Regional Cancer Report Summary:

Burlington, Camden and Gloucester Counties

Jean F. Mouch, MD, MPH Hilary Dugger Colbert, MPA

Camden County Coordinator Burlington County Coordinator

History of the NJCCCP

In 2002, the Task Force on Cancer Prevention, Early Detection and

Treatment in New Jersey released the New Jersey’s Comprehensive Cancer Control Plan (NJ-CCCP). This plan was put together by work groups made up of a variety of individuals and organizations dedicated to cancer control.

The CDC defines Comprehensive Cancer Control as “an integrated and coordinated approach to reduce the incidence, morbidity and mortality of cancer through prevention, early detection, treatment, rehabilitation and palliation.”

http://www.state.nj.us/health/ccp/ccc_plan.htm

NJCCCP, ACS & NJ CEED Cancer Priority Areas

NJCCCP ACS CEED

1. BREAST Y Y Y

2. CERVICAL Y NO Y

3. COLORECTAL Y Y Y

4. LUNG Y Y NO

5. MELANOMA Y NO NO

6. ORAL/O-P Y NO NO

7. PROSTATE Y Y Y

Cancer Deaths in New Jersey by Race

http://cancercontrolplanet.cancer.gov

Source: http://cancercontrolplanet.cancer.gov

Source: http://cancercontrolplanet.cancer.gov

BurlingtonCounty

CamdenCounty

Gloucester County

Total for Region

Total Cancer Deaths 918 1,140 540 2598

White 782 966 463 2211

Black 126 163 56 345

Age Adjusted Cancer Death Rate per 100,000*

Total 217.9 226.0 217.6 NA

White 213.0 226.4 214.4 NA

Black 278.0 250.8 281.4 NA

Cancer as Cause of Death in 2000 for the Tri-County Region

Actual Number and Age-Adjusted Death Rate per 100,000 Population in New Jersey for Region (including Burlington, Camden and Gloucester Counties) by Race

Source: Community Health Status Profiles and State Profile http://www.state.nj.us/health/chs/county00.pdf#cam *Age adjusted rates are computed per 100,000 based on the 2000 standard population

Rates are per 100,000 age adjusted, Census 2000Source: NJ Cancer Registry, August 2003

Burlington County

Camden County

Gloucester County

New Jersey

Male Female Male Female Male Female Male Female

White 634.5 462.8 616.3 469.0 572.9 489.7 624.2 461.7

Black 765.2 443.3 737.3 397.0 793.8 436.5 697.7 408.1

All Races 644.0 456.9 625.3 456.4 587.4 479.6 623.7 449.4

Hisp-Ethnicity* 562.2 547.3 517.2 364.2 795.5** 615.5** 541.4 359.1

* Hispanics may be of any race; therefore, the categories of race and ethnicity are not mutually exclusive.

** The Gloucester County Hispanic incidence rates are high and need to be studied.

Cancer Incidence Rates for Tri-County Region and NJ

Incidence Rates per 100,000 for All Cancer Sites and All Ages, for 1996-2000in Tri-County Region and New Jersey by Race, Ethnicity, and Gender

