Mapping Cancer Incidence

David Grkovic

Joe Pascarosa

Andrew Waters

Faculty Advisor: Dr. Cynthia KlevickisNPR

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!

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.

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.

Introduction

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

Introduction

• Clip from NPR about cancer.

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

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.

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

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

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

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

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

Confidentiality Protection

• Since on World Wide Web, confidentiality protection important

• Cannot use many demographics

– Age

– Race

– Gender

– Detailed whereabouts

– Any other personal information

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)

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

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

Virginia Cancer MapsIncidence by Anatomical Site

Cancer Ra te/100,000 popu la tionA ll Sites (Mid-Atlan tic)

94 .50 to 291.30

291.30 to 323.40

323.40 to 344.90

344.90 to 350.30

350.30 to 356.80

356.80 to 360.40

360.40 to 372.00

372.00 to 381.70

381.70 to 396.10

396.10 to 419.70

All Sites

Cancer Ra te/100,000 popu la tionFem ale B reast (Mid-Atlan tic)

32 .60 to 80.00

80 .00 to 89.80

89 .80 to 92.10

92 .10 to 93.50

93 .50 to 96.10

96 .10 to 97.50

97 .50 to 99.30

99.30 to 104.30

104.30 to 110.00

110.00 to 126.40

Female Breast Cancer

Cancer Ra te/100,000 popu la tionProstate (Mid-Atlan tic)

21 .00 to 84.50

84.50 to 104.80

104.80 to 119.90

119.90 to 124.40

124.40 to 130.00

130.00 to 136.10

136.10 to 138.90

138.90 to 150.30

150.30 to 150.30

150.30 to 181.40

Prostate Cancer

Cancer Ra te/100,000 popu la tionCo lo recta l (Mid-Atlan tic)

12 .20 to 31.80

31 .80 to 36.70

36 .70 to 38.70

38 .70 to 39.90

39 .90 to 40.30

40 .30 to 40.40

40 .40 to 42.20

42 .20 to 42.90

42 .90 to 46.70

46 .70 to 49.40

Colorectal Cancer

Cancer Ra te/100,000 popu la tionLung and Bronchus (Mid-Atlan tic)

9 .30 to 42.80

42 .80 to 50.40

50 .40 to 52.20

52 .20 to 55.50

55 .50 to 57.30

57 .30 to 62.20

62 .20 to 66.60

66 .60 to 68.20

68 .20 to 69.70

69 .70 to 76.20

Lung and Bronchus Cancer

Cancer Ra te/100,000 popu la tionUrina ry B ladder

4.00 to 8.70

8 .70 to 10.20

10 .20 to 12.30

12 .30 to 13.40

13 .40 to 14.40

14 .40 to 15.60

15 .60 to 16.90

16 .90 to 20.90

20 .90 to 23.30

23 .30 to 25.50

Urinary Bladder Cancer

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

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

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?

Accessing your health district

• http://www.isat.jmu.edu/users/klevicca/cancer_database/healthdistricts/healthdistricts.html

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

Interactive Web Page

• Questions?

• Navigate through our web page

• Answer questions on the quiz

Special Thanks

•Dr. Cindy Klevickis