Survey
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
Cancer Statistics in Metropolitan Detroit 2012 Metropolitan Detroit Cancer Surveillance System Surveillance, Epidemiology and End Results Program December 2012 Table of Contents Table of Contents 1 Metropolitan Detroit Cancer Surveillance System (MDCSS) 2 Geographic Coverage Area 3 Population Estimates 4 Michigan Department of Community Health Collaboration, and MDCSS Authority to Collect Cancer Data 5 Cancer Trends, Incidence, Mortality and Survival in Metropolitan Detroit 6 Temporal Cancer Trends 7 Cancer Incidence and Mortality: All Races 8 Cancer Incidence and Mortality: Whites 10 Cancer Incidence and Mortality: African-Americans 12 Survival Analysis by Stage: Prostate Cancer 14 Survival Analysis by Stage: Female Breast Cancer 15 Survival Analysis by Stage: Lung Cancer 16 Survival Analysis by Stage: Colorectal Cancer 17 Cancer Research at MDCSS 18 The Young Women’s Health History Study Breast Cancer Risk Factors in Young Women 19 Risk Factors for Ovarian Cancer in African-American Women 20 Patterns of Care Study 21 Genetic Pathways of Inflammation and Risk of Lung Cancer and Chronic Obstructive Pulmonary Disease 22 The Epidemiology Research Core 24 List of Studies Conducted at the MDCSS 25 MDCSS/SEER Publications 2010-2012 28 Affiliations and Acknowledgements 32 MDCSS Participating Institutions 33 Appendix A: Michigan Public Health Code and Health Insurance Portability and Accountability Act (HIPAA) Excerpts 34 Credits36 Metropolitan Detroit Cancer Surveillance System (MDCSS) and Surveillance, Epidemiology and End Results (SEER) Cancer Program Description and Goals 2 Program Description Program Goals The Metropolitan Detroit Cancer Surveillance System (MDCSS) has been recording data on cancer in Wayne, Oakland and Macomb Counties since 1973. Cancer is a reportable disease under State of Michigan law. The MDCSS is the arm of the Michigan Department of Community Health (MDCH) responsible for the collection and reporting of cancer data for residents of the tri-county area. The MDCSS is also one of 20 cancer registries in the United States providing cancer data to the National Cancer Institute as part of the Surveillance, Epidemiology and End Results (SEER) Program. The SEER Program was established pursuant to the National Cancer Act of 1971. The MDCSS is a founding participant in that program and is now completing its 40th year of data collection as a SEER Registry. The national SEER Program collects cancer data on approximately 28% of the United States population. Participating registries are chosen in part for the special populations represented within their borders. The Detroit tri-county area is an ideal location because of its urban, industrial setting and diverse population. The goals of the Detroit SEER Program are to: The MDCSS has a staff of more than 50 people who collect data from hospitals, laboratories, radiation centers and other facilities that serve cancer patients. A follow-up program tracks more than 95% of the cancer survivors diagnosed since 1973, providing yearly updates on their vital status. Funding for the registry is provided by the National Cancer Institute to Wayne State University. Additional funding for research studies is provided by the National Cancer Institute and other agencies through grants and contracts and distributed to university, state and national researchers investigating cancer-related topics. Strict rules are in place to preserve the confidentiality of individual patient information and the hospitals and physicians who provide these data. 1. Assemble and report estimates of cancer incidence, survival and mortality in the tri-county area. 2. Monitor annual cancer trends to identify unusual changes in specific forms of cancer in population subgroups. 3. Provide information on changes over time in the extent of disease at diagnosis, therapy and patient survival. 4. Promote and conduct studies designed to identify factors leading to cancer causes, prevention and control. 5. Respond to requests from individuals and organizations for data on cancer in the tri-county area. Over the past 40 years, we have seen remarkable improvements in cancer diagnosis and therapy. Early detection leads to improved survival. In fact, mortality from cancer has decreased in recent years, which is most likely due to early detection and better therapies. Geographic Coverage Area: Metropolitan Detroit The MDCSS and the Metropolitan Detroit SEER Program provide reporting for Wayne, Oakland and Macomb counties in southeastern Michigan. These three counties are home to 3,863,924 people, approximately 39% of the total state population. There are 1,820,584 individuals residing in Wayne County, 39% of those in the City of Detroit, which has a population of 713,777. Oakland County residents number 1,202,362 and Macomb County has the smallest population of the three, with 840,978 residents. About 69% of the population in the tri-county area are White and 26% African-American. An additional 5% of the population are of other races, primarily Asian and Native American or are multi-racial. (U.S. Census 2010.) As of the 2010 census, persons of Hispanic ethnicity made up about 4% of the total population. The tri-county area also has great ethnic diversity, which includes groups of Polish-, German-, Italian-, and Arab-Americans. In 2010, there were 24,651 new invasive and in situ cancers diagnosed in residents of the metropolitan Detroit (tricounty) area. This is about half the number reported for the entire state. Because of the large population encompassed in the metropolitan Detroit area and the diversity found here, the MDCSS is especially vital to both State of Michigan and national cancer statistics reporting. Newly Diagnosed Invasive and In Situ Cancers in the Metropolitan Detroit Area (2010) Cancers 11,314 New Wayne County Cancers 7,797 New Oakland County Cancers 5,540 New Macomb County 3 Population by Age, Sex, Race and Ethnicity in Metropolitan Detroit, 2011 OAKLAND MACOMB WAYNE 4 AMERICAN INDIAN/ WHITEAFRICAN-AMERICAN ALASKA NATIVE AGE ASIAN/PACIFIC HISPANIC* ISLANDER ALL RACES MALE FEMALEMALEFEMALE MALEFEMALEMALEFEMALEMALEFEMALEMALEFEMALE 00-04 years 74,443 71,227 37,033 35,689 783 760 6,291 5,934 9,101 8,736118,550113,610 05-09 years 82,624 78,660 36,392 34,865 777 819 6,915 6,755 8,921 8,739126,708121,099 10-14 years 89,203 84,559 40,276 39,271 847 844 6,264 5,988 7,966 7,714136,590130,662 15-19 years 87,808 81,699 44,995 43,715 889 923 5,211 4,599 7,346 6,890138,903130,936 20-24 years 77,771 75,432 38,494 41,051 782 757 4,373 4,410 6,263 5,875121,420121,650 25-29 years 79,629 78,017 27,689 32,977 673 671 5,369 5,894 6,455 6,027113,360117,559 30-34 years 80,248 78,917 26,928 34,046 652 764 6,109 7,331 6,770 6,365113,937121,058 35-39 years 80,373 79,405 29,062 37,611 696 739 7,062 7,992 6,221 5,975117,193125,747 40-44 years 95,525 94,753 30,739 38,345 750 836 6,972 6,879 5,426 5,118133,986140,813 45-49 years 104,613104,665 29,734 36,356 742 808 5,821 5,636 4,496 4,434140,910147,465 50-54 years 110,011112,777 30,812 38,277 706 824 4,562 4,499 3,708 3,652146,091156,377 55-59 years 98,606100,855 27,536 35,233 623 687 3,611 3,895 2,776 3,028130,376140,670 60-64 years 82,404 87,034 22,902 30,490 428 556 2,986 3,726 2,104 2,146108,720121,806 65-69 years 56,38562,51114,652 19,365 238 325 2,341 2,499 1,321 1,403 73,616 84,700 70-74 years 38,43947,291 9,451 13,642 195 226 1,665 1,629 817 98949,75062,788 75-79 years 29,004 40,223 6,809 11,413104145892 1007634888 36,809 52,788 80-84 years 25,007 38,145 4,973 9,024 53123451666521718 30,484 47,958 85+ years 20,716 44,071 4,072 9,425 53144310506389607 25,151 54,146 Total 1,312,809 1,360,241 462,549540,795 9,99110,95177,20579,84581,23579,304 1,862,554 1,991,832 Source: Surveillance, Epidemiology, and End Results (SEER) Program (www.seer.cancer.gov) SEER*Stat Database: Populations - *Note: Persons of Hispanic origin may be of any race, therefore Hispanic counts not added to totals. Total U.S. (1990-2011) <Katrina/Rita Adjustment> - Linked To County Attributes - Total U.S., 19692011 Counties, National Cancer Institute, DCCPS, Surveillance Research Program, Surveillance Systems Branch, released October 2012. Michigan Department of Community Health Collaboration and the MDCSS Authority to Collect Cancer Data The 28-year collaboration between the State of Michigan Department of Community Health (MDCH) and the Metropolitan Detroit Cancer Surveillance System (MDCSS) was recently renewed by the State of Michigan. The following letter grants authority to the MDCSS to collect cancer data as a designated public health authority of the State. Because the MDCSS is designated by the MDCH as a “state-authorized entity for the collection and reporting of individually identifiable cancer information,” HIPAA allows hospitals to disclose such information to the MDCSS. 5 Cancer Trends, Incidence, Mortality and Survival in Metropolitan Detroit 6 Temporal Cancer Trends 7 Cancer Incidence and Mortality: All Races 8 Cancer Incidence and Mortality: Whites 10 Cancer Incidence and Mortality: African-Americans 12 Survival Analysis by Stage: Prostate Cancer 14 Survival Analysis by Stage: Female Breast Cancer 15 Survival Analysis by Stage: Lung Cancer 16 Survival Analysis by Stage: Colorectal Cancer 17 Temporal Cancer Trends in Metropolitan Detroit Lung cancer has been the leading cause of cancer mortality among males since 1973, but it has declined somewhat since 1992. Mortality among females from lung cancer continues to increase, reflecting an increase in smoking. Mortality rates for prostate and female breast cancer have been decreasing over time. Age-Adjusted Incidence for Invasive Lung & Bronchus, Prostate & Female Breast Cancers, Metropolitan Detroit, 1973 – 2009 RATES PER 100,000 POPULATION 300 300 250 250 200 200 150 150 100 100 50 50 1975 1980 1985 1990 1995 2000 2005 Source: Surveillance, Epidemiology, and End Results (SEER) Program (www.seer.cancer.gov) SEER*Stat Database: Incidence - SEER 9 Regs Research Data, Nov 2011 Sub, Vintage 2009 Pops (1973-2009) <Katrina/Rita Population Adjustment> - Linked To County Attributes - Total U.S., 1969-2010 Counties, National Cancer Institute, DCCPS, Surveillance Research Program, Surveillance Systems Branch, released April 2012, based on the November 2011 submission. Female Lung Male Lung Prostate Female Breast Age-Adjusted Mortality Rates for Invasive Lung & Bronchus, Prostate & Female Breast Cancers, Metropolitan Detroit, 1973 – 2009 RATES PER 100,000 POPULATION Incidence rates for prostate cancer peaked in 1992, but have remained high due to increased detection through the PSA (prostate specific antigen) test. Female breast cancer incidence rates have remained steady since the late 1980’s. Mammography screening has played an important role in the early diagnosis of this cancer. While rates of lung cancer have been declining among males since the mid 1990’s, rates among females are only now leveling off. 100 100 80 80 60 60 40 40 20 20 1975 1980 1985 1990 1995 2000 2005 Source: Surveillance, Epidemiology, and End Results (SEER) Program (www.seer.cancer.gov) SEER*Stat Database: Mortality - All COD, Aggregated With State, Total U.S. (1969-2009) <Katrina/Rita Population Adjustment>, National Cancer Institute, DCCPS, Surveillance Research Program, Surveillance Systems Branch, released April 2012. Underlying mortality data provided by NCHS (www.cdc.gov/nchs). 7 All Races Cancer Incidence, Mortality and Age Adjusted Rates per 100,000 Population by Site, Race and Sex, Metropolitan Detroit, 2009 8 All Races Incidence Rate Mortality Rate Total MaleFemale Total MaleFemale Total MaleFemale Total MaleFemale All Sites (Invasive) 21,97211,22810,744508.3593.3451.47,9494,0133,936184 224.3158.8 Oral Cavity and Pharynx 518 345 173 11.9 17.2 7.3 90 60 30 2.1 3.1 1.2 Lip 14 7 7 0.3 0.4 0.3 * * 0 * * 0 Tongue 152 102 50 3.4 5 2.1 17 11 * 0.4 0.6 * Salivary Gland 59 33 26 1.4 1.8 1.1 * * * * * * Floor of Mouth 38 25 13 0.9 1.2 0.6 * * 0 * * 0 Gum and Other Mouth 82 44 38 1.9 2.3 1.6 14 * * 0.3 * * Nasopharynx 19 13 6 0.4 0.6 0.2 11 * * 0.3 * * Tonsil 71 60 11 1.6 2.8 0.5 * * * * * * Oropharynx 27 19 8 0.6 0.9 0.3 10 * * 0.2 * * Hypopharynx 37 30 7 0.9 1.6 0.3 * * * * * * Other Oral Cavity and Pharynx 19 12 7 0 0.5 0 16 * * 0.4 * * Digestive System 3,9972,0981,89991.7 111.177.2 2,0401,111929 46.8 60.8 36.7 Esophagus 24716879 5.6 8.8 3.1 18413153 4.2 7 2.1 Stomach 3512211308.1 12.25.4 16695 71 3.9 5.5 2.8 Small Intestine 109 50 59 3 2.8 2.4 12 * * 0.3 * * Colon and Rectum 1,993 950 1,043 46 50.6 42.7 759 374 385 17.5 21.2 14.9 Colon excluding Rectum1,432 65278033.235.331.864130533614.917.513.1 Cecum 333 131 202 7.8 7.2 8.3 † † † † † † Appendix 30 15 15 0.7 0.8 0.7 † † † † † † Ascending Colon 287 121 166 6.7 6.6 6.7 † † † † † † Hepatic Flexure 81 36 45 1.9 2 1.8 † † † † † † Transverse Colon 113 52 61 2.6 2.7 2.4 † † † † † † Splenic Flexure 40 22 18 0.9 1.1 0.7 † † † † † † Descending Colon 80 46 34 1.9 2.6 1.5 † † † † † † Sigmoid Colon 370 185 185 8.5 9.7 7.6 † † † † † † Large Intestine, NOS 98 44 54 2.3 2.5 2.2 † † † † † † Rectum and 56129826312.815.410.911869 49 2.7 3.7 1.8 Rectosigmoid Junction Rectosigmoid Junction 134 72 62 3.1 3.7 2.6 † † † † † † Rectum 427 226 201 9.7 11.6 8.3 † † † † † † Anus, Anal Canal 80 34 46 1.8 1.8 1.8 * * * * * * and Anorectum Liver and Intrahepatic Bile Duct 34626086 7.5 12.73.4 25418074 5.7 9 3 Liver 32424678 7.1 11.93.1 20814959 4.6 7.4 2.4 Intrahepatic Bile Duct 22 14 8 0.5 0.8 0.3 46 31 15 1 1.6 0.6 Gallbladder 6221411.41.21.625 * 220.6* 0.8 Other Biliary 84 45 39 1.9 2.4 1.6 19 10 * 0.4 0.6 * Pancreas 66633033615.317.613.658930028913.516.311.6 Retroperitoneum 10 7 * 0.2 0.4 * * * * * * * Peritoneum, Omentum and Mesentery 26 * 25 0.6 * 1 * * * * * * Other Digestive Organs 23 11 12 1 0.6 1 12 * * 0.3 * * Respiratory System 3,5751,8651,71084 101.971.5 2,3371,2701,06754.8 70.3 44 Nose, Nasal Cavity and Middle Ear 28 19 9 0.7 1 0.4 * * * * * * Larynx 184146384 7.62 4737101.12 0.4 Lung and Bronchus 3,3261,6741,65278.3 91.7 69.1 2,2761,2231,05353.3 67.7 43.4 Pleura 31 23 8 0.7 1.3 0.3 * * 0 * * 0 Trachea, Mediastinum and Other Respiratory Organs 6 * * 0.1 * * * * * * * * Bones and Joints 32 18 14 0.8 0.9 0.7 19 12 * 0.4 0.6 * Soft Tissue including Heart 12861673.13.23 5533221.31.81 Skin excluding Basal and Squamous 75141533617.522.114.811777 40 2.6 4.2 1.6 Melanoma of the Skin 639 351 288 14.9 18.7 12.7 91 61 30 2.1 3.3 1.2 Other Non-Epithelial Skin 11264483 3.52 2616100.60.90.4 Breast 3,123 21 3,102 72 1.2 131.3 614 * 606 14.1 * 24.6 All Races Incidence Rate Mortality Rate Total MaleFemale Total MaleFemale Total MaleFemale Total MaleFemale Female Genital System 1,309 01,309 29.6 054.7 383 0383 8.8 015.7 Cervix Uteri 174 0174 4.2 07.9 490491.2 02.2 Corpus and Uterus, NOS 707 0 707 15.7 0 28.9 128 0 128 2.9 0 5.2 Corpus Uteri 685 0 685 15.2 0 28 59 0 59 1.4 0 2.5 Uterus, NOS 22 0 22 0.5 0 0.9 69 0 69 1.6 0 2.7 Ovary 3210 3217.3 0 13.31820 1824.2 0 7.4 Vagina 26 0 26 0.6 0 1.1 * 0 * * 0 * Vulva 640 641.50 2.6140 140.30 0.5 Other Female Genital Organs 17 0 17 0 0 0.8 * 0 * * 0 * Male Genital System 3,689 3,689 0 84 188.9 0 358 358 0 8.2 21.7 0 Prostate 3,5633,5630 81 182.10 353 353 0 8.1 21.5 0 Testis 102 102 0 2.7 5.5 0 * * 0 * * 0 Penis 19 19 0 0.4 1 0 * * 0 * * 0 Other Male Genital Organs * * 0 * * 0 0 0 0 0 0 0 Urinary System 1,8351,266569 42.368.823.2410 268 142 9.6 15.35.7 Urinary Bladder 1,006 75025623.242.110.221514471 5 8.4 2.8 Kidney and Renal Pelvis 778 486 292 17.9 25 12.2 186 119 67 4.4 6.7 2.8 Ureter 30 16 14 0.7 1 0.5 * * * * * * Other Urinary Organs 21 14 7 0.5 0.8 0.3 * * * * * * Eye and Orbit 23 12 11 0.6 0.7 0.4 * * * * * * Brain and Other Nervous System 2661371296.4 7.2 5.8 18310182 4.2 5.2 3.4 Brain 241 124 117 5.8 6.6 5.3 † † † † † † Cranial Nerves Other Nervous System 25 13 12 0.6 0.7 0.5 † † † † † † Endocrine System 61915046914.87.7 21.438 16 22 0.9 0.8 0.9 Thyroid 593 137 456 14.2 7 20.8 23 * 16 0.5 * 0.6 Other Endocrine including Thymus 26 13 13 0.6 0.7 0.6 15 * * 0.4 * * Lymphoma 99252646623.628.220.13081691397.2 9.7 5.6 Hodgkin’s Lymphoma 130 65 65 3.3 3.5 3.1 17 * 11 0.4 * 0.5 Hodgkin’s - Nodal 124 62 62 3.1 3.4 2.9 † † † † † † Hodgkin’s - Extranodal 6 * * 0.2 * * † † † † † † Non-Hodgkin’s Lymphoma (NHL) 86246140120.324.717 2911631286.8 9.4 5.1 NHL - Nodal 597 331 266 14 17.8 11.2 † † † † † † NHL - Extranodal 265 130 135 6.3 6.9 5.9 † † † † † † Myeloma 3151821337.39.85.416483 81 3.84.53.2 Leukemia 50429520912 16.29 3301771537.8 10.36 Lymphocytic Leukemia 22114576 5.37.93.383 48 35 1.92.81.4 Acute Lymphocytic Leukemia 44 27 17 1.2 1.4 0.9 11 * * 0.3 * * Chronic Lymphocytic Leukemia 16010456 3.85.82.368 38 30 1.62.31.2 Other Lymphocytic Leukemia 17 14 * 0.4 0.7 * * * * * * * Myeloid and Monocytic Leukemia 2571361216.17.55.216184 77 3.84.83.2 Acute Myeloid Leukemia 155 77 78 3.7 4.3 3.4 132 74 58 3.2 4.3 2.4 Acute Monocytic Leukemia * 0 * * 0 * * 0 * * 0 * Chronic Myeloid Leukemia 93 54 39 2.2 2.9 1.6 19 * 14 0.4 * 0.5 Other Myeloid/Monocytic Leukemia 8 * * 0.2 * * * * * * * * Other Leukemia 2614120.60.80.58645412 2.71.5 Other Acute Leukemia 10 * 7 0.2 * 0.3 30 16 14 0.7 1 0.5 Aleukemic, Subleukemic and NOS 16 11 * 0.4 0.6 * 56 29 27 1.3 1.7 1 Miscellaneous 2961481486.7 8.1 5.7 49826922911.415.38.9 Rates are per 100,000 and age-adjusted to the 2000 US Std Population (19 age groups - Census P25-1130) standard. † Not reported * Statistic not displayed due to fewer than 6 cases. Source: Surveillance, Epidemiology, and End Results (SEER) Program (www.seer.cancer.gov) SEER*Stat Database. Underlying mortality data provided by NCHS (www.cdc.gov/nchs). 9 Whites Cancer Incidence, Mortality and Age Adjusted Rates per 100,000 Population by Site, Race and Sex, Metropolitan Detroit, 2009 10 WHITE IncidenceRateMortality Rate Total MaleFemale Total MaleFemale Total MaleFemale Total MaleFemale All Sites (Invasive) 16,4048,3678,037501.4573.8455.55,9153,0082,907177 215.2153.6 Oral Cavity and Pharynx 383 254 129 11.7 16.6 7.3 62 40 22 1.9 2.8 1.2 Lip 13 7 6 0.4 0.5 0.3 * * 0 * * 0 Tongue 118 82 36 3.6 5.3 2 15 10 * 0.5 0.7 * Salivary Gland 46 25 21 1.5 1.9 1.2 * * 0 * * 0 Floor of Mouth 27 19 8 0.8 1.1 0.5 * * 0 * * 0 Gum and Other Mouth 63 35 28 1.9 2.5 1.6 12 * * 0.4 * * Nasopharynx 12 8 * 0.4 0.5 * * * * * * * Tonsil 53 44 9 1.6 2.7 0.5 * * 0 * * 0 Oropharynx 16 10 6 0.5 0.7 0.3 * * * * * * Hypopharynx 23 18 * 0.7 1.3 * * * * * * * Other Oral Cavity and Pharynx 12 6 6 0.3 0.3 0.3 11 * * 0.3 * * Digestive System 2,7921,4971,29583.5 102.569 1,448812 636 42.9 56.9 32.6 Esophagus 19214250 5.79.52.515211240 4.57.62 Stomach 226153736.810.7 3.99867313 4.81.6 Small Intestine 66 35 31 2 2.4 1.6 * * * * * * Colon and Rectum 1,419 69572442.848 38.954026827215.919.213.5 Colon excluding Rectum1,013 47553830.433.228.545421424013.415.712 Cecum 234 98 136 7.1 6.9 7.1 † † † † † † Appendix 21 11 10 0.7 0.8 0.6 † † † † † † Ascending Colon 209 88 121 6.3 6.1 6.3 † † † † † † Hepatic Flexure 59 27 32 1.8 2 1.6 † † † † † † Transverse Colon 83 35 48 2.4 2.3 2.5 † † † † † † Splenic Flexure 23 15 8 0.6 1 0.4 † † † † † † Descending Colon 49 29 20 1.5 2.1 1.1 † † † † † † Sigmoid Colon 267 141 126 8.1 9.7 6.8 † † † † † † Large Intestine, NOS 68 31 37 2 2.2 2 † † † † † † Rectum and Rectosigmoid Junction 406 220 186 12.3 14.8 10.4 86 54 32 2.5 3.6 1.5 Rectosigmoid Junction 86 43 43 2.6 2.9 2.4 † † † † † † Rectum 320 177 143 9.7 11.9 8.1 † † † † † † Anus, Anal Canal and Anorectum 62 23 39 1.8 1.5 2.1 * * * * * * Liver and Intrahepatic Bile Duct 20715849 6 10.22.5 15911346 4.7 7.5 2.5 Liver 18514441 5.49.22.212389 34 3.75.91.9 Intrahepatic Bile Duct 22 14 8 0.6 1 0.4 36 24 12 1.1 1.6 0.7 Gallbladder 4114271.21 1.419 * 160.5* 0.7 Other Biliary 63 33 30 1.8 2.3 1.6 15 * * 0.4 * * Pancreas 46622624013.915.512.643422920512.916 10.8 Retroperitoneum 10 7 * 0.3 0.5 * * * * * * * Peritoneum, Omentum and Mesentery 22 * 21 0.7 * 1.1 * * * * * * Other Digestive Organs 18 10 8 0.6 0.8 0.4 * * * * * * Respiratory System 2,6831,3731,31082.4 97 72.4 1,759928 831 53.4 66.1 44.8 Nose, Nasal Cavity and Middle Ear 21 15 6 0.6 1.1 0.3 * * * * * * Larynx 130 100 30 4 6.9 1.7 26 23 * 0.8 1.6 * Lung and Bronchus 2,4981,2341,26476.787.369.91,722897 825 52.363.944.6 Pleura 31 23 8 0.9 1.6 0.4 * * 0 * * 0 Trachea, Mediastinum and Other Respiratory Organs * * * * * * * * 0 * * 0 Bones and Joints 27 15 12 0.9 1.1 0.8 15 * * 0.5 * * Soft Tissue including Heart 10245573.43.23.54429151.42 1 Skin excluding Basal and Squamous 71439831622.327.319.411375 38 3.3 5.2 2.1 Melanoma of the Skin 624 349 275 19.5 23.8 17.1 88 59 29 2.6 4.1 1.6 Other Non-Epithelial Skin 90 49 41 2.7 3.4 2.3 25 16 * 0.7 1.1 * Breast 2,319 16 2,303 70.8 1.2 132.3 430 * 425 12.8 * 22.6 WHITE IncidenceRateMortality Rate Total MaleFemale Total MaleFemale Total MaleFemale Total MaleFemale Female Genital System 9970 99730 0 56.72860 2868.5 0 15.4 Cervix Uteri 113 0113 3.8 07.4 270270.9 01.7 Corpus and Uterus, NOS 552 0 552 16.2 0 30.6 89 0 89 2.6 0 4.8 Corpus Uteri 545 0 545 15.9 0 30.2 43 0 43 1.3 0 2.4 Uterus, NOS 7070.2 00.4 460461.4 02.4 Ovary 2500 2507.5 0 14.11490 1494.4 0 7.9 Vagina 16 0 16 0.5 0 1 * 0 * * 0 * Vulva 530 531.60 2.9120 120.40 0.6 Other Female Genital Organs 13 0 13 0.4 0 0.8 * 0 * * 0 * Male Genital System 2,589 2,589 0 78.6 172.5 0 248 248 0 7.2 18.8 0 Prostate 2,478 2,478 074.5 164.1 0243 243 0718.5 0 Testis 90 90 0 3.5 6.8 0 * * 0 * * 0 Penis 16 16 0 0.5 1.1 0 * * 0 * * 0 Other Male Genital Organs * * 0 * * 0 0 0 0 0 0 0 Urinary System 1,4731,037436 44.372 23.7343 224 119 10.316.26.4 Urinary Bladder 86765721025.846.611 17912356 5.3 9 2.9 Kidney and Renal Pelvis 560 351 209 17.1 23.3 11.9 156 97 59 4.7 7 3.3 Ureter 28 16 12 0.8 1.2 0.6 * * * * * * Other Urinary Organs 18 13 * 0.6 0.9 * * * * * * * Eye and Orbit 18 8 10 0.5 0.6 0.5 * * * * * * Brain and Other 11 Nervous System 20511095 6.77.85.815285 67 4.65.83.7 Brain 186 100 86 6.1 7.1 5.2 † † † † † † Cranial Nerves Other Nervous System 19 10 9 0.6 0.7 0.5 † † † † † † Endocrine System 48112435715.98.4 23.328 10 18 0.8 0.7 1 Thyroid 467 118 349 15.5 8 22.8 19 * 13 0.5 * 0.7 Other Endocrine including Thymus 14 6 8 0.4 0.4 0.4 * * * * * * Lymphoma 80843037825.730.422.12611441177.8 10.56 Hodgkin’s Lymphoma 104 53 51 3.8 4.1 3.5 14 * * 0.4 * * Hodgkin’s - Nodal 98 50 48 3.5 3.8 3.3 † † † † † † Hodgkin’s - Extranodal 6 * * 0.3 * * † † † † † † Non-Hodgkin’s Lymphoma (NHL) 70437732721.926.318.62471391087.3 10.15.5 NHL - Nodal 486 265 221 15.1 18.5 12.4 † † † † † † NHL - Extranodal 218 112 106 6.8 7.8 6.1 † † † † † † Myeloma 19111378 5.88.14.197 48 49 2.83.42.3 Leukemia 40124116012.617.19.3 2551421137.8 10.75.7 Lymphocytic Leukemia 18011961 5.88.53.763 38 25 1.93 1.2 Acute Lymphocytic Leukemia 35 20 15 1.4 1.5 1.2 * * * * * * Chronic Lymphocytic Leukemia 13186454 6.12.45332211.62.51.1 Other Lymphocytic Leukemia 14 13 * 0.4 0.9 * * * * * * * Myeloid and Monocytic Leukemia 20111190 6.27.85.111868 50 3.65 2.7 Acute Myeloid Leukemia 123 65 58 3.8 4.6 3.3 98 61 37 3.1 4.5 2 Acute Monocytic Leukemia * 0 * * 0 * 0 0 0 0 0 0 Chronic Myeloid Leukemia 71 41 30 2.2 2.8 1.6 12 * * 0.3 * * Other Myeloid/Monocytic Leukemia 6 * * 0.2 * * * * * * * * Other Leukemia 20 11 9 0.60.80.574 36 38 2.22.81.8 Other Acute Leukemia 9 * 6 0.3 * 0.3 27 14 13 0.8 1.1 0.6 Aleukemic, Subleukemic and NOS 11 8 * 0.3 0.6 * 47 22 25 1.4 1.7 1.1 Miscellaneous 2211171046.4 8.2 5.2 36920816110.915 8.2 Rates are per 100,000 and age-adjusted to the 2000 US Std Population (19 age groups - Census P25-1130) standard. † Not reported * Statistic not displayed due to fewer than 6 cases. Source: Surveillance, Epidemiology, and End Results (SEER) Program (www.seer.cancer.gov) SEER*Stat Database. Underlying mortality data provided by NCHS (www.cdc.gov/nchs). African-Americans Cancer Incidence, Mortality and Age Adjusted Rates per 100,000 Population by Site, Race and Sex, Metropolitan Detroit, 2009 12 AFRICAN-AMERICANIncidence Rate Mortality Rate Total MaleFemale Total MaleFemale Total MaleFemale Total MaleFemale All Sites (Invasive) 5,0262,5952,431544.1687.3448.41,951971 980 221.7280.2185.3 Oral Cavity and Pharynx 125 85 40 12.8 19.9 7.5 28 20 * 3 4.7 * Lip *0 **0 *000000 Tongue 32 19 13 3.2 4.4 2.3 * * * * * * Salivary Gland 11 6 * 1.2 1.3 * * * * * * * Floor of Mouth 9 * * 1.1 * * 0 0 0 0 0 0 Gum and Other Mouth 18 9 9 1.8 1.8 1.7 * 0 * * 0 * Nasopharynx * * * * * * * * 0 * * 0 Tonsil 18 16 * 1.8 3.8 * * * * * * * Oropharynx 11 9 * 1.1 2.1 * * * * * * * Hypopharynx 14 12 * 1.5 2.9 * * * 0 * * 0 Other Oral Cavity and Pharynx 6 * * 0.6 * * * * * * * * Digestive System 1,106 552554122149.1 103.9 56528627963.981.252.2 Esophagus 5426286 7.65.13118133.55.22.3 Stomach 113644913.2 209.46226367.38.56.8 Small Intestine 42 15 27 4.9 5 5.1 * * * * * * Colon and Rectum 51922729257.461.154.921410411025.331.821.1 Colon excluding Rectum 380 156 224 42.9 43.7 42.5 182 89 93 21.5 27.1 17.9 Cecum 91 27 64 10.6 8.1 12.5 † † † † † † Appendix 7 * * 0.8 * * † † † † † † Ascending Colon 75 31 44 8.6 8.6 8.5 † † † † † † Hepatic Flexure 21 9 12 2.3 2.4 2.2 † † † † † † Transverse Colon 27 15 12 3 4.3 2.2 † † † † † † Splenic Flexure 16 6 10 1.9 1.7 1.9 † † † † † † Descending Colon 28 16 12 3.1 4.7 2.2 † † † † † † Sigmoid Colon 88 37 51 9.4 9.6 9.4 † † † † † † Large Intestine, NOS 27 13 14 3.1 3.8 2.6 † † † † † † Rectum and Rectosigmoid Junction139716814.6 17.4 12.4 3215173.94.73.1 Rectosigmoid Junction 44 27 17 4.9 7.1 3.3 † † † † † † Rectum 95 44 51 9.7 10.3 9.1 † † † † † † Anus, Anal Canal and Anorectum 17 10 7 1.7 2.3 1.2 * * * * * * Liver and Intrahepatic Bile Duct 123903312.1 20.7 5.78762259 14.8 4.6 Liver 123903312.1 20.7 5.78057238.213.6 4.2 Intrahepatic Bile Duct 0 0 0 0 0 0 * * * * * * Gallbladder 20 6 14 2.2 1.5 2.6 * 0 * * 0 * Other Biliary 18 11 7 2.1 3.1 1.5 * * * * * * Pancreas 193 102 91 21.527.717.2149 69 80 16.518.814.8 Retroperitoneum 000000 **0 **0 Peritoneum, Omentum and Mesentery * 0 * * 0 * 0 0 0 0 0 0 Other Digestive Organs * * * * * * * * * * * * Respiratory System 84346537893.6126.9 71.156333422964 94 44.4 Nose, Nasal Cavity and Middle Ear * * * * * * * * 0 * * 0 Larynx 51 43 8 5.1 10.9 1.3 21 14 * 2.3 3.8 * Lung and Bronchus 78441636887.6114.5 69.553931822161.389.742.7 Pleura 000000 **0 **0 Trachea, Mediastinum and Other Respiratory Organs * * * * * * * 0 * * 0 * Bones and Joints * * * * * * * * * * * * Soft Tissue including Heart 24 15 9 2.4 3.5 1.6 11 * * 1.2 * * Skin excluding Basal and Squamous 31 15 16 3.3 3.9 2.9 * * * * * * Melanoma of the Skin 10 * 9 1 * 1.6 * * * * * * Other Non-Epithelial Skin 21 14 7 2.2 3.7 1.3 * 0 * * 0 * Breast 715 * 710 76.5 * 129.4 175 * 172 19.3 * 31.8 AFRICAN-AMERICANIncidence Rate Mortality Rate Total MaleFemale Total MaleFemale Total MaleFemale Total MaleFemale Female Genital System 280 0280 29.5 050.5 9309310.6 017.8 Cervix Uteri 550 555.70 9.9200 202.20 3.7 Corpus and Uterus, NOS 142 0 142 15 0 25.5 39 0 39 4.6 0 7.5 Corpus Uteri 127 0 127 13.4 0 22.9 16 0 16 1.9 0 3.1 Uterus, NOS 15 0 15 1.5 0 2.6 23 0 23 2.7 0 4.4 Ovary 600 606.40 10.9 310 313.70 6.1 Vagina 10 0 10 1.1 0 1.8 * 0 * * 0 * Vulva 10 0 10 1.1 0 1.8 * 0 * * 0 * Other Female Genital Organs * 0 * * 0 * 0 0 0 0 0 0 Male Genital System 9899890 104.9 2560 1081080 13.337.20 Prostate 9769760 103.5 2530 1081080 13.337.20 Testis 1010012.3 0000000 Penis **0 **0000000 Other Male Genital Organs 000000000000 Urinary System 321 201 120 35.556.921.864 42 22 7.5 12.54.1 Urinary Bladder 12280421424.2 7.73520154.25.92.8 Kidney and Renal Pelvis 195 120 75 21.1 32.3 13.7 28 21 * 3.2 6.2 * Ureter *0 **0 *000000 Other Urinary Organs * * * * * * * * 0 * * 0 Eye and Orbit * * * * * * 0 0 0 0 0 0 Brain and Other 13 Nervous System 4821274.94.95 2915143 3.32.7 Brain 43 18 25 4.4 4.1 4.7 † † † † † † Cranial Nerves Other Nervous System * * * * * * † † † † † † Endocrine System 103 15 88 10.5 4 15.6 * * * * * * Thyroid 93 10 83 9.4 2.6 14.6 * * * * * * Other Endocrine including Thymus 10 * * 1.1 * * * * * * * * Lymphoma 153837016.2 20.9 12.9 4525204.96.73.8 Hodgkin’s Lymphoma 18 8 10 1.8 1.9 1.8 * * * * * * Hodgkin’s - Nodal 18 8 10 1.8 1.9 1.8 † † † † † † Hodgkin’s - Extranodal 0 0 0 0 0 0 † † † † † † Non-Hodgkin’s Lymphoma (NHL) 135756014.3 1911.1 4224184.66.53.4 NHL - Nodal 97 58 39 10.2 14.7 7.1 † † † † † † NHL - Extranodal 38 17 21 4.1 4.3 4 † † † † † † Myeloma 121685313.3 17.8 10.1 6535307.49.55.9 Leukemia 8745429.912.7 8 6932377.89 7 Lymphocytic Leukemia 3420143.85.32.72010102 2.31.8 Acute Lymphocytic Leukemia 9 7 * 0.9 1.4 * * * 0 * * 0 Chronic Lymphocytic Leukemia 23 12 11 2.7 3.6 2.1 15 * * 1.5 * * Other Lymphocytic Leukemia * * * * * * * 0 * * 0 * Myeloid and Monocytic Leukemia 4722255.46.64.83713244.54 4.7 Acute Myeloid Leukemia 2811173.33.43.32810183.43.23.5 Acute Monocytic Leukemia 0 0 0 0 0 0 * 0 * * 0 * Chronic Myeloid Leukemia 17 11 6 1.9 3.2 1.1 * * * * * * Other Myeloid/Monocytic Leukemia * 0 * * 0 * * * 0 * * 0 Other Leukemia 6 * * 0.7 * * 12 * * 1.3 * * Other Acute Leukemia * 0 * * 0 * * * * * * * Aleukemic, Subleukemic and NOS * * * * * * * * * * * * Miscellaneous 7130418 8.27.7121586314.2 1811.8 Rates are per 100,000 and age-adjusted to the 2000 US Std Population (19 age groups - Census P25-1130) standard. † Not reported * Statistic not displayed due to fewer than 6 cases. Source: Surveillance, Epidemiology, and End Results (SEER) Program (www.seer.cancer.gov) SEER*Stat Database. Underlying mortality data provided by NCHS (www.cdc.gov/nchs). Survival Analysis of Prostate Cancer by Stage Over the past 31 years, the treatment of men with prostate cancer diagnosed at an early stage has improved. In the tri-county area, the current five-year relative survival for men diagnosed with local stage prostate cancer is near 100%. Dramatic improvement in survival of men with prostate cancer that is diagnosed after it has spread to other parts of the body has not been seen. The five-year relative survival for men diagnosed with distant stage disease has fluctuated for the last 31 years between 20-38%, with African-American men showing a better trend in the last decade than White men. Armed with successful treatment for early stage disease, there has been a concerted effort to identify these cancers while they are in local stage. Currently, about 95% of the men who are newly diagnosed with prostate cancer in the tri-county area are diagnosed at local or regional stages. A few of the risk factors for developing the disease are age, race (African-American), and family Localized/Regional 14 100 Distant Invasive Prostate Cancer – White Males Stage Distribution 1973 – 2009 Metropolitan Detroit 100 6080 6080 60 40 60 40 40 20 40 20 20 20 1975 1975 1980 1980 1975 1985 1990 1995 2000 2005 1975 1980 1980 1985 1990 1995 2000 2005 YEAR DIAGNOSED - 3 YEAR MOVING AVERAGE YEAR DIAGNOSED - 3 YEAR MOVING AVERAGE 5-Year Relative Survival Rates for Prostate Cancer – White Males by Stage, 1973 – 2009 Metropolitan Detroit 5 -Year Relative Survival Rates for Prostate Cancer – African-American Males by Stage, 1973 – 2009 Metropolitan Detroit 100 80 80 PERCENTAGE 100 PERCENTAGE Invasive Prostate Cancer – African-American Males Stage Distribution 1973 – 2009 Metropolitan Detroit PERCENTAGE PERCENTAGE 100 80 PERCENTAGE PERCENTAGE 100 80 100 history (men with close blood relatives such as fathers or brothers who have been diagnosed with the disease). 