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SMC ANNUAL
REPORT FOR 2007
FOCUS STUDY ON BREAST
CANCER
2000-2005
This year, 2007, the NCI estimates
there will be over 180,000 new cases
of Breast Cancer in the United
States. Approximately 41,000 deaths
will occur for an adjusted mortality of
22.7%. This continues the favorable
overall national trend with a 1.1%
decline in incidence and a 2.4%
decline in mortality as well as a
proportional decline in Colorado.
TOP TEN PRIMARY SITES AT SMC IN 2006
NUMBER
0
20
40
60
80
100
120
140
BREAST
141
PROSTATE
134
PIRMARY SITE
LUNG
91
COLORECTAL
50
LYMPH NODES
27
KIDNEY
25
BLADDER
23
ESOPHAGUS
UNKNOWN
BONE MARROW
19
17
16
160
For the Registry year of 2006, Breast
Cancer was our number one site,
accessioning a total of 141 cases. The
age of presentation for Breast Cancer
at SMC (St. Mary-Corwin Regional
Medical Center) peaked in the sixth
decade with just under 40% diagnosed
in Stage I. 95% of patients underwent
surgical treatment with up to 75%
completing some form of adjuvant
treatment.
AGE OF BREAST CANCER PATIENTS DIAGNOSED 2000-2005
NCDB, SMC AND COLORADO
30
PERCENTAGE
25
20
NCDB DATA
SMC
15
COLORADO
10
5
0
16-29
30-39
40-49
50-59
AGE
60-69
70-79
80+
Adjuvant treatments, directed by
our Board Certified Radiation and
Medical Oncologists, include
radiation, chemotherapy, hormone
therapy and targeted therapies
based on the specific prognostic
profile of each individual patient.
TREATMENT OF BREAST CANCER DIAGNOSED 2000-2005
NCDB, SMC AND COLORADO
40
35
PERCENTAGE
30
25
NCDB
SMC
COLORADO
20
15
10
5
0
Surg
Surg & Surg &
Rad
Chemo
Surg,
Rad &
Chemo
Surg,
Rad &
Horm.
Surg &
Horm
TREATMENT
Surg,
Surg,
Rad, Chemo
Chemo, & Horm
Horm
Other
No 1st
course
tx
The patterns of age and treatment
did differ slightly at SMC when
compared to state and national
statistics. Local incidence showed a
5% shift into the older 7th and 8th
decades which dictated a slight shift
away from adjuvant chemotherapy
and towards more hormonal therapy.
There was no significant shift in
stage however when the data is
compared with the NCDB
(National Cancer Data Base).
Comparison with Colorado State
data for stage is more difficult as
there is an 8% cohort of unstaged
Breast cancers in the Colorado
State Registry.
STAGE OF BREAST CANCER DIAGNOSED 2000-2005
NCDB, SMC AND COLORADO
45
40
35
PERCENTAGE
30
NCDB DATA
SMC
25
20
COLORADO
15
10
5
0
0
I
II
III
STAGE
IV
UNKNOWN
Observed Survival by Year for Stage I Breast Cancer
100.0%
95.0%
Percentage
90.0%
SMC
COLORADO
NCDB
85.0%
80.0%
75.0%
1
2
3
Year(s) after diagnosis
4
5
Observed Survival by Year for Stage II Breast Cancer
120.0%
100.0%
Percentage
80.0%
SMC
60.0%
COLORADO
NCDB
40.0%
20.0%
0.0%
1
2
3
Year(s) after diagnosis
4
5
Observed Survival by Year for Stage III Breast Cancer
120.0%
100.0%
Percentage
80.0%
SMC
60.0%
COLORADO
NCDB
40.0%
20.0%
0.0%
1
2
3
Year(s) after diagnosis
4
5
When compared to NCDB, both State
and local data however show gross
differences in survival for all stages as
shown:
Stage I
5% LESS
Stage II
7%
Stage III EVEN
Stage IV INADEQUATE
SAMPLING #
Explanation of these survival
differences are difficult but
probably lie in several areas:
1.Older population
2.Higher comorbid disease
3.Lower access to care in rural
areas.
