Overview of Cancer in New Jersey Antoinette (Nan) Stroup, PhD 1 New Jersey Cancer Prevention Summit September 18, 2014 1 Director, Cancer Epidemiology Services/New Jersey State Cancer Registry, NJDOH Associate Professor and Chief, Cancer Epidemiology Division Rutgers School of Public Health and Rutgers Cancer Institute of New Jersey
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Overview of Cancer in New Jersey - Continuing education · Acknowledgements: This work was supported by the New Jersey State Cancer Registry and Rutgers Cancer Institute of New Jersey,
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Overview of Cancer in New Jersey
Antoinette (Nan) Stroup, PhD1
New Jersey Cancer Prevention SummitSeptember 18, 2014
1 Director, Cancer Epidemiology Services/New Jersey State Cancer Registry, NJDOHAssociate Professor and Chief, Cancer Epidemiology DivisionRutgers School of Public Health and Rutgers Cancer Institute of New Jersey
Outline
• “Who” is New Jersey? (population)• “What” is their cancer story? (cancer profile)
– Race/Ethnic Disparities• “Where” are we now? (2011 vs Healthy NJ
2020)– Lung Cancer– Colorectal Cancer– Melanoma of the Skin– Invasive Cervical Cancer (Females)
• “How” we’ve come a long way (time trends)• Concluding thoughts
Data
• US Census Bureau, Social Explorer• New Jersey State Cancer Registry (NJSCR)
– NCI Surveillance, Epidemiology, and End Results (SEER) Program (SEER*Stat, GIS.Gov)
– CDC National Program of Cancer Registries (NPCR) Program [United States Cancer Statistics (USCS)]
– North American Association of Central Cancer Registries (NAACCR)
NJ Population Change 2000 to 2010by Race/Ethnicity
All race categories non-Hispanic
Population Changes by Race/Ethnicity & Geography from 2000 to 2010
Figure: New Jersey’s Changing PopulationThe New York Times: New Jersey’s Ethnic Makeup Shifts, and Population Drifts SouthwardBy Richard Perez-PenaFebruary 3, 2011.Sources: Census Bureau; Social Explorerhttp://www.nytimes.com/interactive/2011/02/04/nyregion/20100204-jersey.html?ref=nyregion
State of New Jersey - Population Characteristics 2012
Characteristic2 New Jersey U.S.
Population 8,867,749 (2.8%) 313,873,685
Pop Density, 2010 (persons/mi2) 1,195.5 87.4
65+ 14.1% 13.7%Female 51.2% 50.8%
NH White (alone) 58.2% 63.0%
Black (alone) 14.7% 13.1%Hispanic or Latino 18.5% 16.9%Asian (alone) 9.0% 5.1%Native Hawaiian/Pacific Islander (alone) 0.1% 0.2%
% Foreign Born (2008-2012) 20.8% 12.9%
2 Source: US Census Bureau: State and County QuickFacts - 2012, unless otherwise specified.
State of New Jersey - Population Characteristics(continued)
Characteristic2 New Jersey U.S.
Language other than English (5+) 29.6% 20.5%
College Degree (25+) 35.4% 28.5%
Median Household Income $71,637 $53,046
Persons below poverty 9.9% 14.9%
Mean travel time to work (16+) (minutes) 30.3 25.4
2 Source: US Census Bureau: State and County QuickFacts – 2008-2012, unless otherwise specified
CANCER PROFILE“What” is their cancer story?
http://apps.nccd.cdc.gov/DCPC_INCA/DCPC_INCA.aspx
Males & Females, 2011
State: New JerseyRate: 480.5 (95% CI: 476.1, 484.9)Rank: 41 out of 50
Soft Tissue including HeartBrain and Other Nervous System
Lung and BronchusOral Cavity and Pharynx
Small IntestineAnus, Anal Canal and Anorectum
Liver Kidney and Renal Pelvis
Eye and Orbit
Age-Adjusted Rate Difference (%)
Cancer Incidence3 by Site: NJ vs US* Females
Higher than USLower than US
(150%, 0.2)
3 NJ Data from SEER*Stat, Nov 2013 Submission; US data from NAACCR 2014 Call for Data, Dec 2013 Submission* US = 47 States + DC (excl. NV, MN, AS)
NJ Cancer Incidence 2007-2011 by Race and Ethnicity, Males
Stomach & Liver in Top 10 for minority populations only: Likely due to high prevalence ofH.Pylori, high dietary sources of nitrates, and hepatitis infections.