60 40 20 60 40 20 1975 1975 1980 1980 2000 1985 1990 1995 2000 YEAR DIAGNOSED - 3 YEAR MOVING AVERAGE 2005 1975 1980 1985 1990 1995 2000 YEAR DIAGNOSED - 3 YEAR MOVING AVERAGE 2005 Survival Analysis of Female Breast Cancer by Stage Both diagnosis and treatment for female breast cancer have improved since 1973. Due to mammography screening, more cases are diagnosed at an earlier stage. Currently, five-year relative survival for cases diagnosed at local stage is 95% for women in the general population. For women with regional stage disease, survival also has improved. For women diagnosed with late stage disease, survival has remained relatively steady, at 10-20% for women in the general population. AfricanAmerican women tend to have a higher proportion of late stage diagnoses and five-year survival, regardless of stage, tends to be poorer than for White women. Gender and age are the greatest risk factors for developing breast cancer. Breast cancer can Regional Localized 100 strike men and women both, but women are many times more likely to develop the disease than men. A family history of breast cancer has also been linked to increasing a woman’s likelihood of developing the disease. Gender, age, and family history are things that cannot be prevented, however women can increase their chances of surviving this disease by con- Distant Invasive Breast Cancer – White Females Stage Distribution 1973 – 2009 Metropolitan Detroit 80 80 PERCENTAGE 100 PERCENTAGE 15 Invasive Breast Cancer – African-American Females Stage Distribution 1973 – 2009 Metropolitan Detroit 100 60 40 20 60 40 20 1975 1980 1985 1990 1995 2000 2005 1975 YEAR DIAGNOSED - 3 YEAR MOVING AVERAGE 1980 1985 1990 1995 2000 2005 YEAR DIAGNOSED - 3 YEAR MOVING AVERAGE 5-Year Relative Survival Rates for Breast Cancer – 5-Year Relative Survival Rates for Breast Cancer – African-American Females by Stage, 1973 – 2009 Metropolitan Detroit 100 White Females by Stage, 1973 – 2009 Metropolitan Detroit 100 80 80 PERCENTAGE 100 PERCENTAGE sulting with their physician, and following recommended screening for their specific age and risk group. Women who are at an increased risk due to a family history should consult with their doctor about whether they should begin mammography screening at an earlier age. 60 40 20 60 40 20 1975 1980 1985 1990 1995 2000 YEAR DIAGNOSED - 3 YEAR MOVING AVERAGE 2005 1975 1980 1985 1990 1995 2000 YEAR DIAGNOSED - 3 YEAR MOVING AVERAGE 2005 Survival Analysis of Lung Cancer by Stage Diagnosis of lung cancer in local stage is difficult because symptoms usually do not appear until the disease is advanced. Only about 23% of lung cancers in Whites and 18-19% in African-Americans are diagnosed at the local stage. Most early stage lung cancer cases are diagnosed incidentally. The five-year survival rate for local stage cancer is less than 50% for the general population. The five- year survival for distant stage cancer is approximately 2%. An effective method for screening for lung cancer has not yet been developed although promising methods are being tested. When a new method is developed, the hope is that it will be as effective and universally used as mammography screening has been for breast cancer and the PSA blood test has been for prostate cancer. Regional Localized 16 100 The major risk factor for lung cancer is tobacco smoking. The risk increases over time as a person continues to smoke. However, if a person is able to quit smoking before cancer has developed, the lung tissue can begin to repair itself. An ex-smoker can lower his risk of lung cancer, but his risk will still be higher than that of someone who has never smoked. Nonsmokers who are exposed to Distant Invasive Lung Cancer – White Population Stage Distribution 1973 – 2009 Metropolitan Detroit Invasive Lung Cancer – African-American Population Stage Distribution 1973 – 2009 Metropolitan Detroit 80 80 60 60 PERCENTAGE 100 PERCENTAGE 100 40 40 20 20 1975 1980 1985 1990 1995 2000 2005 1975 YEAR DIAGNOSED - 3 YEAR MOVING AVERAGE 1980 1985 1990 1995 2000 2005 YEAR DIAGNOSED - 3 YEAR MOVING AVERAGE 5-Year Relative Survival Rates for Lung Cancer – 100 White Population by Stage, 1973 – 2009 Metropolitan Detroit 5-Year Relative Survival Rates for Lung Cancer – African-American Population by Stage, 1973 – 2009 Metropolitan Detroit 100 80 80 60 60 PERCENTAGE 100 PERCENTAGE second hand smoke in the home or workplace are also at increased risk for developing lung cancer. Exposure to carcinogens in the workplace or the environment and having a family history of lung cancer have also been found to contribute to an increased risk for getting the disease. 40 40 20 20 1975 1980 1985 1990 1995 2000 YEAR DIAGNOSED - 3 YEAR MOVING AVERAGE 2005 1975 1980 1985 1990 1995 2000 YEAR DIAGNOSED - 3 YEAR MOVING AVERAGE 2005 Survival Analysis of Colorectal Cancer by Stage The five-year survival rate for colorectal cancer has gradually increased over the past 31 years for the general population. Currently, the five-year relative survival rate for local stage cancer is over 90% compared to 73% in 1973. At distant stage, the five-year relative survival rate is over 10% compared to 4% in 1973. This improved survival has been linked to improved early detection practices including the increased use of screening sigmoidoscopy. Age, family history, and diet are risk factors in developing colorectal cancer. The symptoms of colorectal cancer may mimic some other conditions such as hemorrhoids or inflammatory Regional Localized 100 bowel disease. It is best to consult with a physician to determine the correct cause of the symptoms. Screening typically begins at age 50 for the general population. If there is family history of the disease, a patient needs to confer with their physician to discuss when screening should begin. Distant Invasive Colorectal Cancer – White Population Stage Distribution 1973 – 2009 Metropolitan Detroit Invasive Colorectal Cancer – African-American Population Stage Distribution 1973 – 2009 Metropolitan Detroit 6080 80 60 40 60 PERCENTAGE 100 PERCENTAGE PERCENTAGE 80 100 40 20 20 40 20 1985 1975 1980 1985 1990 1995 2000 2005 1980 1985 1990 1990 1995 1995 2000 2000 2005 YEAR DIAGNOSED - 3 YEAR MOVING AVERAGE YEAR DIAGNOSED - 3 YEAR MOVING AVERAGE 5-Year Relative Survival Rates for Colorectal Cancer – 5-Year Relative Survival Rates for Colorectal Cancer – African-American Population by Stage, 1973 – 2009 Metropolitan Detroit 100 White Population by Stage, 1973 – 2009 Metropolitan Detroit 80 100 PERCENTAGE PERCENTAGE 1975 100 80 60 40 60 PERCENTAGE 6080 40 20 20 40 20 1975 1980 1985 1990 1995 2000 YEAR DIAGNOSED - 3 YEAR MOVING AVERAGE 2005 1975 1980 1985 1990 1995 2000 YEAR DIAGNOSED - 3 YEAR MOVING AVERAGE 2005 17 Cancer Research at MDCSS 18 The Young Women’s Health History Study - Breast Cancer Risk Factors in Young Women 19 Risk Factors for Ovarian Cancer in African-American Women 20 Patterns of Care Study 21 Genetic Pathways of Inflammation and Risk of Lung Cancer and Chronic Obstructive Pulmonary Disease 22 The Young Women’s Health History Study Breast Cancer Risk Factors in Young Women Ellen Velie, PhD (Principal Investigator), Kendra Schwartz, MD, MSPH Ellen Velie, PhD at Michigan State University, with Co-Investigators, Kendra Schwartz, MD, MSPH at Wayne State University (WSU) and Ann Hamilton, PhD at the University of Southern California (USC), assisted by Westat, a research corporation, are conducting the “Young Women’s Health History Study”, funded by the National Cancer Institute, to evaluate risk factors for breast cancer in young women. The study is being conducted in a socioeconomically diverse population of African-American and White women in Metropolitan Detroit and Los Angeles County. The study’s objectives are to examine whether potentially modifiable lifestyle factors measured over a woman’s lifetime, related genetic factors, as well as the social conditions that influence lifestyle factors, explain why some young women develop specific types of breast cancer. Researchers plan to enroll 4,000 young women – both those who have had breast cancer and those who have had not, to compare these two groups of women. The “Young Women’s Health History Study” began recruitment of participants in December of 2011. Young women randomly selected for this study are encouraged to participate. Whether or not women have had breast cancer, their story will give researchers a fuller picture of women’s lives. Unfortunately, due to the studies’ scientific methodology, women who are not contacted cannot volunteer themselves. For questions regarding this research, please visit the study web-site, http://ywhhs.org/. In the metropolitan Detroit area you can also contact the study toll-free phone number: 1-(877)679-9687 and either Dr. Kendra Schwartz or the Study Project Coordinator, Ms. Kathy Cross will get back with you. Age-Adjusted Incidence of Invasive Female Breast Cancer in Women (50+), SEER-9, 1992 – 2009 RATE PER 100,000 400 400 300 300 1992 1995 1998 2001 2004 2007 YEAR OF DIAGNOSIS Age-Adjusted Incidence of Invasive Female Breast Cancer in Women (<40), SEER-9, 1992 – 2009 20 RATE PER 100,000 In the United States, White women are more likely to develop breast cancer after age 50 (figure 1), but among the youngest women, under age 40, African American women are more likely to develop breast cancer (figure 2)3. African American and poorer women also appear more likely to develop tumors with the worst prognosis3,4. In addition, compared to similarly aged White women, AfricanAmerican women have higher death rates from breast cancer (figure 3). In young African-American, under 40 years of age, only about 42% of breast cancers are diagnosed at the local stage, before the cancer has spread beyond the breast, whereas in young White women 48% are diagnosed before the cancer has spread5. Screening is not usually recommended before age 40 because current screening modalities do not work well for young women. It’s therefore particularly important we understand the causes of breast cancer in young women, in order to prevent the development of the disease. 500 16 12 8 19 1992 1995 1998 2001 2004 2007 YEAR OF DIAGNOSIS Surveillance, Epidemiology, and End Results (SEER) Program (www.seer.cancer.gov) SEER*Stat Database: Incidence - SEER 13 Regs Research Data, Nov 2011 Sub, Vintage 2009 Pops (1992-2009) <Katrina/Rita Population Adjustment> - Linked To County Attributes - Total U.S., 1969-2010 Selection restricted to SEER 9 registries only. White African-American Age-Adjusted Mortality of Invasive Female Breast Cancer in Young Women (<40), SEER-9, 1973 – 2009 66 RATE PER 100,000 Each year in the United States, about 44,000 women are newly diagnosed with breast cancer before 50 years of age (SEER)1. Tumors in these young women are more likely to be aggressive with a worse prognosis, but their causes remain poorly understood2. 55 44 33 22 11 0 1975 1980 1985 1990 1995 2000 2005 YEAR OF DEATH Reference: 1.Howlader N, Noone AM, Krapcho M, Neyman N, Aminou R, Altekruse SF, Kosary CL, Ruhl J, Tatalovich Z, Cho H, Mariotto A, Eisner MP, Lewis DR, Chen HS, Feuer EJ, Cronin KA (eds). SEER Cancer Statistics Review, 1975-2009 (Vintage 2009 Populations), National Cancer Institute. Bethesda, MD, http://seer.cancer.gov/ csr/1975_2009_pops09/, based on November 2011 SEER data submission, posted to the SEER web site, April 2012. 2.Brinton LA, Sherman ME, Carreon JD, Anderson WF. Recent trends in breast cancer among younger women in the United States. J Natl Cancer Inst. 2008 Nov 19;100 (22):1643-8. Epub 2008 Nov 11. 3.Andaya AA, Enewold L, Horner MJ, Jatoi I, Shriver CD, Zhu K. Socioeconomic disparities and breast cancer hormone receptor status. Cancer Causes Control 2012 23: 951-958. Surveillance, Epidemiology, and End Results (SEER) Program (www.seer.cancer.gov) SEER*Stat Database: Mortality - All COD, Aggregated With State, Total U.S. (1969-2009) . 4.Krieger N, Chen JT, Ware JH, Kaddour A. Race/ethnicity and breast cancer estrogen receptor status: impact of class, missing data, and modeling assumptions. Cancer Causes Control 2008 19 (10): 1305-1318. 5.Surveillance, Epidemiology, and End Results (SEER) Program (www.seer.cancer. gov) SEER*Stat Database: Incidence - SEER 18 Regs Research Data + Hurricane Katrina Impacted Louisiana Cases, Nov 2011 Sub (1973-2009 varying) - Linked To County Attributes - Total U.S., 1969-2010 Counties, National Cancer Institute, DCCPS, Surveillance Research Program, Surveillance Systems Branch, released April 2012, based on the November 2011 submission. Risk Factors for Ovarian Cancer in African-American Women Investigator: Michele L. Cote, PhD 25 20 15 10 5 2000 Ovarian cancer survival is poor, with an overall 5-year survival of 43.9% for white women and 38.8% for African-American women. Although ovarian cancer accounts for 3% of cancer diagnoses among women, it is the fifth most common cause of cancer mortality accounting for 6% of cancer deaths. The high mortality is largely attributable to late detection, with 79% of the cancers diagnosed in regional or distant stages, when there is already spread beyond the pelvis. (Altekruse, et al, 2010) Ovarian cancer mortality statistics are even grimmer for AfricanAmerican women. The ratio of mortality to incidence rates is 74% for African-Americans compared to 65% for whites. (SEER) It has been noted that five-year survival rates for white women increased from 36% to 45% from the period 1975-77 to 1996-2004, whereas 5-year survival for African-Americans has decreased, dropping from 43% in 1975-77 to 38% in 1996-2004. (SEER) Thus, despite improvements in surgical techniques and chemotherapy 5-year survival has not improved for African-American women after a diagnosis of ovarian cancer. Risk factors for ovarian cancer have been explored primarily in white women. In the few studies that have included AfricanAmerican women, reproductive factors such as a greater number of pregnancies, oral contraceptive use and tubal ligation are associated with reduced risk of ovarian cancer in both races (John 1993, Ness 2000, and Mooreman 2008). These analyses have all been limited by the small number of African-Americans included in the studies. Thus, there is a need to further investigate ovarian cancer risk factors among African-American women, including known genetic risk factors (i.e. BRCA mutations) and other less-common exposures. Joining eight other institutions and led by investigators at Duke University, Dr. Michele Cote and researchers at the Metropolitan Detroit Cancer Surveillance System (MDCSS) of Wayne State University have embarked upon a study of ovarian cancer in AfricanAmerican women. During the course of the 5 year study, investigators plan to interview and obtain blood specimens from 1,000 African-American women with ovarian cancer and 1,000 healthy women. Medical record release and yearly follow up will also be requested of the women with ovarian cancer. MDCSS hopes to contribute about 13% of the study subjects. The goal of the study is to examine epidemiologic and genetic risk factors for ovarian cancer among African-American women. 