2009 Cancer Report

Contents:

• Cancer Program review for 2009
• Summary of Cancer Registry data for 2008
• Cancer site distribution for 2008
• Role of the MMH Cancer Registry

Our Cancer Program

The Oncology Committee of Manatee Memorial Hospital (MMH) is pleased to present this report of MMH Cancer Program activities during 2009. Except where expressly noted, the Cancer Registry data in this report is from 2008.

The Commission on Cancer (CoC) has approved the MMH cancer program as a Community Hospital Cancer Program (CHCP). To achieve approval status a facility must show that its patients have access to all major modalities of cancer treatment, either on site or by referral, and meet national standards for multidisciplinary interaction by the entire cancer care team. In addition to cancer diagnostic, staging and treatment modalities, these standards require ongoing performance improvement, demonstration of adherence to quality measures, outcomes analyses, staff education, patient support services and community outreach activities.

In 2009 the MMH Cancer Program activities included the following highlights:

• Addition of palliative care physician to the medical staff
• Specialized da Vinci® robotic arm utilized for gynecology and urology surgical procedures
• Tobacco prevention and cessation awareness monthly session at MMH
• Breast cancer awareness activities in October
• Cancer topics at the Thursday CME conference open to all staff
• Improved patient safety through the implementation of electronic medication reconciliation
• Implementation of automatic interface of pathology reports in the electronic medical record
• Public forums discussing topics such as "The Art of Palliative Medicine" and "Using the daVinci Robot System for GYN and Urology Surgery"

The success of the above is due to the extraordinary day-to-day cancer patient care activities. MMH believes that providing the best cancer care lies with each professional individual member providing quality care and support to our cancer patients.

Manatee Memorial Hospital frequently collaborates with the American Cancer Society, the American Lung Association, the Manatee County Health Department and the Wellness Community to provide cancer support, cancer screenings and educational services to the local cancer patient population.

Summary of Cancer Registry Data for 2008

Since January 1, 2004, cancer registries have been required by federal and state legislation to also collect and report benign brain tumors.

A total of 699 new cancer patients were treated at MMH during 2008. Of these, 575 (82%) were analytic (newly diagnosed) and 124 (18%) were nonanalytic (diagnosed and completed first-course therapy elsewhere).

The demographic (sex, race, age) distributions of our analytical cancer patient populations is important for planning effective cancer services. This information can provide MMH insight in identifying what additional services such as treatment modalities and support services are needed in the community.

In 2008, gender distribution was 58% female cancer patients and 42% male cancer patients. This represents a slight increase from prior year in the female cancer patients (53%). Racial distribution was 93% white, 6% black and 1% other races. This represents a slight increase from prior year in white race (90%) and decrease in black race (9%). The largest age group diagnosed with cancer were patients 70 years or older which represent 47% of our 2008 population:

Determining the stage or extent of cancer is critical to making effective treatment decisions. The staging system used for this report is the Collaborative Staging System (CSS) developed by the American Joint Committee on Cancer (AJCC), the Commission on Cancer (CoC), and the Surveillance, Epidemiology and End Results (SEER) program of the National Cancer Institute with collaboration from multiple national and state cancer organizations. The CSS staging system uses an algorithm to and staging factors collected by cancer registries to derive a stage that may combine clinical and pathologic tumor (T), lymph node (N) and metastatic (M) components. The overall AJCC stage distribution of MMH analytic cancer cases is as follows:

• Stage 0 – 8%
• Stage 1 – 22%
• Stage 2 – 14%
• Stage 3 – 14%
• Stage 4 – 16%
• Stage Unknown – 16%
• Stage Not Applicable – 9%

The five most frequent sites of cancer seen at MMH during 2008 were breast (25%), lung (18%), colorectal (13%), bladder (8%) and uterus (4%). Per the Cancer Facts & Figures 2008, published by the American Cancer Society, the five most common cancers in the United States were lung, prostate, breast, colorectal, and bladder in that order. Per the same source, the most common cancers in Florida were lung, breast, prostate, colorectal and bladder in that order. A chart comparing the frequency of cancer sites seen at MMH in 2008 compared to national and Florida incidence follows: