2011 Cancer Committee Annual ReportShands at the University of Florida

with statistical data from 2010

Message from the Shands at UF Cancer Committee ChairThis report represents my final duty as out-going chair of the Shands at UF Can-cer Committee. I am proud of the committee’s recent accomplishments aimed at guiding and improving cancer care at Shands at the University of Florida, and I’m pleased to have had the opportunity to work with such dedicated physicians, nurses and support personnal who are deeply committed the care and treatment of pa-tients.

This committee provides the interdisciplinary groups involved in patient-centered patient care the opportunity to interact, collaborate, and coordinate efforts to estab-

lish and maintain the highest quality of service to our cancer patients and their families. Meeting quarterly, the committee’s goals continue to be that of auditing patient care, assuring the breadth and depth of educational programs, tumor conferences and other clinical activites, ensuring patient access to consultative services in all disciplines and providing oversight and quality control of data from the Oncology Data Center.

Our work is part of the UF Shands Cancer Center’s interdisciplinary initiative at the UF Health Science Center’s Gainesville and Jacksonville campuses, Shands at UF in Gainesville, and Shands Jacksonville. More than 250 clinicians and scientists perform original scientific discovery to enhance the diagnosis, treatment and preven-tion of cancer. This report demonstrates the clinical and research effort involved in that enterprise during the calendar year 2011.

Steven Hochwald, M.D.Associate Professor, Surgery

Section Chief, Surgical OncologyChair, Shands at UF Cancer Committee

Cancer Care Summary: 2010 DataShands at the University of Florida Oncology Data Center has analyzed data for all patients with reportable disease first seen at UF Shands Cancer Center between Jan. 1, 2010 and Dec. 31, 2010. During that time, 2,731 new cases were diagnosed and/or treated here as either inpatients, outpatients, or both. Of these cases, 2,251 were analytic (82 percent) meaning they received all or part of their first course of treatment at our facility. The remaining 480 (18 percent) were non-analytic, meaning patients were diagnosed and received their entire initial course of therapy elsewhere. The total new cases volume decreased by 6 percent from 2009, and decreased 3 percent for analytic cases only. However, increases were noted in several overall and analytic site groups. Among them is colorectal with an increase of 17 percent in total malignant cases. Kidney/renal cancers also experienced an increase of 14 percent over 2009 figures for malignant sites, and 8 percent for analytic cases. Prostate also experienced an increase of 44 percent over 2009 figures.

Increases were seen in numerous sites. Primary sites with the greatest increases in total new case volumes overall were liver (24 per-cent), Hodgkin’s disease (20 percent), non-Hodgkin’s (15 percent), oral cavity (15 percent), and breast (4 eprcent). Several primary sites experienced declines in total new case volumes. These included prostate (44 percent decline), ovary (30 percent decline), kidney/renal (13 percent decline), and lung (8 percent decline).

Holding to our customary patterns, individuals from virtually every county in the State of Florida continue to seek care at the UF Shands Cancer Center. Individuals residing in counties of the North Central Florida and North East Florida areas comprised 53 per-cent (1,450) of the total new cases in 2010. This is only six cases fewer than the total new cases from the same geographic area in 2009. Figures from the top five individual counties in Florida are as follows: Alachua 565 (21 percent), Marion 288 (11 percent), Columbia 107 (4 percent), Lake 107 (4 percent), and Citrus 94 (3 percent). Out of state cases accounted for 5 percent (146) of all new cases in 2010.

Cases for females totaled 1,293, or 47 percent. Cases for males totaled 1,438, or 53 percent. The female group decreased by 3 percent and males decreased by 9 percent.

New Cancer Cases

PRIMARY SITE

Breast (female)

Lung

Prostate

Colorectal

Bladder

Non-Hodgkin Lymphoma

Corpus Uteri

Melanoma

Leukemia

Cervix

All Others

Total Cases

UNITED STATES1

230,48014.4%

221,13013.8%

240,89015.1%

141,2108.8%

69,2504.3%

66,3604.2%

46,4702.9%

70,2304.4%

44,6002.8%

12,7100.8%

453,34028.4%

1,596,670100%

FLORIDA1

15,33013.5%17,15015.1%16,78014.8%10,180

9%5,4904.8%4,7204.2%2,9602.6%5,2604.6%3,440

3%900

0.8%31,19027.5%

113,400100%

SHANDS AT UF2

2268.3%

2117.7%

1154.2%

1214.4%

1234.5%

1284.7%

511.9%

1224.5%

1003.7%

311.1%1,50355%

2,731100%

1. These estimates are offered as a rough guide. They are calculated according to the distribution of estimated new cancer cases by state for the year 2011. These figures were obtained from the 2011 Cancer Facts & Figures, published by the American Cancer Society. Excludes basal and squamous cell skin cancers and in-situ carcinomas (except urinary bladder).2. Shands at UF figures were obtained from the total number of accessioned cases at Shands at UF during 2010.