1975 1980 1985 1990 1995 2000 2005 YEAR OF DIAGNOSIS White African-American Age-Adjusted Incidence-based Mortality from Malignant Ovarian Cancer, 1973 – 2009 25 20 RATE PER 100,000 20 Age-Adjusted Incidence of Malignant Ovarian Cancer by Race, SEER-9, 1973 – 2009 RATE PER 100,000 Ovarian cancer is diagnosed in more than 22,000 women in the United States each year, making it the 9th most commonly diagnosed cancer in women. (Jemal et al, 2009) Incidence rates are higher among white women than African-American women (14.1/100,000 and 10.1/100,000, respectively), and incidence rates have been declining over time. (Altekruse, et al, 2010) The decrease in incidence trends from 1975 to 2005 is much higher among white women (-2.7%) than African-Americans (-0.4%). The median age at diagnosis is younger among African-Americans compared to whites (61 versus 64 years). (Altekruse, et al, 2010) 15 10 5 2000 1975 1980 1985 1990 1995 2000 2005 YEAR OF DEATH References: 1. 2. 3. 4. 5. Altekruse SF, Kosary CL, Krapcho M, Neyman N, Aminou R, Waldron W, Ruhl J, Howlader N, Tatalovich Z, Cho H, Mariotto A, Eisner MP, Lewis DR, Cronin K, Chen HS, Feuer EJ, Stinchcomb DG, Edwards BK (eds). SEER Cancer Statistics Review, 1975-2007, National Cancer Institute. Bethesda, MD, http://seer.cancer. gov/csr/1975_2007/, based on November 2009 SEER data submission, posted to the SEER web site, 2010. Jemal A, Siegel R, Ward E, Hao Y, Xu J, Thun MJ. Cancer statistics, 2009. CA Cancer J Clin. 2009 Jul-Aug;59(4):225-49. John EM, Whittemore AS, Harris R, Itnyre J Characteristics relating to ovarian cancer risk: collaborative analysis of seven U.S. case-control studies. Epithelial ovarian cancer in black women. Collaborative Ovarian Cancer Group.J Natl Cancer Inst. 1993 Jan 20;85(2):142-7. Moorman PG, Palmieri RT, Akushevich L, Berchuck A, Schildkraut JM Am J Epidemiol. Ovarian cancer risk factors in African-American and white women. 2009 Sep 1;170(5):598-606. Ness RB, Grisso JA, Cottreau C, Klapper J, Vergona R, Wheeler JE, Morgan M, Schlesselman JJ. Factors related to inflammation of the ovarian epithelium and risk of ovarian cancer. Epidemiology. 2000 Mar;11(2):111-7. Patterns of Care Study Ikuko Kato (Principal Investigator), PhD, Patricia Arballo-Spong, BS, Ann S. Bankowski, MSW, Kari A. Borden, RHIT, CTR SEER Patterns of Care (POC) Studies have been funded by the National Cancer Institute in order to assess the incorporation of state-of-theart cancer treatments into clinical practice and the extent to which cancer patients receive such treatments. These studies are designed to describe, characterize, and compare practice patterns and treatments provided for cancer in different geographic areas of the United States. The Metropolitan Detroit Cancer Surveillance System (MDCSS) has participated in POC studies to provide representative samples from metropolitan Detroit since 1997, when this study was integrated into the SEER program. The results of POC studies have been summarized by NCI staff and disseminated in scientific journals and professional meetings; and used to develop educational or training opportunities to improve the use of state-of-the-art cancer therapy in community practice through collaboration with professional organizations. Each year three to four types of cancer are selected for this study. Table 1 lists cancers studied in years 1997 to 2010. These pertain to patients diagnosed in years 1995 -2008, i.e., 2 years behind the years of the survey, to allow for sufficient time to capture all care that patients received during the initial course of treatment. Choices of cancers reflect the introduction of new treatment methods, therapeutics, diagnostic tests, predictive and prognostic markers for particular cancer sites, as well as special research interests. Examples include use of less invasive surgeries such a laparoscopic resection and cryosurgery, radioimmunotherapy, new monoclonal antibodies and antiangiogenic agents, active surveillance for prostate cancer, and HER2 and Oncotype tests for breast cancer. Some cancers have been chosen more than once during this period to examine chronological trends. For the past 10 years, approximately 340 cases per year have been included from the MDCSS in this study. These samples are randomly selected by a computer program at a time point when the number of selected cancer cases reach 95% of the projected number of cases for a given year. There are two major components in POC studies: (1) re-abstracting medical records in more detail beyond regular abstracts required for SEER and (2) physicians’ surveys. The former includes individual chemo-, immuno-, hormona-therapeutic agents, in addition to other new treatments/tests/markers of interest. SEER abstracting staff complete these tasks at all facilities where a patient received diagnosis and treatments. Typically, multiple medical record abstracts are required per patient. The physicians’ survey is mailed to a follow-up physician identified through the MDCSS. This is a very crucial part of the study because private physicians provide a large proportion of treatment received by cancer patients, particularly adjuvant chemotherapy, hormonal therapy and immunotherapy, on an outpatient basis, while the current SEER program is focused primarily on collection of treatment data from hospitals, radiation oncology facilities and larger clinics. Thus, our ability to assess the extent to which such therapies are provided, the characteristics of patients and providers in relation to treatments rendered and the efficacy of those treatments depends upon the use of supplemental data collection efforts such as the POC Study. Table 1 - Cancers selected for SEER Patterns of Care (POC) Studies, 1997 – 2010 Year of Survey Cancer Sites/Types 1997 Bladder, Breast, Colorectal, Melanoma 1998 Childhood Cancer, Non-Small Cell Lung, Ovarian, Melanoma 1999 Childhood Brain Stem, DCIS Breast, Cervical, Head and Neck 2000 Chronic Lymphocyctic Leukemia, Pancreas, Prostate, Corpus Uteri 2001 Vulva, Testicular, Non-Hodgkin’s Lymphoma (NHL), Multiple Myeloma 2002 Breast, Cervical, Colorectal 2003 Cervical, Lower Esophageal/Gastric, Melanoma 2004 Ovarian, Prostate, Sarcoma 2005 B-Cell Lymphoma, Bladder, Chronic Myelogenous Leukemia, Multiple Myeloma 2006 Node negative, ER positive female Breast, Male Breast, Head and Neck, Kidney 2007 Breast, Colorectal, Non-Small Cell Lung 2008 Glioblastoma, Thyroid, Cancers in Adolescent and Young Adult 2009 Small Cell Lung, Acute Myeloid Leukemia, Multiple Myeloma, Liver 2010 Prostate, NHL, Chronic Lymphocytic Leukemia, Gastrointestinal Stromal Tumors Since 2005, we have formed a strong POC study team within the MDCSS, which includes Patricia Arballo-Spong, SEER Project Coordinator; Ann Bankowski, Research Assistant; Kari Borden, Abstracting Supervisor and Dr. Ikuko Kato as the Principal Investigator. Through this teamwork we have implemented several improvements in this study; e.g., development of an efficient database to track the progress of each record and to search alternative follow-up physicians, and electronic data submission and data security. We are very proud that we have contributed high quality data to this SEER-supported study. Finally, we can not thank enough, all physicians who responded to a survey over these years despite their extremely busy work schedules. Through the end of 2009, the POC studies produced 28 publications, including Annual Report to the Nation on the status of Cancer (1). These publications can be accessed online at http:// healthservices.cancer.gov/surveys/poc/ Reference: 1. Edwards BK, Brown ML, Wingo PA, Howe HL, Ward E, Ries LA, Schrag D, Jamison PM, Jemal A, Wu XC, Friedman C, Harlan L, Warren J, Anderson RN, Pickle LW. Annual report to the nation on the status of cancer, 1975-2002, featuring population-based trends in cancer treatment. J Natl Cancer Inst 2005 Oct 5;97(19):1407-27. 21 Genetic Pathways of Inflammation and Risk of Lung Cancer and Chronic Obstructive Pulmonary Disease Investigator: Ann G. Schwartz, PhD, MPH 22 It has been shown that a family history of COPD increases risk of lung cancer, even after accounting for familial clustering of smoking. This suggests a common underlying genetic contribution to these two diseases. The biologic mechanisms linking COPD and lung cancer are not known, but chronic inflammation of lung tissue is likely to play a role. Both lung cancer and COPD develop in a lung environment battling chronic inflammation, which is developed over a lifetime from cigarette smoke exposure. This environment is conducive to genetic damage, cancer initiation and progression. We do not yet know which specific genetic inflammatory mediators either jointly or independently promote COPD and tumor development. Although biologic responses to tobacco smoke underlie both COPD and lung cancer, the inflammatory processes leading to COPD and those associated with lung cancer may be different. This is suggested by the absence of COPD features in some lung cancer patients and the absence of lung cancer in some COPD patients. Which inflammation-producing genetic pathways are activated and/or suppressed is likely to determine the course of disease development among smokers. However, no comprehensive study evaluating multiple genetic markers of inflammation in smokers with lung cancer compared to smokers with COPD and smokers without either disease has ever been conducted. In addition, African-Americans, who are more likely to develop lung cancer but are less often diagnosed with COPD than Whites, have historically not been included in large numbers in studies of genetic variation in inflammation-related genes. This study, called the “InHALE Study”, Age-Adjusted Incidence Rates of Lung & Bronchus Cancers, SEER-9, 1973 – 2009 100 80 RATE PER 100,000 Lung cancer is the leading cause of cancer deaths and chronic obstructive pulmonary disease (COPD) is the fourth leading cause of all adult deaths in the United States. COPD is a heterogeneous set of diseases, including emphysema and chronic bronchitis. Lung cancer and COPD together account for substantial deaths and morbidity. Five year survival following a lung cancer diagnosis is only 15%. African-Americans are hardest hit by lung cancer, having both the highest rates of new lung cancers and lung cancer deaths than any other racial or ethnic group. Smoking contributes to both COPD and lung cancer. About 15% of smokers will develop at least one of these diseases. About 85-90% of all lung cancers and COPD diagnoses are attributable to cigarette smoking. Having COPD also contributes to the risk of getting lung cancer. After being diagnosed with COPD, the risk of subsequently developing lung cancer increases about 2-fold, even among people who have never smoked. This risk seems to be most closely associated with a history of emphysema. While low dose CT has recently been shown to be an accepted screening method for lung cancer, population screening is not yet under way. Without screening, lung cancer is identified in late stages and it is often too late for surgical treatment. Neither lung cancer, nor COPD are particularly responsive to treatment. Therefore it is vitally important to understand the underlying susceptibility to lung cancer and COPD, in order to understand the carcinogenic process and to identify those persons at highest risk of getting these diseases. Once we understand who is at greatest risk of getting lung cancer and COPD, those at risk can be targeted for screening and prevention interventions. 60 40 20 1975 1980 1985 1990 1995 2000 2000 2005 YEAR OF DIAGNOSIS White African-American Source: Surveillance, Epidemiology, and End Results (SEER) Program (www.seer.cancer.gov) SEER*Stat Database: Incidence - SEER 9 Regs Research Data, Nov 2010 Sub (1973-2008) <Katrina/Rita Population Adjustment> - Linked To County Attributes - Total U.S., 1969-2009 Counties, National Cancer Institute, DCCPS, Surveillance Research Program, Cancer Statistics Branch, released April 2011 (updated 10/28/2011), based on the November 2010 submission. Note: Rates are per 100,000 and age-adjusted to the 2000 US Std Population (19 age groups - Census P251130) standard. will investigate the hypotheses that genetic variation in inflammation-related genes contributes to the development of lung cancer and that this association varies by the presence or absence of COPD, and by race. To study the underlying inflammatory mechanisms linking COPD and lung cancer, we will evaluate single nucleotide polymorphisms (SNPs) in inflammatory pathway genes. Our goal is to develop a genetic profile that predicts susceptibility to lung cancer with and without COPD in response to tobacco exposure. Our study will expand on previous work by incorporating COPD phenotyping using CT diagnosis of emphysema and spirometry to evaluate lung function. There has not been a study of these pathway genes in AfricanAmericans, a group that is less likely to report COPD, smokes fewer cigarettes, but sadly, is more likely to be diagnosed and die of lung cancer than Whites. We will invite patients from two large, urban health systems, Karmanos Cancer Institute (KCI) and Henry Ford Health System (HFHS), to participate in this important study. We will recruit 2050 lung cancer cases and 2050 smokers with and without COPD. We hope to equally include African-Americans and Whites in this study, so we can better understand why AfricanAmericans are harder hit with lung cancer and design better prevention strategies for everyone. All study participants will be invited to complete a risk factor questionnaire, undergo CTs and spirometry, provide a blood and saliva sample, and when available a tissue block, so that we can investigate the genetic variation contributing to inflammation and thereby potentially identify a way to prevent or reduce inflammation that may contribute to development of COPD and lung cancer. No other large study has been done that includes detailed phenotyping of lung cancer and COPD and jointly evaluates inflammatory genes in germline DNA and target tissue in the same individuals. This work will lead to a better understanding of the inflammatory process in lung carcinogenesis, provide avenues for the identification of a high risk group for intervention, and provide insight into possible treatment options. InHALE, as well as all studies conducted through the MDCSS, follows strict confidentiality guidelines during all aspects of the research study. Independent Institutional Review Boards (IRB) that protect human rights during research oversee the study, both at KCI (overseen by the Wayne State University IRB) and Henry Ford Health System. Each participant will be given a consent form that describes all aspects of the study and who they can contact with any questions. In this way, each participant is fully informed about the study and how the study will be conducted, before deciding if they wish to participate. All confidential data is maintained in locked files and there is only limited access to computerized data. Paper records that contain identifiers are kept separate from the risk factor questionnaires. The risk factor questionnaires are identified only by a unique ID number, to hide the study participant’s identity and to keep the information they provide confidential. The interview will include questions about health history including history of other lung diseases and inflammatory conditions, use of anti-inflammatory drugs, such as aspirin, smoking history, passive smoking history, height, weight, occupation, and exposure history. Blood and other biological samples will also be labeled with only a unique ID number. This 5 year study into the genetic inflammatory pathways underlying development of COPD and lung cancer is now enrolling patients at both the Karmanos Cancer Institute and the Henry Ford Health Gene content for the custom, focused SNP array (640 genes total, ~ 6700 SNPS). (243 genes) Lung Cancer (84 genes) References: 1. SEER Cancer Statistics Review, 1975-2006. 