosed and/or treated at SAMC. 38.5% received all or part of first course treatment at our facility. 7.8% were diagnosed here and seen elsewhere for treatment.
    12. 12. 1987-2006 SAMC Analytic Esophagus Cancer Incidence by 5 Year Interval N=244 29.5% 27.5% 26% 17% 0% 5% 10% 15% 20% 25% 30% 35% 1987-1991 1992-1996 1997-2001 2002-2006 Year percent N=41 N=64 N=72 N=67
    13. 13. 2001-2005 Analytic Esophagus Cancer SEER Comparison Age at Diagnosis 0% 5% 10% 15% 20% 25% 30% 35% 35-44 45-54 55-64 65-74 75-84 85+ Age at Diagnosis percent SAMC SEER
    14. 14. 1987-2006 SAMC Analytic Esophagus Cancer Histology by 5 Year Interval N=244 0 5 10 15 20 25 30 35 40 45 50 1987-1991 1992-1996 1997-2001 2002-2006 Year numberofcases Carcinoma In-situ Squamous Cell CA Adenocarcinoma Small Cell CA Other
    15. 15. 1987-2006 SAMC Analytic Esophagus Cancer Site by 5 Year Interval N=244 Site 1987-1991 N=41 1992-1996 N=64 1997-2001 N=72 2002-2006 N=67 total 244 Upper 3rd 12.1% 12.5% 9.7% 8.9% 11% Middle 3rd 34.1% 23.4% 25.0% 16.4% 24% Lower 3rd 51.2% 51.5% 58.3% 65.6% 57% Overlapping & NOS 2.3% 12.5% 6.9% 8.9% 8%
    16. 16. 1987-2006 SAMC Analytic Esophagus Cancer Site by Sex N=244 8.8% 19.3% 62.4% 9.3% 15.8% 36.5% 4.7% 42.8% Upper 3rd Middle 3rd Lower 3rd Overlapping/NOS Site Male Female
    17. 17. 1987-2006 SAMC Analytic Esophagus Cancer Ethnicity by Sex N=244 1%2%3% 12% 83% 0%2%3% 13% 83% White Hispanic Black Asian Other Male Female
    18. 18. 1987-2006 SAMC Analytic Esophagus Cancer Personal History of Multiple Primaries N=244 78% Esophageal Cancer only 79% Esophageal Cancer only 22% with 2 or more primaries 21% with 2 or more primaries Male Female
    19. 19. 1987-2006 SAMC Analytic Esophagus Cancer Treatment by Stage at Diagnosis N=244 1% 4.0% 20.3% 50% 77% 59% 61% 40% 15% 20.5% 38.5% 60% 3.3% 20.5% 18.0% 11.5% 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% Stage 0 Stage I Stage II Stage III Stage IV percent None Single Bi Tri N=5 N=26 N=90 N=34 N=59 Year
    20. 20. 1998-2000 Analytic Esophagus Cancer National Cancer Data Base 5 Year Survival Comparison ~ All Stages 24.0% SAMC N=25 15.3% NCDB N=21,169
    21. 21. Analytic Esophagus Cancer National Cancer Data Base 5 Year Survival Comparison ~ Stage II/III Combined 16.6% NCDB 1998-2000 N=10,471 29.4% SAMC 1998-2002 N=34
    22. 22. Sources: # 1. SAMC Cancer Registry database*; www.samc.org. Comment: The report is developed from our hospital based registry experience which is not ‘population based’ data. # 2. SEER Fact Sheet, Cancer of the Stomach; www.seer.cancer.gov/statfacts # 3. Centers for Disease Control, National Cancer Institute, State Cancer Profiles, Incidence Rate Report for California by Count, All Races, Both Sexes, Stomach, All Ages; www.statecancerprofiles.cancer.gov/recenttrend # 4. California, Cancer Facts & Figures, 2008; www.ccrcal.org/publications # 5. Fresno County demographics, www.factfinders.census.gov. Comment: Fresno County statistics breaks out Hispanic or Latino which, they note can be of any race, comprises 47.6% of the county demographic. # 6. National Cancer Data Base: ©Commission on Cancer, American College of Surgeons. NCDB Benchmark Reports, v1.1. Chicago, IL, 2002. The content reproduced from the applications remains the full and exclusive copyrighted property of the American College of Surgeons. The American College of Surgeons is not responsible for any ancillary or derivative works based on the original Text, Tables, or Figures.

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