BREASTBRAIN/CNSLUNGORAL CAVITYKIDNEY/RENALTOTAL

Total

191184179144123821

0

460056

57

I

790

342474

208

II

460

11154

76

III

140

35142184

IV

120

1077825

222

UNK

320

23187

80

N/A

0221

134

229

Top Sites: Reportable, Analytic Cases (AJCC/TNM Staging)

All Other Sites 42.6%

Breast 9.1%

Lung/Bronchus 8.5%

Oral Cavity 5.4%

Kidney/Renal 5.6%

Non-Hodgkin’s Lymphoma 5.1%

Liver 5%

Bladder 4.9%

Melanoma 4.9%Colorectal 4.8%Leukemia 4%

Site CountBREAST 226LUNG/BRONCHUS 212ORAL CAVITY 135KIDNEY/RENAL 140NON-HODGKIN’S LYMPHOMA 128LIVER 126BLADDER 123MELANOMA 122COLORECTAL 121LEUKEMIA 99ALL OTHER SITES 1063TOTAL 2495

Ten Most Frequent Malignant Sites

Geographic Distribution by County

ALACHUA 565MARION 288COLUMBIA 107LAKE 107CITRUS 94BREVARD 93LEVY 92PUTNAM 91SUWANEE 86VOLUSIA 86SUMTER 82LEON 79DUVAL 76CLAY 61BRADFORD 47ST. JOHNS 38ORANGE 37ESCAMBIA 31GILCHRIST 31FLAGLER 28ST. LUCIE 27BAY 26DIXIE 23OKALOOSA 21INDIAN RIVER 19PALM BEACH 19

HERNANDO 18PINELLAS 18UNION 18GASDEN 17HAMILTON 17POLK 17TAYLOR 17WAKULLA 17HILLSBOROUGH 15LEE 14PASCO 12JACKSON 11SEMINOLE 11MARTIN 10NASSAU 10JEFFERSON 9COLLIER 8BAKER 7BROWARD 7LAFAYETTE 7MADISON 7WALTON 7MANATEE 6OSCEOLA 6SANTA ROSA 6WASHINGTON 6

CHARLOTTE 5SARASOTA 5DADE 4HIGHLANDS 4CALHOUN 3FRANKLIN 3OKEECHOBEE 3HOLMES 2LIBERTY 2GULF 1HARDEE 1MONROE 1OUT OF STATE 146OVERALL TOTALS 2732

Shands at the Univer-sity of Florida is ranked No. 35 for cancer in the

2011 U.S. News & World Report Rankings and is

among the elite, top 4 per-cent of all cancer hospitals

nationwide

2010 Primary Site TablePRIMARY SITE

ALL SITESORAL CAVITY LIP TONGUE OROPHARYNX HYPOPHARYNX OTHERDIGESTIVE SYSTEM ESOPHAGUS STOMACH COLON RECTUM ANUS/ANAL CANAL LIVER PANCREAS OTHERRESPIRATORY SYSTEM NASAL/SINUS LARYNX LUNG/BRONCHUS OTHERBLOOD & BONE MARROW LEUKEMIA MULTIPLE MYELOMA OTHERBONECONNECT/SOFT TISSUESKIN MELANOMA OTHERBREASTFEMALE GENITAL CERVIX UTERI CORPUS UTERI OVARY VULVA OTHERMALE GENITAL PROSTATE TESTIS OTHERURINARY SYSTEM BLADDER KIDNEY/RENAL OTHERBRAIN & CNS BRAIN (BENIGN) BRAIN (MALIGNANT) OTHERENDOCRINE THYROID OTHERLYMPHATIC SYSTEM HODGKIN’S DISEASE NON-HODGKIN’SUNKNOWN PRIMARYOTHER/ILL-DEFINED

TOTAL

2731157

53597

1014914036843711

12610255

2669

42211

418410061234478

14812226

2261583151382711

1371151210

28312314119

2211292

1171244084

15224

1283923

PERCENT

100.00%5.75%0.18%1.28%0.33%0.26%3.70%

17.98%1.46%1.32%3.08%1.35%0.40%4.61%3.73%2.01%9.74%0.33%1.54%7.73%0.15%6.74%3.66%2.23%0.84%1.61%2.86%5.42%4.47%0.95%8.28%5.79%1.14%1.87%1.39%0.99%0.40%5.02%4.21%0.44%0.37%

10.36%4.50%5.16%0.70%8.09%0.44%3.37%4.28%4.54%1.46%3.08%5.57%0.88%4.69%1.43%0.84%