2009. http://SEER.cancer.gov/csr. Accessed June 1, 2009. 2. Mathers CD, Loncar D. Projections of global mortality and burden of disease from 2002 to 2030. PLoS Med. Nov 2006;3(11):e442. PMID: 17132052 3 Sethi JM, Rochester CL. Smoking and chronic obstructive pulmonary disease. Clinics in chest medicine. Mar 2000;21(1):67-86, viii. PMID: 10763090 4. CDC. Cigarette smoking among adults--United States, 2002. Morbidity and Mortality Weekly Report. 2004;53(20):428-431. PMID: 5. Mannino DM, Aguayo SM, Petty TL, Redd SC. Low lung function and incident lung cancer in the United States: data From the First National Health and Nutrition Examination Survey follow-up. Archives of internal medicine. Jun 23 2003;163(12):1475-1480. PMID: 12824098 6. Schabath MB, Delclos GL, Martynowicz MM, et al. Opposing effects of emphysema, hay fever, and select genetic variants on lung cancer risk. Am J Epidemiol. Mar 1 2005;161(5):412-422. PMID: 15718477 7. Littman AJ, Thornquist MD, White E, Jackson LA, Goodman GE, Vaughan TL. Prior lung disease and risk of lung cancer in a large prospective study. Cancer Causes Control. Oct 2004;15(8):819-827. PMID: 15456995 8. Turner MC, Chen Y, Krewski D, Calle EE, Thun MJ. Chronic obstructive pulmonary disease is associated with lung cancer mortality in a prospective study of never smokers. American journal of respiratory and critical care medicine. Aug 1 2007;176(3):285-290. PMID: 17478615 9. Mayne ST, Buenconsejo J, Janerich DT. Familial cancer history and lung cancer risk in United States nonsmoking men and women. Cancer Epidemiol Biomarkers Prev. Dec 1999;8(12):1065-1069. PMID: 10613338 Inflammation COPD System. Should your physician invite you to participate in this important research, please consider saying “Yes.” The physician will then put you in contact with the study interviewers. They will be available during normal clinic appointments to meet with you. This study will also enroll people who do not have lung cancer, but who do smoke, for comparison purposes. You may see our study brochures handed out at your church, area health fairs or cancer awareness programs; you may also hear or see ads for the “InHALE Study”. Together, we hope to prevent future lung cancers and COPD. (358 genes) 10. Wu AH, Yu MC, Thomas DC, Pike MC, Henderson BE. Personal and family history of lung disease as risk factors for adenocarcinoma of the lung. Cancer Res. Dec 15 1988;48(24 Pt 1):7279-7284. PMID: 3191498 11. Schwartz AG, Ruckdeschel JC. Familial lung cancer: genetic susceptibility and relationship to chronic obstructive pulmonary disease. American journal of respiratory and critical care medicine. Jan 1 2006;173(1):16-22. PMID: 16141445 12. Gohagan J, Marcus P, Fagerstrom R, Pinsky P, Kramer B, Prorok P. Baseline findings of a randomized feasibility trial of lung cancer screening with spiral CT scan vs chest radiograph: the Lung Screening Study of the National Cancer Institute. Chest. Jul 2004;126(1):114-121. PMID: 15249451 23 The Epidemiology Research Core Director: Kendra Schwartz, MD, MSPH; Co-Director: Fawn D.Vigneau, JD, MPH; Project Coordinator: Patricia Arballo-Spong; Administrator: Sharon Moton Wayne State University (WSU) and Karmanos Cancer Institute (KCI) house the Metropolitan Detroit Cancer Surveillance System (MDCSS) and the Epidemiology Research Core (ERC). The MDCSS is a National Cancer Institute (NCI)-funded, population-based Surveillance Epidemiology and End Results (SEER) cancer registry. The MDCSS collects cancer data for the metropolitan Detroit area (Wayne, Oakland and Macomb counties) population of nearly four million residents. Data are collected from approximately 60 different hospitals, clinics, pathology laboratories and radiation therapy facilities in the area (Figure 1). data for population-based investigations of cancer prevention, etiology, treatment and outcomes. Specifically, the Epidemiology Research Core provides: • Consultation. Consultation and collaborative research expertise focused on study design, proposal development, IRB applications, and interpretation of population-based local and national SEER data. • Rapid Case Ascertainment. Rapid identification and ascertainment of eligible study participants, requiring review of all pathology reports indicating a cancer diagnosis at approximately 60 metropolitan area hospitals, clinics, pathology laboratories and radiation therapy facilities and rapid collection of patient demographic information. This speeds up case identification for population-based studies, with most cases identified within one to two months of diagnosis. • Control Identification. Identification of population-based control groups for case-control study designs via random digit dialing, Centers for Medicaid and Medicare Services (CMS) records, Department of Motor Vehicles (DMV) records, and other mechanisms. • Research Support and Training. Liaison for WSU IRB, regulatory training of epidemiology study staff, oversight and research support for epidemiology studies. 24 • Collection and Abstraction of Medical Records. Collection of medical records and abstracting of study-specific data which are not available in the MDCSS registry. • Biospecimen Collection. Collection of biologic specimens, including blood, buccal cells and tumor blocks, from study participants and/or diagnosing hospitals. • Database Query. Response to requests for population-based data requiring query of the MDCSS and/or the national SEER Limited-Use data files for descriptive analyses. Figure 1. MDCSS/Detroit SEER – Participating Facilities The MDCSS receives SEER contractual funding for the conduct of cancer case-finding, medical record abstraction for SEER-required information, vital status follow-up, and the provision of data back to the contributing facilities for clinical and accreditation purposes. NCI contractual funding for the MDCSS covers only basic registry operations. The ERC was developed to support population-based cancer research. The services of the ERC represent populationbased research activities that are outside the scope of the MDCSS/ SEER cancer registry data collection. The ERC does this by accessing metropolitan Detroit cancer case data for research, epidemiology consulting and collaboration with researchers conducting investigations in cancer prevention, etiology, treatment and outcomes. The ERC benefits cancer research in metropolitan Detroit by centralizing access to SEER data and standardizing patient, physician and hospital interactions for population-based research purposes. SEER data are complex and require knowledge of and expertise with the data management system for manipulation. Furthermore, strict confidentiality measures must be maintained. The ERC maintains patient and provider confidentiality by performing all patient, physician and hospital contact for the conduct of population-based research in-house. ERC faculty and staff have extensive expertise in using both local and national SEER data and provide the necessary support for access and utilization of these • Database Linkage. Linkage of outside data sources to MDCSS data for the collection of patient demographics, treatment and survival data. Current projects utilizing ERC services include: • Inflammation Pathways and COPD in the Development of Lung Cancer • Life Course Energy Balance and Breast Cancer Risk in Black/ White Women Under 50 • Patient and Provider Influences on Disparities in Colorectal Cancer Care • The Epidemiology of Ovarian Cancer in African-American Women Researchers wishing to utilize Metropolitan Detroit SEER data can contact: Kendra L. Schwartz, MD, MSPH Director, Epidemiology Research Core [email protected] Fawn D. Vigneau, JD, MPH Co-Director, Epidemiology Research Core [email protected] Prices for use of ERC services are listed on our web-site: https://research1.karmanos.org/research/Home2/Researchers2/CoreFacilities/ EpidemiologyResearch/ServicesFees.aspx List of Studies Conducted at the Metropolitan Detroit Cancer Surveillance System The Metropolitan Detroit Cancer Surveillance System participates in a number of collaborative research projects. A brief description of a sample of these projects conducted during the past 2 years follows. foundation to conduct studies of other cancers in African-American women in the future. We will expand the examination of genetic association to a more comprehensive genome-wide association study once data collection is complete. Inflammation Pathways and COPD in the Development of Lung Cancer Dr. Cote commenced rapid case ascertainment in December 2010 for the Metropolitan Detroit site of the multi-site study. The national collaboration will attempt to enroll 1,000 cases and 1,000 controls at nine sites across the U.S. The Detroit site started Biospecimen Collection in October, 2011 and will collect blood and tissue on 35 cases annually. A. Schwartz The biologic mechanisms linking COPD and lung cancer are unknown, but chronic inflammation is likely to play a role. This study will evaluate SNPs and copy number variation in genes in inflammatory pathways. The study will expand on previous work by incorporating COPD phenotyping using CT diagnosis of emphysema and pulmonary function testing (PFT). It also will expand on the panel of genes beyond those few already evaluated, will incorporate copy number variation as well as non-synonymous and functional SNPs, and will include a large African-American population. There has not been a study of these pathway genes in African-Americans, a group that is less likely to report COPD, smokes fewer cigarettes, but is more likely to be diagnosed with lung cancer than whites. It is hypothesized that genetic variation in inflammation-related genes contributes to the development of lung cancer and this association varies by the presence or absence of COPD, and by race. The goal is to develop a genetic profile based on SNPs and copy number variation in inflammation pathway genes that predicts susceptibility to lung cancer with and without COPD in response to tobacco exposure. Transdisciplinary Research in Cancer of the Lung (TRICL) A. Schwartz/C. Amos This study integrates data from multiple genome-wide association studies in lung cancer and carries these findings forward to characterize mechanisms by which the identified genes influence lung cancer risk. We will use results from extended epidemiological studies to develop refined risk models to predict lung cancer risk and to validate the results using data from cohort studies. The Epidemiology of Ovarian Cancer in African-American Women A Genome Wide Study of Lung Cancer in Never Smokers A. Schwartz/O. Gorlova This study will identify genetic architecture of the predisposition to lung cancer in never smokers. 25 Genetic Susceptibility for Lung Cancer in African-Americans A. Schwartz/C. Amos The aim of this work is to validate novel genetic variants identified in genome-wide association studies in African-American lung cancer cases and age, race and gender-matched controls identified from our existing study populations. Pancreatic Cancer Genetic Epidemiology Consortium A. Schwartz/G. Petersen This project establishes the PACGENE Consortium of six institutions throughout the Unites States and Canada whose purpose is to identify and recruit kindreds with familial pancreatic cancer for gene discovery research. Family history and risk factor information will be collected from participating family members, along with DNA specimens for a 10-cM genome screen for linkage and subsequent fine mapping of selected chromosomal regions. Dr. Schwartz is the PI of a subcontract to the Mayo Clinic, where the PI of the Consortium is Dr. Gloria Petersen. A. Schwartz/M. Cote To address the lack of knowledge regarding ovarian cancer among African-American women, investigators at nine institutions in areas with relatively large numbers of African-Americans in the population (North Carolina, South Carolina, Georgia, Alabama, New Orleans, New Jersey, Ohio, Illinois, and Detroit) will conduct a population-based, case-control study to assess etiologic risk factors for African-Americans. Further, we will obtain treatment and outcome information to evaluate prognostic factors in ovarian cancer cases. We anticipate that this study will provide a Genetic Epidemiology of Lung Cancer I A. Schwartz This study is designed to create a family registry and search for lung cancer genes in high risk lung cancer families. A supplemental study will identify additional lung cancer cases with family histories for a future GWAS. List of Studies Conducted at the Metropolitan Detroit Cancer Surveillance System (cont.) Genetic Epidemiology of Lung Cancer A. Schwartz This study is a case-control study of lung cancer in AfricanAmericans that will use admixture mapping to identify genes for lung cancer. This grant has been continuously funded since 1999 and also focused on familial aggregation and candidate gene studies in early onset and never smoking lung cancer cases. A supplement is focused on reconsenting participants for use of their biospecimens in an NCI-directed GWAS in African-Americans. Life Course Energy Balance and Breast Cancer Risk in Black/White Women Under 50 K. Schwartz/E. Velie 26 Breast cancer in younger women (under age 50) is poorly understood and understudied. Moreover, it is associated with a worse prognosis than breast cancer in older women. Potentially modifiable risk factors related to energy balance over the life course (e.g. growth and puberty patterns, body mass, insulin resistance, diet and physical activity) have been implicated in the etiology of breast cancer in younger women. The overall objective of this study is to investigate, in a socioeconomically diverse population of Black and White women, whether life course energy balance pathways are associated with breast cancer risk. The study will also investigate the association of energy balance with the different breast cancer molecular subtypes. Dr. Kendra Schwartz is the local PI for this National Cancer Institute funded study. Racial, Ethnic and SES Disparities in Quality of Breast Cancer Systemic Therapy K. Schwartz/J. Griggs The study will conduct a medical record review and tests on previously removed breast cancer tumor tissue to explore the quality of adjuvant chemotherapy and hormonal therapy as well as variations based on race and ethnicity. It is a companion study to “Racial/Ethnic Disparities in Work and QOL Outcomes in Survivors of Breast Cancer” for patients who were initially diagnosed with invasive breast cancer without distant metastasis. Racial/Ethnic Disparities in Work and QOL Outcomes in