Cancers with Effective Primary Prevention: Incidence (per 100,000)
Cancer Site HNJ 2010Incidence
Rate Target
2011 Incidence4
(95% CI)HNJ 2020Incidence
Rate TargetInvasive Cervical(Females)
6.8 7.6(6.8-8.4)
7.2
Melanoma of the Skin(Males & Females)
12.0 20.8(19.9-21.7)
None
Colorectal(Males & Females)
None 41.6(40.4-42.9)
39.7
Lung(Males & Females)
None 58.6(57.1-60.1)
None
4 U.S. Cancer Statistics Working Group. United States Cancer Statistics: 1999-2011 Incidence and Mortality Web-based Report. Atlanta: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention and National Cancer Institute; 2014. Available at: www.cdc.gov/uscs.
Higher than targetLower than target
Cancers with Effective Primary Prevention:Mortality (per 100,000)
Cancer Site HNJ 2010Mortality
Rate Target
2011 Mortality4
(95% CI)HNJ 2020Mortality
Rate TargetInvasive Cervical(Females)
1.6 2.6(2.2-3.2)
1.9
Melanoma of the Skin(Males & Females)
None 2.3(2.0-2.6)
2.4
Colorectal(Males & Females)
19.0 15.5(14.7-16.2)
15.8
Lung(Males & Females)
43.0 41.4(40.1-42.7)
42.0
Higher than targetLower than target
4 U.S. Cancer Statistics Working Group. United States Cancer Statistics: 1999-2011 Incidence and Mortality Web-based Report. Atlanta: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention and National Cancer Institute; 2014. Available at: www.cdc.gov/uscs.
Incidence (per 100,000)by Race/Ethnicity
HNJ 2010Target
20114
(95% CI)HNJ 2020
TargetWhite 6.8 7.5
(6.6-8.4)7.1
Black 6.8 9.5(7.4-12.1)
9.0
Hispanic (Any Race) 6.8 10.9(8.5-13.8)
11.6
Racial/Ethnic Disparities: Invasive Cervical Cancer
Deaths (per 100,000)by Race/Ethnicity
HNJ 2010Target
20114
(95% CI)HNJ 2020
TargetWhite 1.6 2.3
(1.8-2.8)1.6
Black 6.0 4.8(3.3-6.7)
3.6Higher than targetLower than target
4 U.S. Cancer Statistics Working Group. United States Cancer Statistics: 1999-2011 Incidence and Mortality Web-based Report. Atlanta: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention and National Cancer Institute; 2014. Available at: www.cdc.gov/uscs.
Incidence (per 100,000)by Race/Ethnicity
HNJ 2010Target
20114
(95% CI)HNJ 2020
Target
White None 40.5(39.1-41.9)
39.8
Black None 45.1(41.2-49.3)
41.2
Hispanic (Any Race) None 37.2(33.3-41.4)
31.2
Racial/Ethnic Disparities: Colorectal Cancer
Deaths (per 100,000)by Race/Ethnicity
HNJ 2010Target
20114
(95% CI)HNJ 2020
TargetWhite 19.0 15.2
(14.4-16.1)16.2
Black 22.0 21.8(19.0-24.8)
20.1
Hispanic None 9.3(7.3-11.5)
9.5Higher than targetLower than target
4 U.S. Cancer Statistics Working Group. United States Cancer Statistics: 1999-2011 Incidence and Mortality Web-based Report. Atlanta: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention and National Cancer Institute; 2014. Available at: www.cdc.gov/uscs.
TRENDS OVER TIME(My!) “How” we’ve come a long way!
Geographic Disparities Over Time:NJ LungCancer DeathRates 1971-2010 HNJ
2020 Target42.0
https://gis.cancer.gov/atlas/
Geographic Disparities Over Time:NJ MelanomaDeathRates 1971-2010
HNJ 2020 Target
2.4
https://gis.cancer.gov/atlas/
Geographic Disparities Over Time:NJ ColorectalCancer DeathRates 1971-2010
HNJ 2020 Target15.8
https://gis.cancer.gov/atlas/
Concluding Thoughts
• NJ has seen progress in decreasing the mortality from cancers that can be prevented through screening or behavioral changes (melanoma, colorectal, and lung)
• Work remains to reach Healthy New Jersey 2020 goals for invasive cervical cancer and incidence of melanoma and colorectal cancers
• Disparities demographically and geographically persist– Stomach & liver cancer among minorities– Melanoma among whites– Invasive colorectal and cervical among blacks
Acknowledgements: This work was supported by the New Jersey State Cancer Registry and Rutgers Cancer Institute of New Jersey, which are funded by SEER (Contract No. HHSN261201000027C), the Centers for Disease Control and Prevention NPCR (Grant No. 5U58DP003931-03), and the State of New Jersey.