A2251144

23197

954163332513211

1109849

2249

32179

41227534133270

13110922

1911422648322511

1058979

23091

12316

1848

8393

11837819112793516

N/A4801334006

7574

3350

1646

420

10320

62252710128

17134

351653620

322651

5332183

3749

24633

61124947

M1438113

32686

70293342036255

915329

1466

32104

410758351419479275172000000

1371151210

2081009216

1009

51405417378612742113

F1293

442911

31198

61648126

354926

1203

10107

07742269

253156479

22415831513827110000

7523493

1213

41777023476612541810

CLASS GENDER

A=Analytic cases diagnosed and/or receiving all or part of the initial course of therapy at the UF Shands Cancer CenterN/A=Non-analytic cases diagnosed and/or receiving all of the first course of therapy elsewhere; cases diagnosed at autopsy.Number of cases excluded=1. This report includes CA in-situ cervix cases, squamous and basal cell skin cases, and intraepithelial neoplasia cases.

Shands at UF Cancer Committee Membership 2010-11Robert Allan, MDAssociate Professor of PathologySuzanne Bird, RD, LD/NFood and Nutrition ServicesShirley Bloodworth, RN, BSN, MNPatient AdvocateColeen Booker, RN, BSNNurse Navigator, GI Oncology CenterLindy BrounleyCommunications Director, Cancer CenterByron P. Croker, MD, PhDAssociate Professor of PathologyKaren Daily, DOAssistant Professor of Hematology OncologyJennifer M. Duff, MDFellow, Hematology OncologyErin McQ. Dunbar, MDAssociate Professor of Neuro-OncologyThomas George, MDAssociate Professor of Hematology Oncology Scott Gilbert, MD Associate Professor of UrologyJon Graham, PhD Deputy Director Clinical Admin, Cancer CtrSuzanne GreerAmerican Cancer SocietyKati Harlan, RN, MSN, LRHMShands Quality ManagementSteven Hochwald, MDAssociate Professor of Surgery, Cancer Com-mittee Chair, Cancer Liaison Physician

Marcia Hodge, CTROncology Data CenterRobert W. Hurley, MD, PhDAssociate Professor of AnesthesiologyFrederic Kaye, MDAssociate Professor of Hematology OncologyJudith Lightsey, MDAssociate Professor of Radiation OncologyMerry-Jennifer Markham, MDAssociate Professior of Hematology OncologyKevin McDonald, PTRehabilitative ServicesLinda S. Morgan, MDProfessor of Obstetrics and Gynecology, On-cology Data Center Medical DirectorPatricia Moser, MDAssociate professor of RadiologyPaul Okunieff, MDMedical Director, Shands Cancer Hospital; Director, Cancer Center; Chair, Radiation OncologyDeidra Pereira, PhDAssociate Professor of Clinical and Health PsychologyNina Powell, LCSWPatient and Family Resources/Patient Ser-vicesAndrew RagsdaleMarketing/PR, Shands HealthcareSteve RitzClinical Administration,Radiation Oncology

Mark Scarborough, MDAssociate Professor of OrthopedicsMichele Scavone-StoneClinical Administration, ACU Adult Hema-tology Oncology and Shands Infusion CenterGale Smith, LCSWPatient and Family Resources/Patient Ser-vicesAndrew Smithson, MBAAssociate VP Operations, Shands HealthcareLee Starling, RHITHealth Information and Record ManagementBruce Stechmiller, MDAssociate Professor of Hematology OncologySukanthini Subbiah, MDFellow, Hematology OncologyJames L. Talbert, MDProfessor Emeritus of SurgeryAnne M. Tallent, CTROncology Data CenterGlenn E. Turner, DDSAssociate Professor of ProsthodonticsHelen Welsh, BSN, RNNursing, Shands HealthcareLaura Wiggins, PharmDPharmacy ServicesJohn R. Wingard, MDDirector, Bone Marrow Transplant Program; Deputy Director for Research, Cancer CenterFong Wong, DDSAssociate Professor of Prosthodontics

Shands at UF Oncology Data Center

PO Box 103633, Gainesville FL 32610Tel: (352) 273-8010 Online: cancer.ufl.edu

The Oncology Data Center is an essential part of the hospital cancer program, functioning within the guidelines of the Ameri-can College of Surgeons Commission on Cancer approvals program. The Oncology Data Center collects data on all cancer cases diagnosed and/or treated at Shands at the University of Florida in Gainesville. In addition to maintaining the hospital’s database, the Oncology Data Center participates in several external oncology-related activities including the National Cancer Database, the American Cancer Society Facility Information Profile System, the Florida Cancer Data System and the Florida Association of Pediatric Tumor Programs.

Requests for data are welcomed and should be directed to: Shands at UF Oncology Data Center, PO Box 100342, Gainesville, FL 32610-0342, (352) 265-0740, or emailed to Anne Tallent at tallea@shands.ufl.edu.