Survivors of Breast Cancer K. Schwartz/S. Hawley The study will re-survey female breast cancer patients four years after diagnosis to explore employment changes, quality of life ratings, decisions about adjuvant therapy, and variations in experience based on race and ethnicity. This is a follow-up study designed specifically for patients who enrolled in “Health System Factors and Patient Outcomes in Breast Cancer.” Disparity in Quality of Breast Cancer Treatment and Effects on Outcome K. Schwartz/J. Griggs In this research study we will investigate the relationship between the quality of breast cancer adjuvant treatment and disease-free and overall survival; determine whether racial, socioeconomic, and weight-based disparities exist in the quality of breast cancer adjuvant treatment and timing of treatments; and verify that disparities in outcomes exist. Health System Factors and Patient Outcomes in Breast Cancer K. Schwartz/S. Katz This study measures the impact of the breast cancer experience on women, addressing topics such as barriers to diagnosis and treatment, coordination of care and employment difficulties related to treatment. Prostate Cancer Treatment Decision Making ACS Mentored Research Award K. Schwartz/J. Xu This study uses both qualitative and quantitative methods to better understand racial/ethnic disparities in prostate cancer decision treatment. A structured interview will be conducted with recently diagnosed prostate cancer patients, prior to treatment. This information will be used in creating a culturally sensitive comprehensive instrument to determine factors associated with prostate cancer treatment choice, which will then be pilot tested as a mailed questionnaire to recently diagnosed prostate cancer cases identified through SEER. Patient and Provider Influences on Disparities in Colorectal Cancer Care I. Kato The investigators seek to examine whether racial disparities in use of chemotherapy for stage III colorectal cancer are primarily due to socioeconomic, psychosocial and patient-provider relationship factors. The project will be conducted in collaboration with the Atlanta SEER registry under leadership of Dr. Morris at the University of Michigan. Analysis of Cancer Rates and Trends Using Census Tract Variables from Multiple Registries Oxidative Stress, Antioxidants and Racial Disparities in Prostate Cancer I. Kato C. Bock Despite the growing recognition of the magnitude and persistence of health disparities, few indicators for socioeconomic status (SES) are available in most of the US public health surveillance databases to date. Using the data from four SEER registries, Detroit, Hawaii, Utah and Seattle-Puget, that have a long history of high quality cancer registration and excellent census tract coverage, we intend to develop common objective and transferrable census tract SES variables across multi-decennial data from 1970 to 2000 and examine long-term chronological trends in cancer survival for selected cancer sites according to those census tract variables. This investigation may help identify specific SES groups in the community which require more intensive intervention in reducing disparities. This study will examine three genes in the oxidative stress pathway along with intake of three antioxidants to determine whether variation in the genes modifies prostate cancer risk associated with intake of each of the antioxidants. SEER Patterns of Care Study I. Kato The SEER Patterns of Care (POC) Study annually examines treatment patterns in the U.S. for rotating cancer sites. The 2012 POC study will collect data on metastatic melanoma, mesothelioma, oligodendroglioma/astrocytoma, neuroblastoma, and ovarian cancer diagnosed in the year 2011. Exploring Common Linkage Regions in Lung Cancer and COPD M. Cote The overall goal of this research plan is to investigate the importance of chromosome 6 on lung cancer and COPD development. A Genome Wide Admixture Scan of Multiple Myeloma in African-Americans J. Zonder/C. Bock African-Americans experience the highest risk of multiple myeloma in the world. The reason for the higher risk is not known, but there is evidence that genetic factors might contribute. The purpose of this research study is to identify the causes of multiple myeloma in African-Americans, especially genetic risk factors, which we hope, will lead to better treatments and prevention. We expect that about 2,000 patients will participate in this study. Patients are being recruited from California, Alabama, New Jersey, Louisiana, Detroit, Atlanta, Houston, Baltimore and Chicago. This study is being led by Wendy Cozen, DO, MPH. Genetic Susceptibility to Cancers of the Prostate and Urinary Bladder J. Beebe-Dimmer The overall goal of this research is to estimate the effects of genetic factors on risk of prostate and bladder cancers in two established studies. 27 Metropolitan Detroit Cancer Surveillance System/SEER Publications 2010-2012 In Press Becker N, Falster MO, Vajdic CM, de Sanjose S, Martinez-Maza O, Bracci PM, Melbye M, Smedby KE, Engels EA, Turner J, Vineis P, Costantini AS, Holly EA, Spinelli JJ, La Vecchia C, Zheng T, Chiu BCH, Montella M, Cocco P, Maynadie M, Foretova L, Staines A, Brennan P, Davis S, Severson R, Cerhan JR, Breen EC, Birmann B, Cozen W, Grulich AE, Newton R. Self-reported history of infections and the risk of non-hodgkin lymphoma: an InterLymph pooled analysis. Int J Cancer. In press. Keegan TH, Lichtensztajn DY, Kato I, Kent EE, Wu XC, West MM, Hamilton AS, Zebrack B, Bellizzi KM, Smith AW, and the AYAHSCG. Unmet adolescent and young adult cancer survivors information and service needs: a population-based cancer registry study. J Cancer Surviv. In press. Parsons HM, Harlan LC, Lynch CF, Hamilton AS, Wu XC, Kato I, Schwartz SM, Smith AW, Keel G, Keegan TH. Impact of Cancer on Work and Education Among Adolescent and Young Adult Cancer Survivors. J Clin Oncol. In press. Schwartz AG, Schwartz K, Harris J. USA, Michigan, Metropolitan Detroit. In Cancer Incidence in Five Continents, Volume IX: IARC Scientific Publication. In press. 28 Simon MS, Lamerato L, Krajenta R, Booza JR, Ruterbusch JJ, Kunz S, Schwartz K. Racial Differences in the Use of Adjuvant Chemotherapy for Breast Cancer in a Large Urban Integrated Health System. International Journal of Breast Cancer. In press. Wang SS, Hartge P, Cerhan J, Cozen W, Davis S, Severson R, Chatterjee N, Yeager M, Chanock S, Rothman N. Immune gene polymorphisms and risk of non-Hodgkin lymphoma in the NCI-SEER case control study. J Clin Oncol. In press. Wang SS, Purdue M, Cerhan JR, Zheng T, Menashe I, Armstrong B, Lan Q, Hartge P, Kricker A, Zhang Y, Morton LM, Valdjic C, Holford T, Severson RK, Grulich A, Leaderer B, Davis S, Zahm S, Cozen W, Yeager M, Chanock SJ, Chatterjee N, Rothman N. Common Genetic Variations in the Tumor Necrosis Factor (TNF) and TNF Receptor Superfamilies and Nuclear Factor Kappa Beta Transcription Factors and Risk of Non-Hodgkin Lymphoma. PLoS ONE. In press. Wang S, Levin A, Smolinski S, Vigneau F, Levin N, Tainsky M. Breast Cancer and Other Neoplasia in Women with Neurofibromatosis Type 1: A Retrospective Review of Cases in the Detroit Metropolitan Area. Am J Med Genet Part A. In press. 2012 Al-Sukhni W, Joe S, Lionel AC, Zwingerman N, Zogopoulos G, Marshall CR, Borgida A, Holter S, Gropper A, Moore S, Bondy M, Klein AP, Petersen GM, Rabe KG, Schwartz AG, Syngal S, Scherer SW, Gallinger S. Identification of germline genomic copy number variation in familial pancreatic cancer. Hum Genet. 2012. [Epub ahead of print] Beebe-Dimmer JL, Cetin K, Shahinian V, Morgenstern H, Yee C, Schwartz KL, Acquavella J. Timing of androgen deprivation therapy use and fracture risk among elderly men with prostate cancer in the United States. Pharmacoepidemiol Drug Saf. 2012;21(1):70-8. Bellizzi KM, Smith A, Schmidt S, Keegan TH, Zebrack B, Lynch CF, Deapen D, Shnorhavorian M, Tompkins BJ, Simon M, and the A, Young Adult Health O, Patient Experience Study Collaborative G. Positive and negative psychosocial impact of being diagnosed with cancer as an adolescent or young adult. Cancer. 2012. [Epub ahead of print] Boleij A, Roelofs R, Danne C, Bellais S, Dramsi S, Kato I, Tjalsma H. Selective Antibody Response to Streptococcus gallolyticus Pilus Proteins in Colorectal Cancer Patients. Cancer Prev Res (Phila). 2012;5(2):260-5. Chen LS, Saccone NL, Culverhouse RC, Bracci PM, Chen CH, Dueker N, Han Y, Huang H, Jin G, Kohno T, Ma JZ, Przybeck TR, Sanders AR, Smith JA, Sung YJ, Wenzlaff AS, Wu C, Yoon D, Chen YT, Cheng YC, Cho YS, David SP, Duan J, Eaton CB, Furberg H, Goate AM, Gu D, Hansen HM, Hartz S, Hu Z, Kim YJ, Kittner SJ, Levinson DF, Mosley TH, Payne TJ, Rao DC, Rice JP, Rice TK, Schwantes-An TH, Shete SS, Shi J, Spitz MR, Sun YV, Tsai FJ, Wang JC, Wrensch MR, Xian H, Gejman PV, He J, Hunt SC, Kardia SL, Li MD, Lin D, Mitchell BD, Park T, Schwartz AG, Shen H, Wiencke JK, Wu JY, Yokota J, Amos CI, Bierut LJ. Smoking and genetic risk variation across populations of European, Asian, and AfricanAmerican ancestry--a meta-analysis of chromosome 15q25. Genet Epidemiol. 2012;36(4):340-51. PMC3387741. Cote ML, Kam A, Chang CY, Raskin L, Reding KW, Cho KR, Gruber SB, Ali-Fehmi R. A pilot study of microsatellite instability and endometrial cancer survival in white and African-American women. Int J Gynecol Pathol. 2012;31(1):66-72. Cote ML, Liu M, Bonassi S, Neri M, Schwartz AG, Christiani DC, Spitz MR, Muscat JE, Rennert G, Aben KK, Andrew AS, Bencko V, Bickeboller H, Boffetta P, Brennan P, Brenner H, Duell EJ, Fabianova E, Field JK, Foretova L, Friis S, Harris CC, Holcatova I, Hong YC, Isla D, Janout V, Kiemeney LA, Kiyohara C, Lan Q, Lazarus P, Lissowska J, Le Marchand L, Mates D, Matsuo K, Mayordomo JI, McLaughlin JR, Morgenstern H, Mueller H, Orlow I, Park BJ, Pinchev M, Raji OY, Rennert HS, Rudnai P, Seow A, Stucker I, Szeszenia-Dabrowska N, Dawn Teare M, Tjonnelan A, Ugolini D, van der Heijden HF, Wichmann E, Wiencke JK, Woll PJ, Yang P, Zaridze D, Zhang ZF, Etzel CJ, Hung RJ. Increased risk of lung cancer in individuals with a family history of the disease: A pooled analysis from the International Lung Cancer Consortium. Eur J Cancer. 2012. [Epub ahead of print] Cote ML, Colt JS, Schwartz KL, Wacholder S, Ruterbusch JJ, Davis F, Purdue M, Graubard BI, Chow WH. Cigarette smoking and renal cell carcinoma risk among black and white Americans: effect modification by hypertension and obesity. Cancer Epidemiol Biomarkers Prev. 2012;21(5):770-9. PMC3348421. Djuric Z, Severson RK, Kato I. Association of dietary quercetin with reduced risk of proximal colon cancer. Nutr Cancer. 2012;64(3):351-60. PMC3329181. Jacobs KB, Yeager M, Zhou W, Wacholder S, Wang Z, Rodriguez-Santiago B, Hutchinson A, Deng X, Liu C, Horner MJ, Cullen M, Epstein CG, Burdett L, Dean MC, Chatterjee N, Sampson J, Chung CC, Kovaks J, Gapstur SM, Stevens VL, Teras LT, Gaudet MM, Albanes D, Weinstein SJ, Virtamo J, Taylor PR, Freedman ND, Abnet CC, Goldstein AM, Hu N, Yu K, Yuan JM, Liao L, Ding T, Qiao YL, Gao YT, Koh WP, Xiang YB, Tang ZZ, Fan JH, Aldrich MC, Amos C, Blot WJ, Bock CH, Gillanders EM, Harris CC, Haiman CA, Henderson BE, Kolonel LN, Le Marchand L, McNeill LH, Rybicki BA, Schwartz AG, Signorello LB, Spitz MR, Wiencke JK, Wrensch M, Wu X, Zanetti KA, Ziegler RG, Figueroa JD, Garcia-Closas M, Malats N, Marenne G, Prokunina-Olsson L, Baris D, Schwenn M, Johnson A, Landi MT, Goldin L, Consonni D, Bertazzi PA, Rotunno M, Rajaraman P, Andersson U, Freeman LE, Berg CD, Buring JE, Butler MA, Carreon T, Feychting M, Ahlbom A, Gaziano JM, Giles GG, Hallmans G, Hankinson SE, Hartge P, Henriksson R, Inskip PD, Johansen C, Landgren A, McKeanCowdin R, Michaud DS, Melin BS, Peters U, Ruder AM, Sesso HD, Severi G, Shu XO, Visvanathan K, White E, Wolk A, Zeleniuch-Jacquotte A, Zheng W, Silverman DT, Kogevinas M, Gonzalez JR, Villa O, Li D, Duell EJ, Risch HA, Olson SH, Kooperberg C, Wolpin BM, Jiao L, Hassan M, Wheeler W, Arslan AA, Bueno-de-Mesquita HB, Fuchs CS, Gallinger S, Gross MD, Holly EA, Klein AP, Lacroix A, Mandelson MT, Petersen G, Boutron-Ruault MC, Bracci PM, Canzian F, Chang K, Cotterchio M, Giovannucci EL, Goggins M, Bolton JA, Jenab M, Khaw KT, Krogh V, Kurtz RC, McWilliams RR, Mendelsohn JB, Rabe KG, Riboli E, Tjonneland A, Tobias GS, Trichopoulos D, Elena JW, Yu H, Amundadottir L, Stolzenberg-Solomon RZ, Kraft P, Schumacher F, Stram D, Savage SA, Mirabello L, Andrulis IL, Wunder JS, Garcia AP, Sierrasesumaga L, Barkauskas DA, Gorlick RG, Purdue M, Chow WH, Moore LE, Schwartz KL, Davis FG, Hsing AW, Berndt SI, Black A, Wentzensen N, Brinton LA, Lissowska J, Peplonska B, McGlynn KA, Cook MB, Graubard BI, Kratz CP, Greene MH, Erickson RL, Hunter DJ, Thomas G, Hoover RN, Real FX, Fraumeni JF, Jr., Caporaso NE, Tucker M, Rothman N, Perez-Jurado LA, Chanock SJ. Detectable clonal mosaicism and its relationship to aging and cancer. Nat Genet. 2012;44(6):651-8. PMC3372921. Mina N, Soubani AO, Cote ML, Suwan T, Wenzlaff AS, Jhajhria S, Samarah H, Schwartz AG. The relationship between chronic obstructive pulmonary disease and lung cancer in African-American patients. Clin Lung Cancer. 2012;13(2):149-56. Patel MK, Cote ML, Ali-Fehmi R, Buekers T, Munkarah AR, Elshaikh MA. Trends in the utilization of adjuvant vaginal cuff brachytherapy and/or external beam radiation treatment in stage I and II endometrial cancer: a surveillance, epidemiology, and end-results study. Int J Radiat Oncol Biol Phys. 2012;83(1):178-84. Roberts NJ, Jiao Y, Yu J, Kopelovich L, Petersen GM, Bondy ML, Gallinger S, Schwartz AG, Syngal S, Cote ML, Axilbund J, Schulick R, Ali SZ, Eshleman JR, Velculescu VE, Goggins M, Vogelstein B, Papadopoulos N, Hruban RH, Kinzler KW, Klein AP. ATM mutations in patients with hereditary pancreatic cancer. Cancer Discov. 2012;2(1):41-6. Rosenberger A, Bickeboller H, McCormack V, Brenner DR, Duell EJ, Tjonneland A, Friis S, Muscat JE, Yang P, Wichmann HE, Heinrich J, Szeszenia-Dabrowska N, Lissowska J, Zaridze D, Rudnai P, Fabianova E, Janout V, Bencko V, Brennan P, Mates D, Schwartz AG, Cote ML, Zhang ZF, Morgenstern H, Oh SS, Field JK, Raji O, McLaughlin JR, Wiencke J, LeMarchand L, Neri M, Bonassi S, Andrew AS, Lan Q, Hu W, Orlow I, Park BJ, Boffetta P, Hung RJ. Asthma and lung cancer risk: a systematic investigation by the International Lung Cancer Consortium. Carcinogenesis. 2012;33(3):587-97. PMC3291861. Schwartz AG. Genetic epidemiology of cigarette smoke-induced lung disease. Proc Am Thorac Soc. 2012;9(2):22-6. PMC3359114. Semaan A, Ali-Fehmi R, Munkarah AR, Bandyopadhyay S, Morris RT, Rizk S, Mert I, Ruterbusch JJ, Cote ML. Clinical/pathologic features and patient outcome in early onset endometrial carcinoma: A population based analysis and an institutional perspective from the Detroit metropolitan area, Michigan. Gynecol Oncol. 2012;124(2):265-9. Sethi S, Ali-Fehmi R, Franceschi S, Struijk L, van Doorn LJ, Quint W, Albashiti B, Ibrahim M, Kato I. Characteristics and survival of head and neck cancer by HPV status: a cancer registry-based study. Int J Cancer. 2012;131(5):1179-86. PMC3319485. Seward S, Ali-Fehmi R, Munkarah AR, Semaan A, Al-Wahab ZR, Elshaikh MA, Cote ML, Morris RT, Bandyopadhyay S. Outcomes of patients with uterine serous carcinoma using the revised FIGO staging system. Int J Gynecol Cancer. 