Further analysis of survival is not
currently possible but could be the
focus of future studies.
Vaughan Cipperly, MD
Created by statecancerprofiles.cancer.gov on 10/31/2007 8:58 am.
Death Rate/Trend Comparison by Cancer,
death years through 2004
Colorado Counties versus United States
Breast
All Races, Female
Above US Rate
Priority 1: rising
Rising
Trend
[none]
Priority 4: stable
Stable
Trend
Trend
[none]
Priority 2: rising
and similar
[none]
and above
and above
Priority 6: stable
Priority 8: falling
Below US Rate
Priority 3: rising
and below
[none]
and similar
Fremont County
La Plata County
Mesa County
Montrose County
Morgan County
Weld County5
[none]
Priority 5: falling
Falling
and above
Similar to US Rate
Priority 7: stable
and below
Douglas County
and similar
Colorado
Adams County5
Arapahoe County
Boulder County5
Denver County
El Paso County
Jefferson County5
Larimer County
Priority 9: falling
Pueblo County
and below
Trend2
Rising
when 95% confidence interval of annual percent change is above 0.
Stable
when 95% confidence interval of annual percent change includes 0.
Falling
when 95% confidence interval of annual percent change is below 0.
Rate Comparison
Above
when 95% confident the rate is above and Rate Ratio 3 > 1.10
Similar
when unable to conclude above or below with confidence.
Below
when 95% confident the rate is below and Rate Ratio 3 < 0.90
1
Priority indices were created by ordering from rates that are rising and above the comparison rate to rates that are falling and below the comparison rate.
Recent trend in death rates were calculated using the Joinpoint Regression Program and are expressed as the annual percent change over the recent trend period. Recent
trend period is the period since last change in trend as determined by Joinpoint.
3 Rate ratio is the county rate divided by the US rate.
4 Due to data availability issues, the time period used in the calculation of the joinpoint regression model may differ for selected racial groups or counties.
5 The county boundaries for Adams, Boulder, Jefferson and Weld changed in 2002 when Broomfield was incorporated into a county (officially November 15, 2001) from portions
of Adams, Boulder, Jefferson and Weld. Data prior to 2002 is used in the calculation of statistics for these counties using the old county boundaries. Additionally, data for
Broomfield County has been suppressed since five years of data is not available.
2
Source: Death data provided by the National Vital Statistics System public use data file. Death rates calculated by the National Cancer Institute using SEER*Stat. Death rates are
age-adjusted to the 2000 US standard population (19 age groups: <1, 1–4, 5–9, … , 80–84, 85+). Population counts for denominators are based on Census populations as
modified by NCI.
Note: When the population size for a denominator is small, the rates may be unstable. A rate is unstable when a small change in the numerator (e.g., only one or two additional
cases) has a dramatic effect on the calculated rate. Suppression is used to avoid misinterpretation when rates are unstable.
State Cancer Registries may provide more current or more local data. Data presented on the State Cancer Profiles Web Site may differ from statistics reported by the State
Cancer Registries (for more information).
Data for the following has been suppressed to ensure confidentiality and stability of rate and trend estimates:
Alamosa County, Archuleta County, Baca County, Bent County, Broomfield County 45, Chaffee County, Cheyenne County, Clear Creek County, Conejos County, Costilla County,
Crowley County, Custer County, Dolores County, Eagle County, Elbert County, Gilpin County, Grand County, Gunnison County, Hinsdale County, Huerfano County, Jackson
County, Kiowa County, Kit Carson County, Lake County, Las Animas County, Lincoln County, Logan County, Mineral County, Moffat County, Ouray County, Park County,
Phillips County, Pitkin County, Prowers County, Rio Blanco County, Rio Grande County, Routt County, Saguache County, San Juan County, San Miguel County, Sedgwick
County, Summit County, Washington County, Yuma County
Trend for the following could not be reliably determined due to small number of deaths per year:
Delta County, Garfield County, Montezuma County, Otero County, Teller County
Found at:
 http://statecancerprofiles.cancer.gov/