Prostate Cancer Lung Cancer Colorectal Cancer

Incidence Rate

Regional / Distant Stage at

diagnosis

Death Rate

Incidence Rate

DeathRate

Incidence Rate

Regional / Distant Stage at

diagnosis

Death Rate

Burlington County

Total Men 193.8 11.9% 35.6 94.6 75.8 76.7 54.3% 31.2

White 175.4 12.2% 33.0 94.3 74.7 76.8 53.7% 30.6

Black 314.8 11.6% 66.3 98.8 95.2 78.7 57.7% 40.2

Hispanic 276.6 a 17.7% * 138.9 b * 94.0 b 88.9% *

Camden County

Total Men 172.0 12.3% 33.6 107.0 87.5 81.1 47.8% 30.5

White 162.1 11.5% 30.9 105.5 86.0 83.3 48.1% 30.8

Black 242.7 14.6% 59.8 123.1 99.9 75.4 48.5% 33.1

Hispanic 206.2 13.5%45.3

a85.3 41.4

78.5 67.6%30.4

a

Gloucester County

Total Men 161.1 13.5% 29.4 117.2 95.3 85.2 47.1% 28.3

White 147.4 13.1% 26.1 117.1 95.3 88.1 46.8% 28.0

Black 290.9 16.0% 70.3 128.0 105.2 60.5 50.0% *

Hispanic 262.4 16.7% * 82.7 * * 33.3% *

Top 3 Cancers for Men in Tri-County Region by Race/Ethnicity Summary of Men’s Cancer Rates: Incidence, Mortality and Staging for the

Three Most Common Cancer Diagnoses in the Tri-County Region (1996-2000)

Top 3 Cancers for Women in Tri-County Region by Race/Ethnicity Summary of Women’s Cancer Rates: Incidence, Mortality and Staging for the

Three Most Common Cancer Diagnoses in the Tri-County Region (1996-2000)

  Breast Cancer Lung Cancer Colorectal Cancer

Incidence Rate

%Regional or Distant Stage at diagnosis

Death Rate

Incidence Rate

DeathRate

Incidence Rate

%Regional or Distant Stage at diagnosis

Death Rate

Burlington County

Total Women 141.7 27.3% 29.3 59.4 45.2 53.9 55.7% 21.4

White 144.9 26.5% 29.6 59.9 45.3 54.9 56.1% 21.7

Black 130.6 33.8% 32.4 62.1 49.4 45.3 47.7% 19.8

Hispanic 137.8 32.3% * 52.6 * 66.9 38.5% *

Camden County

Total Women 128.0 29.3% 34.6 60.1 47.5 59.9 52.2% 19.7

White 131.2 28.4% 34.6 62.0 47.7 59.5 51.9% 20.0

Black 118.5 37.1% 38.3 56.4 52.5 64.2 54.3% 18.5

Hispanic 89.2 28.8%a * 44.7 13.7 71.5 62.8% 13.7

Gloucester County

Total Women 137.1 24.6% 27.0 66.2 48.8 59.7 48.2% 25.6

White 138.1 24.9% 25.2 67.4 50.1 60.3 47.9% 24.6

Black * 25.5% * 60.9 40.2 56.0 55.6% 39.4

Hispanic * 30.8% * * * * 0.0% *

Incidence Rates in Tri-County Region

In most categories, the incidence rates for all 3 counties in the region exceed those of the state of NJ

In some instances, such as cancer incidence in white males in Camden and Gloucester counties, the rate is lower than the state

Higher rates for Hispanics in Gloucester County needs further study

Top Cancers in the Region

Prostate is highest incidence cancer in the region followed by breast cancer in women, lung then colorectal cancer

These 4 cancers represent 55.3% of all new cancer cases for women and 57.4% of all new cancer cases for men

Lung Cancer in New Jersey

Lung and Bronchus cancers kill more people than the top three cancers of Prostate, Breast and Colorectal Cancers

87% of Lung and Bronchus Cancers are attributed to smoking

Over 60% of Lung and Bronchus Cancers are detected in late stages of the disease

In NJ, annual health care expenditures directly caused by tobacco use = $2.6 billion

Further cost savings…

1,000 kids kept from smoking: Decline of $12 million in future health care costs

1,000 adults prompted to quit: Decline of $8 million in further health care costs

Under the age of 18, each year 20,100 young people in NJ begin to smoke

Good News: Since 1999 with the Tobacco Control Program, 42% decrease in smoking among middle school students

Behavioral Risk Factor Surveillance Survey for 2003 at a Tri-County Regional Level with 1.2 Million population

Looks at 5 issues of lifestyle and other behaviors

Gender, race and age group data available at the regional level for adults, >18 years of age:

Fruit and vegetable intake of 5 or more servings daily – 26% BMI Classification of Overweight (obese) – 21% No leisure time physical activity – 26% Not meeting moderate physical activity – 52% Current smoking – 21% Binge drinking within past 30 days – 18%

BRFSS – Cancer Screening Behaviors for 1.2 million population

Tri-County Regional data is available for:

Mammograms within past 2 years (females 40 yrs +) = 70.8%

Pap Smear within past 2 years by age (females 18 yrs +) = 84% Pap Smear within past 3 years by age (females 18 yrs +) = 87.7%

BST within past year or sigmoidoscopy ever for adults 50+ yrs old = 60.1%

The question is raised: “Can we reach the Healthy New Jersey 2010 Targets for Cancer Screening?”e.g. Mammogram in past two years to reach 85% All women >40e.g. Pap Smear within past 2 years to reach 90% All women >18

Survivorship – Living with Cancer

U.S. study on those living with cancer since the SEER-CA-registry began 25 years ago

9.6 million men and women As of January 2000 – 5.3 million women

and 4.2 million men

Estimated # of Persons Alive in U.S. with invasive cancer cases only

http://seer.cancer.gov/faststats/html/inc_all.html

Discussion, Analysis, and Recommendations to form a common Tri-County Regional Approach

For County and Local Priorities

For Statewide Priorities

For Evidence-based Interventions

Recommendations for Tri-County Region and Local Priorities

Concentrate on the top 4 Cancers – Prostate, Breast in women, Lung and Colorectal Cancers

Follow the NJ-CCCP strategies for the Tri-County Region as far as possible

Two principles of implementation: (1) all general awareness, education, and screening

strategies reach out to adults who are >18,

and all health care providers

(2) primary prevention strategies provided for all school age children and youth

…continuing County and Local Priorities

General Awareness and Education for NJCCCP via County Cancer Coalitions; support of ACS activities; provide presentations to major health care provider groups; work with the county health departments on their Community Health Improvement Plans

Research Study on Primary Care Providers and Cancer Prevention, Screening, and Treatment

Continue to strengthen coalition work for Cancer Plan at local levels e.g. directory of providers and other services e.g. support groups

http://www.state.nj.us/health/ccp/index.html

Click on the map to locate cancer resources in a particular county.

Support the choice of Evidenced- based Interventions to address Tri-County Regional cancer problems Prevention of Cancer

(1) Physical Activity / Weight Management(2) Smoking Cessation Programs –adult and youth (3) “Never start smoking” programs for children and youth(4) Fruits and Vegetables

Cancer Screening programs e.g CEED(1) Minority groups - Black, Hispanic, and other minorities e.g. Vietnamese or Korean in largest municipalities in the Counties(2) Poverty areas – focus on the municipalities with >10% poverty rates in the Tri-County Region(3) Use the NCIS medically underserved populations information for programs, media, and outreach strategies

The Three Counties’ Cancer Coalitions focus on common media and events:Multi-media campaigns with South Jersey County Cancer Coalitions that have proven themselves via research tested materials i.e. evidenced based campaignsWebsites for the three Counties and their Cancer Coalitions for greater collaborationCEED be part of an event / education project to promote CEED program with primary care providers

Promote and educate providers for Tri County CEED programs Phone Numbers

Burlington County (609) 267-1950 ext.42881Camden County Toll Free (888) VIRTUA-3 (Virtua

Camden) (856) 968-7308 (Cooper Hospital)

Gloucester County (856) 686-5036

Slogan for Healthy New Jersey 2010

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Resources for creating a county based Cancer Control Plan:

http://cancercontrolplanet.cancer.govNational Cancer Institute

http://www.state.nj.us/health/ccpNJ Office for Cancer Control and Prevention for copy of the NJCCCP

http://seer.cancer.gov/faststats/html/inc_all.htmlUS study on Prevalence of Cancer, 2000Surveillance, Epidemiology and End Results Program covers 26% of the US Population. NJ CA Registry is part of the SEER database.