2012;22(3):452-6. Wu X, Scelo G, Purdue MP, Rothman N, Johansson M, Ye Y, Wang Z, Zelenika D, Moore LE, Wood CG, Prokhortchouk E, Gaborieau V, Jacobs KB, Chow WH, Toro JR, Zaridze D, Lin J, Lubinski J, Trubicka J, Szeszenia-Dabrowska N, Lissowska J, Rudnai P, Fabianova E, Mates D, Jinga V, Bencko V, Slamova A, Holcatova I, Navratilova M, Janout V, Boffetta P, Colt JS, Davis FG, Schwartz KL, Banks RE, Selby PJ, Harnden P, Berg CD, Hsing AW, Grubb RL, 3rd, Boeing H, Vineis P, Clavel-Chapelon F, Palli D, Tumino R, Krogh V, Panico S, Duell EJ, Quiros JR, Sanchez MJ, Navarro C, Ardanaz E, Dorronsoro M, Khaw KT, Allen NE, Buenode-Mesquita HB, Peeters PH, Trichopoulos D, Linseisen J, Ljungberg B, Overvad K, Tjonneland A, Romieu I, Riboli E, Stevens VL, Thun MJ, Diver WR, Gapstur SM, Pharoah PD, Easton DF, Albanes D, Virtamo J, Vatten L, Hveem K, Fletcher T, Koppova K, Cussenot O, Cancel-Tassin G, Benhamou S, Hildebrandt MA, Pu X, Foglio M, Lechner D, Hutchinson A, Yeager M, Fraumeni JF, Jr., Lathrop M, Skryabin KG, McKay JD, Gu J, Brennan P, Chanock SJ. A genome-wide association study identifies a novel susceptibility locus for renal cell carcinoma on 12p11.23. Hum Mol Genet. 2012;21(2):456-62. PMC3276284. 2011 Alderman AK, Hawley ST, Morrow M, Salem B, Hamilton A, Graff JJ, Katz S. Receipt of delayed breast reconstruction after mastectomy: do women revisit the decision? Ann Surg Oncol. 2011;18(6):1748-56. PMC3174852. Beebe-Dimmer J, Morgenstern H, Cetin K, Yee C, Bartoces M, Shahinian V, Fryzek J, Acquavella J, Schwartz KL. Androgen deprivation therapy and cataract incidence among elderly prostate cancer patients in the United States. Ann Epidemiol. 2011;21(3):156-63. Boffetta P, Jayaprakash V, Yang P, Asomaning K, Muscat JE, Schwartz AG, Zhang ZF, Le Marchand L, Cote ML, Stoddard SM, Morgenstern H, Hung RJ, Christiani DC. Tobacco smoking as a risk factor of bronchioloalveolar carcinoma of the lung: pooled analysis of seven case-control studies in the International Lung Cancer Consortium (ILCCO). Cancer Causes Control. 2011;22(1):73-9. PMC3002160. Chang CM, Wang SS, Dave BJ, Jain S, Vasef MA, Weisenburger DD, Cozen W, Davis S, Severson RK, Lynch CF, Rothman N, Cerhan JR, Hartge P, Morton LM. Risk factors for non-Hodgkin lymphoma subtypes defined by histology and t(14;18) in a population-based case-control study. Int J Cancer. 2011;129(4):938-47. PMC3125462. Colt JS, Schwartz K, Graubard BI, Davis F, Ruterbusch J, DiGaetano R, Purdue M, Rothman N, Wacholder S, Chow WH. Hypertension and risk of renal cell carcinoma among white and black Americans. Epidemiology. 2011;22(6):797-804. PMC3188386. Cote ML, Haddad R, Edwards DJ, Atikukke G, Gadgeel S, Soubani AO, Lonardo F, Bepler G, Schwartz AG, Ethier SP. Frequency and type of epidermal growth factor receptor mutations in African-Americans with non-small cell lung cancer. J Thorac Oncol. 2011;6(3):627-30. PMC3057407. Daniel CR, Schwartz KL, Colt JS, Dong LM, Ruterbusch JJ, Purdue MP, Cross AJ, Rothman N, Davis FG, Wacholder S, Graubard BI, Chow WH, Sinha R. Meat-cooking mutagens and risk of renal cell carcinoma. Br J Cancer. 2011;105(7):1096-104. PMC3185955. Filson CP, Miller DC, Colt JS, Ruterbusch J, Linehan WM, Chow WH, Schwartz K. Surgical approach and the use of lymphadenectomy and adrenalectomy among patients undergoing radical nephrectomy for renal cell carcinoma. Urol Oncol. 2011. PMC3123686. [Epub ahead of print] Gold LS, Stewart PA, Milliken K, Purdue M, Severson R, Seixas N, Blair A, Hartge P, Davis S, De Roos AJ. The relationship between multiple myeloma and occupational exposure to six chlorinated solvents. Occup Environ Med. 2011;68(6):391-9. PMC3094509. Harlan LC, Lynch CF, Keegan TH, Hamilton AS, Wu XC, Kato I, West MM, Cress RD, Schwartz SM, Smith AW, Deapen D, Stringer SM, Potosky AL, Group AHSC. Recruitment and follow-up of adolescent and young adult 29 Metropolitan Detroit Cancer Surveillance System/SEER Publications 2010-2012 (continued) cancer survivors: the AYA HOPE Study. J Cancer Surviv. 2011;5(3):30514. PMC3159756. Hinch AG, Tandon A, Patterson N, Song Y, Rohland N, Palmer CD, Chen GK, Wang K, Buxbaum SG, Akylbekova EL, Aldrich MC, Ambrosone CB, Amos C, Bandera EV, Berndt SI, Bernstein L, Blot WJ, Bock CH, Boerwinkle E, Cai Q, Caporaso N, Casey G, Cupples LA, Deming SL, Diver WR, Divers J, Fornage M, Gillanders EM, Glessner J, Harris CC, Hu JJ, Ingles SA, Isaacs W, John EM, Kao WH, Keating B, Kittles RA, Kolonel LN, Larkin E, Le Marchand L, McNeill LH, Millikan RC, Murphy A, Musani S, NeslundDudas C, Nyante S, Papanicolaou GJ, Press MF, Psaty BM, Reiner AP, Rich SS, Rodriguez-Gil JL, Rotter JI, Rybicki BA, Schwartz AG, Signorello LB, Spitz M, Strom SS, Thun MJ, Tucker MA, Wang Z, Wiencke JK, Witte JS, Wrensch M, Wu X, Yamamura Y, Zanetti KA, Zheng W, Ziegler RG, Zhu X, Redline S, Hirschhorn JN, Henderson BE, Taylor HA, Jr., Price AL, Hakonarson H, Chanock SJ, Haiman CA, Wilson JG, Reich D, Myers SR. The landscape of recombination in African-Americans. Nature. 2011;476(7359):170-5. PMC3154982. 30 Hofmann JN, Baccarelli A, Schwartz K, Davis FG, Ruterbusch JJ, Hoxha M, McCarthy BJ, Savage SA, Wacholder S, Rothman N, Graubard BI, Colt JS, Chow WH, Purdue MP. Risk of renal cell carcinoma in relation to blood telomere length in a population-based case-control study. Br J Cancer. 2011;105(11):1772-5. PMC3242602. Lan Q, Wang SS, Menashe I, Armstrong B, Zhang Y, Hartge P, Purdue MP, Holford TR, Morton LM, Kricker A, Cerhan JR, Grulich A, Cozen W, Zahm SH, Yeager M, Vajdic CM, Schenk M, Leaderer B, Yuenger J, Severson RK, Chatterjee N, Chanock SJ, Zheng T, Rothman N. Genetic variation in Th1/Th2 pathway genes and risk of non-Hodgkin lymphoma: a pooled analysis of three population-based case-control studies. Br J Haematol. 2011;153(3):341-50. PMC3075370. Lu Y, Abdou AM, Cerhan JR, Morton LM, Severson RK, Davis S, Cozen W, Rothman N, Bernstein L, Chanock S, Hartge P, Wang SS. Human leukocyte antigen class I and II alleles and overall survival in diffuse large B-cell lymphoma and follicular lymphoma. ScientificWorldJournal. 2011;11:2062-70. PMC3217596. Mujahid MS, Janz NK, Hawley ST, Griggs JJ, Hamilton AS, Graff J, Katz SJ. Racial/ethnic differences in job loss for women with breast cancer. J Cancer Surviv. 2011;5(1):102-11. PMC3040347. Neklason DW, Done MW, Sargent NR, Schwartz AG, Anton-Culver H, Griffin CA, Ahnen DJ, Schildkraut JM, Tomlinson GE, Strong LC, Miller AR, Stopfer JE, Burt RW. Activating mutation in MET oncogene in familial colorectal cancer. BMC Cancer. 2011;11:424. PMC3202244. Peterson L, Soliman A, Ruterbusch JJ, Smith N, Schwartz K. Comparison of exposures among Arab American and non-Hispanic White female thyroid cancer cases in metropolitan Detroit. J Immigr Minor Health. 2011;13(6):1033-40. Purdue MP, Bakke B, Stewart P, De Roos AJ, Schenk M, Lynch CF, Bernstein L, Morton LM, Cerhan JR, Severson RK, Cozen W, Davis S, Rothman N, Hartge P, Colt JS. A case-control study of occupational exposure to trichloroethylene and non-Hodgkin lymphoma. Environ Health Perspect. 2011;119(2):232-8. Purdue MP, Johansson M, Zelenika D, Toro JR, Scelo G, Moore LE, Prokhortchouk E, Wu X, Kiemeney LA, Gaborieau V, Jacobs KB, Chow WH, Zaridze D, Matveev V, Lubinski J, Trubicka J, Szeszenia-Dabrowska N, Lissowska J, Rudnai P, Fabianova E, Bucur A, Bencko V, Foretova L, Janout V, Boffetta P, Colt JS, Davis FG, Schwartz KL, Banks RE, Selby PJ, Harnden P, Berg CD, Hsing AW, Grubb RL, 3rd, Boeing H, Vineis P, Clavel-Chapelon F, Palli D, Tumino R, Krogh V, Panico S, Duell EJ, Quiros JR, Sanchez MJ, Navarro C, Ardanaz E, Dorronsoro M, Khaw KT, Allen NE, Bueno-de-Mesquita HB, Peeters PH, Trichopoulos D, Linseisen J, Ljungberg B, Overvad K, Tjonneland A, Romieu I, Riboli E, Mukeria A, Shangina O, Stevens VL, Thun MJ, Diver WR, Gapstur SM, Pharoah PD, Easton DF, Albanes D, Weinstein SJ, Virtamo J, Vatten L, Hveem K, Njolstad I, Tell GS, Stoltenberg C, Kumar R, Koppova K, Cussenot O, Benhamou S, Oosterwijk E, Vermeulen SH, Aben KK, van der Marel SL, Ye Y, Wood CG, Pu X, Mazur AM, Boulygina ES, Chekanov NN, Foglio M, Lechner D, Gut I, Heath S, Blanche H, Hutchinson A, Thomas G, Wang Z, Yeager M, Fraumeni JF, Jr., Skryabin KG, McKay JD, Rothman N, Chanock SJ, Lathrop M, Brennan P. Genome-wide association study of renal cell carcinoma identifies two susceptibility loci on 2p21 and 11q13.3. Nat Genet. 2011;43(1):60-5. PMC3049257. Purdue MP, Colt JS, Graubard B, Davis F, Ruterbusch JJ, Digaetano R, Karami S, Wacholder S, Schwartz K, Chow WH. A case-control study of reproductive factors and renal cell carcinoma among black and white women in the United States. Cancer Causes Control. 2011;22(11):153744. Reinersman JM, Johnson ML, Riely GJ, Chitale DA, Nicastri AD, Soff GA, Schwartz AG, Sima CS, Ayalew G, Lau C, Zakowski MF, Rusch VW, Ladanyi M, Kris MG. Frequency of EGFR and KRAS mutations in lung adenocarcinomas in African-Americans. J Thorac Oncol. 2011;6(1):28-31. Schwartz AG, Wenzlaff AS, Bock CH, Ruterbusch JJ, Chen W, Cote ML, Artis AS, Van Dyke AL, Land SJ, Harris CC, Pine SR, Spitz MR, Amos CI, Levin AM, McKeigue PM. Admixture mapping of lung cancer in 1812 African-Americans. Carcinogenesis. 2011;32(3):312-7. PMC3047238. Smedby KE, Foo JN, Skibola CF, Darabi H, Conde L, Hjalgrim H, Kumar V, Chang ET, Rothman N, Cerhan JR, Brooks-Wilson AR, Rehnberg E, Irwan ID, Ryder LP, Brown PN, Bracci PM, Agana L, Riby J, Cozen W, Davis S, Hartge P, Morton LM, Severson RK, Wang SS, Slager SL, Fredericksen ZS, Novak AJ, Kay NE, Habermann TM, Armstrong B, Kricker A, Milliken S, Purdue MP, Vajdic CM, Boyle P, Lan Q, Zahm SH, Zhang Y, Zheng T, Leach S, Spinelli JJ, Smith MT, Chanock SJ, Padyukov L, Alfredsson L, Klareskog L, Glimelius B, Melbye M, Liu ET, Adami HO, Humphreys K, Liu J. GWAS of follicular lymphoma reveals allelic heterogeneity at 6p21.32 and suggests shared genetic susceptibility with diffuse large B-cell lymphoma. PLoS Genet. 2011;7(4):e1001378. PMC3080853. Wang SS, Menashe I, Cerhan JR, Cozen W, Severson RK, Davis S, Hutchinson A, Rothman N, Chanock SJ, Bernstein L, Hartge P, Morton LM. Variations in chromosomes 9 and 6p21.3 with risk of non-Hodgkin lymphoma. Cancer Epidemiol Biomarkers Prev. 2011;20(1):42-9. Wang SS, Lu Y, Rothman N, Abdou AM, Cerhan JR, De Roos A, Davis S, Severson RK, Cozen W, Chanock SJ, Bernstein L, Morton LM, Hartge P. Variation in effects of non-Hodgkin lymphoma risk factors according to the human leukocyte antigen (HLA)-DRB1*01:01 allele and ancestral haplotype 8.1. PLoS One. 2011;6(11):e26949. PMC3212525. Wheeler DC, De Roos AJ, Cerhan JR, Morton LM, Severson R, Cozen W, Ward MH. Spatial-temporal analysis of non-Hodgkin lymphoma in the NCI-SEER NHL case-control study. Environ Health. 2011;10:63. PMC3148953. 2010 Amos CI, Pinney SM, Li Y, Kupert E, Lee J, de Andrade MA, Yang P, Schwartz AG, Fain PR, Gazdar A, Minna J, Wiest JS, Zeng D, Rothschild H, Mandal D, You M, Coons T, Gaba C, Bailey-Wilson JE, Anderson MW. A susceptibility locus on chromosome 6q greatly increases lung cancer risk among light and never smokers. Cancer Res. 2010;70(6):2359-67. PMC2855643. Boleij A, Roelofs R, Schaeps RM, Schulin T, Glaser P, Swinkels DW, Kato I, Tjalsma H. Increased exposure to bacterial antigen RpL7/L12 in early stage colorectal cancer patients. Cancer. 2010;116(17):4014-22. PMC2930125. Cetin K, Beebe-Dimmer JL, Fryzek JP, Markus R, Carducci MA. Recent time trends in the epidemiology of stage IV prostate cancer in the United States: analysis of data from the Surveillance, Epidemiology, and End Results Program. Urology. 2010;75(6):1396-404. De Roos AJ, Davis S, Colt JS, Blair A, Airola M, Severson RK, Cozen W, Cerhan JR, Hartge P, Nuckols JR, Ward MH. Residential proximity to industrial facilities and risk of non-Hodgkin lymphoma. Environ Res. 2010;110(1):70-8. PMC2795078. Dombi GW, Rosbolt JP, Severson RK. Neural network analysis of employment history as a risk factor for prostate cancer. Comput Biol Med. 2010;40(9):751-7. Fang S, Pinney SM, Bailey-Wilson JE, de Andrade MA, Li Y, Kupert E, You M, Schwartz AG, Yang P, Anderson MW, Amos CI. Ordered subset analysis identifies loci influencing lung cancer risk on chromosomes 6q and 12q. Cancer Epidemiol Biomarkers Prev. 2010;19(12):3157-66. Geyer SM, Morton LM, Habermann TM, Allmer C, Davis S, Cozen W, Severson RK, Lynch CF, Wang SS, Maurer MJ, Hartge P, Cerhan JR. Smoking, alcohol use, obesity, and overall survival from non-Hodgkin lymphoma: a population-based study. Cancer. 2010;116(12):2993-3000. PMC2889918. Gold LS, Milliken K, Stewart P, Purdue M, Severson R, Seixas N, Blair A, Davis S, Hartge P, De Roos AJ. Occupation and multiple myeloma: an occupation and industry analysis. Am J Ind Med. 2010;53(8):768-79. Grulich AE, Vajdic CM, Falster MO, Kane E, Smedby KE, Bracci PM, de Sanjose S, Becker N, Turner J, Martinez-Maza O, Melbye M, Engels EA, Vineis P, Costantini AS, Holly EA, Spinelli JJ, La Vecchia C, Zheng T, Chiu BC, Franceschi S, Cocco P, Maynadie M, Foretova L, Staines A, Brennan P, Davis S, Severson RK, Cerhan JR, Breen EC, Birmann B, Cozen W. Birth order and risk of non-hodgkin lymphoma--true association or bias? Am J Epidemiol. 2010;172(6):621-30. PMC2950815. Jagsi R, Abrahamse P, Morrow M, Hawley ST, Griggs JJ, Graff JJ, Hamilton AS, Katz SJ. Patterns and correlates of adjuvant radiotherapy receipt after lumpectomy and after mastectomy for breast cancer. J Clin Oncol. 2010;28(14):2396-403. Kakarala M, Rozek L, Cote M, Liyanage S, Brenner DE. Breast cancer histology and receptor status characterization in Asian Indian and Pakistani women in the U.S.--a SEER analysis. BMC Cancer. 2010;10:191. PMC2873947. Karami S, Schwartz K, Purdue MP, Davis FG, Ruterbusch JJ, Munuo SS, Wacholder S, Graubard BI, Colt JS, Chow WH. Family history of cancer and renal cell cancer risk in Whites and African-Americans. Br J Cancer. 2010;102(11):1676-80. PMC2883149. Kato I, Land S, Majumdar AP, Barnholtz-Sloan J, Severson RK. Functional polymorphisms to modulate luminal lipid exposure and risk of colorectal cancer. Cancer Epidemiol. 2010;34(3):291-7. PMC2905870. Kato I, Majumdar AP, Land SJ, Barnholtz-Sloan JS, Severson RK. Dietary fatty acids, luminal modifiers, and risk of colorectal cancer. Int J Cancer. 2010;127(4):942-51. PMC2891322. Katz SJ, Hawley ST, Morrow M, Griggs JJ, Jagsi R, Hamilton AS, Graff JJ, Friese CR, Hofer TP. Coordinating cancer care: patient and practice management processes among surgeons who treat breast cancer. Med Care. 2010;48(1):45-51. Katz SJ, Hawley ST, Abrahamse P, Morrow M, Friese CR, Alderman AK, Griggs JJ, Hamilton AS, Graff JJ, Hofer TP. Does it matter where you go for breast surgery?: attending surgeon’s influence on variation in receipt of mastectomy for breast cancer. Med Care. 2010;48(10):892-9. Liu P, Yang P, Wu X, Vikis HG, Lu Y, Wang Y, Schwartz AG, Pinney SM, de Andrade M, Gazdar A, Gaba C, Mandal D, Lee J, Kupert E, Seminara D, Minna J, Bailey-Wilson JE, Spitz M, Amos CI, Anderson MW, You M. A second genetic variant on chromosome 15q24-25.1 associates with lung cancer. Cancer Res. 2010;70(8):3128-35. Liu P, Vikis HG, Lu Y, Wang Y, Schwartz AG, Pinney SM, Yang P, de Andrade M, Gazdar A, Gaba C, Mandal D, Lee J, Kupert E, Seminara D, Minna J, Bailey-Wilson JE, Amos CI, Anderson MW, You M. Cumulative effect of multiple loci on genetic susceptibility to familial lung cancer. Cancer Epidemiol Biomarkers Prev. 2010;19(2):517-24. PMC2846747. McWalter K, Graham L, Atzinger C. Presented Abstracts from the TwentyNinth Annual Education Conference of the National Society of Genetic Counselors (Dallas, Texas, October 2010) (Abstract by Kennelly, K., Salkowski, A., Schwartz, AG.: Preliminary Response to the Re-consent Process for Inclusion in dbGaP). Journal of Genetic Counseling. 2010;19(6):653. Miller DC, Ruterbusch J, Colt JS, Davis FG, Linehan WM, Chow WH, Schwartz K. Contemporary clinical epidemiology of renal cell carcinoma: insight from a population based case-control study. J Urol. 2010;184(6):2254-8. Nahleh Z, Abrams J, Bhargaval A, Nirmal K, Graff JJ. Outcome of patients with early breast cancer receiving nitrogen-containing bisphosphonates: a comparative analysis from the metropolitan detroit cancer surveillance system. Clin Breast Cancer. 2010;10(6):459-64. Shen M, Menashe I, Morton LM, Zhang Y, Armstrong B, Wang SS, Lan Q, Hartge P, Purdue MP, Cerhan JR, Grulich A, Cozen W, Yeager M, Holford TR, Vajdic CM, Davis S, Leaderer B, Kricker A, Severson RK, Zahm SH, Chatterjee N, Rothman N, Chanock SJ, Zheng T. Polymorphisms in DNA repair genes and risk of non-Hodgkin lymphoma in a pooled analysis of three studies. Br J Haematol. 2010;151(3):239-44. PMC2967772. Truong T, Hung RJ, Amos CI, Wu X, Bickeboller H, Rosenberger A, Sauter W, Illig T, Wichmann HE, Risch A, Dienemann H, Kaaks R, Yang P, Jiang R, Wiencke JK, Wrensch M, Hansen H, Kelsey KT, Matsuo K, Tajima K, Schwartz AG, Wenzlaff A, Seow A, Ying C, Staratschek-Jox A, Nurnberg P, Stoelben E, Wolf J, Lazarus P, Muscat JE, Gallagher CJ, Zienolddiny S, Haugen A, van der Heijden HF, Kiemeney LA, Isla D, Mayordomo JI, Rafnar T, Stefansson K, Zhang ZF, Chang SC, Kim JH, Hong YC, Duell EJ, Andrew AS, Lejbkowicz F, Rennert G, Muller H, Brenner H, Le Marchand L, Benhamou S, Bouchardy C, Teare MD, Xue X, McLaughlin J, Liu G, McKay JD, Brennan P, Spitz MR. Replication of lung cancer susceptibility loci at chromosomes 15q25, 5p15, and 6p21: a pooled analysis from the International Lung Cancer Consortium. J Natl Cancer Inst. 2010;102(13):959-71. PMC2897877. Wang SS, Abdou AM, Morton LM, Thomas R, Cerhan JR, Gao X, Cozen W, Rothman N, Davis S, Severson RK, Bernstein L, Hartge P, Carrington M. Human leukocyte antigen class I and II alleles in non-Hodgkin lymphoma etiology. Blood. 2010;115(23):4820-3. PMC2890176. 31 Affiliations and Acknowledgements STATE OF MICHIGAN The cancer statistics collected and disseminated here could not have been presented without the untiring work of the cancer registrar, editing, follow-up and management teams of the Metropolitan Detroit Cancer Surveillance System. Nor could this work have been presented without the collaboration of each of the facilities on the following page and the entities listed here. 32 Special thanks go to the Michigan Department of Community Health for their ongoing assistance, and also to the many physicians who support our efforts to ensure complete cancer reporting for tri-county residents. Finally, we would like to acknowledge the cancer patients and their families. It is to you we dedicate this work. The Metropolitan Detroit Cancer Surveillance System is funded by: The Division of Cancer Prevention and Control National Cancer Institute Department of Health and Human Services SEER Contract # HHSN261201000028C Control # NO1-PC-00028 Metropolitan Detroit Cancer Surveillance System Participating Institutions The following hospitals, pathology laboratories and radiation oncology treatment facilities are participants in the Metropolitan Detroit Cancer Surveillance System. Their collaboration makes possible Detroit area population-based cancer reporting. Hospitals and Associated Path Labs, Radiation Facilities and Clinics Botsford General Hospital Hutzel Hospital Providence Hospital Children’s Hospital of Michigan John D. Dingell Dept. of Veterans Administration Medical Center St. John Detroit Riverview Hospital Crittenton Hospital Detroit Receiving Hospital Doctors Hospital of Michigan Garden City Hospital Harper Hospital University Health Center Karmanos Cancer Center St. John Hospital and Medical Center McLaren Hospital – Macomb St. John Macomb Hospital Center McLaren Hospital – Oakland St. John Northshore Hospital Michigan Orthopedic Specialty Hospital St. John Oakland Hospital William Beaumont Hospital – Grosse Pointe William Beaumont Hospital – Royal Oak William Beaumont Hospital – Troy Henry Ford Hospital Oakwood Hospital St. Joseph Mercy Hospital Ann Arbor* Henry Ford – Warren Oakwood Annapolis Hospital St. Joseph Mercy Hospital Oakland Henry Ford – Macomb Oakwood Heritage Hospital St. Mary Hospital Henry Ford Wyandotte Hospital Oakwood Southshore Medical Center Sinai-Grace Hospital Huron Valley-Sinai Hospital Southeast Michigan Surgical Hospital University Hospital Ann Arbor* Veterans Administration Medical Center – Ann Arbor* Independent Pathology Laboratories Ameripath Institute of Urology Detroit Bio-Medical Laboratories Medical Diagnostic Lab Pinkus Laboratory Beaumont Reference Laboratory Dianon Systems Michigan Institute of Urology Plus Diagnostics Bio-Reference Laboratory Genoptix Laboratory Midwest Skin Pathology Quest Diagnostics, Inc. Bostwick Laboratories Hilbrich Dermatology Lab, PLC Novice Dermatopathology Lab St. John Oral Pathology Contemporary Imaging Associates Hospital Consolidated Laboratories Oakwood Medical Laboratory Dermatopathology Associates Laboratory Corporation of America Oppenheimer Urologic Reference Laboratory Independent Radiation Oncology Facilities 21st Century Oncology Downriver Center for Oncology Radiation Therapy Associates *Hospital not located in the tri-county area. 33 Appendix A Michigan Public Health Code and HIPAA (Excerpts) Michigan Act 368 of 1978 and HIPAA Law and Federal Rules (Excerpts); Public Law 104-191; 104th Congress; August 21, 1996 333.2619 Cancer registry; establishment; purpose; reports; records; rules; medical or department examination or supervision not required; contracts; evaluation of reports; publication of summary reports; commencement of reporting; effective date of section. and make available to the public reports summarizing the information collected. The first summary report shall be published not later than 180 days after the end of the first 2 full calendar years after the effective date of this section. Subsequent annual summary reports shall be made on a full calendar year basis and published not later than 180 days after the end of each calendar year. Sec. 2619. (1) The department shall establish a registry to record cases of cancer and other specified tumorous and precancerous diseases that occur in the state, and to record information concerning these cases as the department considers necessary and appropriate in order to conduct epidemiologic surveys of cancer and cancer-related diseases in the state. 34 (2) Each diagnosed case of cancer and other specified tumorous and precancerous diseases shall be reported to the department pursuant to subsection (4), or reported to a cancer reporting registry if the cancer reporting registry meets standards established pursuant to subsection (4) to ensure the accuracy and completeness of the reported information. A person or facility required to report a diagnosis pursuant to subsection (4) may elect to report the diagnosis to the state through an existing cancer registry only if the registry meets minimum reporting standards established by the department. (3) The department shall maintain comprehensive records of all reports submitted pursuant to this section. These reports shall be subject to the same requirements of confidentiality as provided in section 2631 for data or records concerning medical research projects. (4) The director shall promulgate rules which provide for all of the following: (8) Reporting pursuant to subsection (2) shall begin the next calendar year after the effective date of this section. (9) This section shall take effect July 1, 1984. History: Add. 1984, Act 82, Eff. July 1, 1984 Popular Name: Act 368 333.2621 Comprehensive policy for conduct and support of research and demonstration activities; conducting and supporting demonstration projects and scientific evaluations. Sec. 2621. (1) The department shall establish a comprehensive policy pursuant to and consistent with section 2611(2) for the conduct and support of research and demonstration activities related to the department’s responsibility for the health care needs of the people of this state. (2) The department shall conduct research and demonstration activities related to the department’s responsibility for the environmental, preventive, and personal health needs of the communities and people of this state, including: (a)The causes, effects, and methods of prevention of illness. (a) A list of tumorous and precancerous diseases other than cancer to be reported pursuant to subsection (2). (b)The determinants of health, including behavior related to health. (b) The quality and manner in which the cases and other information described in subsection (1) are reported to the department. (c)The accessibility, acceptability, availability, organization, distribution, utilization, quality, and financing of health care, especially those services for the medically needy. (c) Th e terms and conditions under which records disclosing the name and medical condition of a specific individual and kept pursuant to this section are released by the department. (3) The department may conduct and support demonstration projects to carry out subsection (2). (5) This section does not compel an individual to submit to medical or department examination or supervision. (6) The department may contract for the collection and analysis of, and research related to, the epidemiologic data required under this section. (7) Within 2 years after the effective date of this section, the department shall begin evaluating the reports collected pursuant to subsection (2). The department shall publish (4) The department shall conduct or support the conduct of scientific evaluations of the effectiveness, efficiency, and relevance of programs conducted or supported by the department. History: 1978, Act 368, Eff. Sept. 30, 1978 Popular Name: Act 368 333.2631 Data concerning medical research project; confidentiality; use. 333.2633 Data concerning medical research projects; liability for furnishing. Sec. 2631. Sec. 2633. The information, records of interviews, written reports, statements, notes, memoranda, or other data or records furnished to, procured by, or voluntarily shared with the department in the conduct of a medical research project, or a person, agency, or organization which has been designated in advance by the department as a medical research project which regularly furnishes statistical or summary data with respect to that project to the department for the purpose of reducing the morbidity or mortality from any cause or condition of health are confidential and shall be used solely for statistical, scientific, and medical research purposes relating to the cause or condition of health. The furnishing of information, records, reports, statements, notes, memoranda, or other data to the department, either voluntarily or as required by this code, or to a person, agency, or organization designated as a medical research project does not subject a physician, hospital, sanatorium, rest home, nursing home, or other person or agency furnishing the information, records, reports, statements, notes, memoranda, or other data to liability in an action for damages or other relief, and is not considered to be the willful betrayal of a professional secret or the violation of a confidential relationship. History: 1978, Act 368, Eff. Sept. 30, 1978 Popular Name: Act 368 History: 1978, Act 368, Eff. Sept. 30, 1978 ;-- Am. 1988, Act 122, Eff. Mar. 30, 1989 Popular Name: Act 368 35 333.2632 Data concerning medical research project; inadmissible as evidence; exhibition or disclosure. Sec. 2632. The information, records, reports, statements, notes, memoranda, or other data described in section 2631 are not admissible as evidence in an action in a court or before any other tribunal, board, agency, or person. Furnishing the data to the department in the conduct of a medical research project or to a designated medical research project does not result in the loss of any privilege which the data may otherwise have making them inadmissible as evidence. The information, records, reports, notes, memoranda, or other data shall not be exhibited nor their contents disclosed in any way, in whole or in part, by the department or its representative, or by any other person, agency, or organization, except as is necessary for the purpose of furthering the medical research project to which they relate consistent with section 2637 and the rules promulgated under section 2678. A person participating in a designated medical research project shall not disclose the information obtained except in strict conformity with the research project. History: 1978, Act 368, Eff. Sept. 30, 1978 Popular Name: Act 368 ••• SEC. 1178. EFFECT ON STATE LAW (b) PUBLIC HEALTH.--Nothing in this part shall be construed to invalidate or limit the authority, power, or procedures established under any law providing for the reporting of disease or injury, child abuse, birth, or death, public health surveillance, or public health investigation or intervention. (c) STATE REGULATORY REPORTING.--Nothing in this part shall limit the ability of a State to require a health plan to report, or to provide access to, information for management audits, financial audits, program monitoring and evaluation, facility licensure or certification, or individual licensure or certification. ••• Rendered 6/7/2005 16:58:30 Michigan Compiled Laws © 2005 Legislative Council, State of Michigan Courtesy of www.legislature.mi.gov Source: http://aspe.hhs.gov/admnsimp/pl104191.htm (emphasis added) Metropolitan Detroit Cancer Surveillance System Epidemiology Section | 4100 John R Street MM04EP | Detroit, MI 48201 For Additional Information: Telephone: (313) 578-4231 Fax: (313) 578-4306 http://seer.cancer.gov/registries/detroit.html Prepared By Contributing Authors Ron Shore, MPH Biostatistical Programmer Michele L. Cote, PhD Patricia Arballo-Spong, BS SEER Project Coordinator Ikuko Kato, MD, PhD, Patricia Arballo-Spong, BS, Ann S. Bankowski, MSW, Kari A. Borden, RHIT, CTR Ellen M. Velie, PhD, Kendra Schwartz, MD, MSPH Fawn D. Vigneau, JD, MPH Co-Director, Epidemiology Research Core 36 Kendra Schwartz, MD, MSPH Director, Epidemiology Research Core Ann G. Schwartz, PhD, MPH Patricia Arballo-Spong, BS Ann S. Bankowski, MSW Ann G. Schwartz, PhD, MPH Director, Metropolitan Detroit Cancer Surveillance System Kari A. Borden, RHIT, CTR Leadership Team Ann G. Schwartz, PhD, MPH Director, Metropolitan Detroit Cancer Surveillance System SEER Principal Investigator Kendra Schwartz, MD, MSPH SEER Co-Investigator Director, Epidemiology Research Core Fawn D. Vigneau, JD, MPH Co-Director, Epidemiology Research Core Patricia Arballo-Spong, BS SEER Project Coordinator William O. Quarshie, MS Biostatistician Joanne Harris, CTR Chief of Cancer Surveillance Nancy L. Lozon, BS, CTR Manager Cancer Surveillance - Office Operations Patrick Nicolin, BA, CTR Manager Cancer Surveillance - Quality Control and Field Operations Richard Pense, BS Director, Basic and Population Science Systems Inhee Han, BS Senior Applications Analyst Gloria Kwiatkowski, BS Senior Applications Analyst Sharon Moton, BS Administrator Published December 2012