The American Cancer Society's Principles of Oncology

Prevention to Survivorship

• Publisher: Wiley-Blackwell
• Year: 2017
• ISBN:
  9781119468882
• Edition: 1
• Topic: Medicine
• Subtopic: Oncology

Developed by the American Cancer Society this new textbook designed for a wide range of learners and practitioners is a comprehensive reference covering the diagnosis of cancer, and a range of related issues that are key to a multidisciplinary approach to cancer and critical to cancer control and may be used in conjunction with the book, The American Cancer Society's Oncology in Practice: Clinical Management.
Edited by leading clinicians in the field and a stellar contributor list from the US and Europe, this book is written in an easy to understand style by multidisciplinary teams of medical oncologists, radiation oncologists and other specialists, reflecting day-to-day decision-making and clinical practice. Input from pathologists, surgeons, radiologists, and other specialists is included wherever relevant and comprehensive treatment guidelines are provided by expert contributors where there is no standard recognized treatment. This book is an ideal resource for anyone seeking a deeper understanding of cancer prevention, screening, and follow-up, which are central to the ACS's worldwide mission on cancer control.

Section 1
Cancer Causes, Prevention, and Early Detection

1
Descriptive Epidemiology

Rebecca L. Siegel, Kimberly D. Miller, and Ahmedin Jemal

Surveillance and Health Services Research, American Cancer Society, Atlanta, Georgia, USA

Introduction

Cancer was the eighth leading cause of death in the United States (US) in 1900 [1], but has been the second leading cause of death, after heart disease, during the last half of the twentieth century, accounting for approximately one in every four deaths [2]. Despite its prevalence throughout history, the recording of cancer incidence at the population level has only been available in the US since the mid‐1970s.

Cancer Surveillance in the US

Cancer surveillance is the systematic collection and analysis of data about cancer diagnoses, including information about the patient (e.g., date of birth, sex, race), the tumor (e.g., site of origin, stage, histology), and the initial course of treatment. Cancer registration is useful to the public health in many important ways. These data are used to measure cancer occurrence in the population, including incidence, mortality, survival, and patterns of care; to plan and evaluate cancer control programs; to prioritize the allocation of healthcare resources; and to advance population‐based epidemiologic and health services research. Population‐based cancer statistics can also be used to corroborate medical hypotheses. For example, the rapid rise and fall of endometrial cancer incidence rates that mirrored the rise and fall in the use of unopposed estrogen as menopausal hormone therapy affirmed the association between estrogen and endometrial cancer risk [3,4]. Likewise, the dramatic 7% decline in breast cancer incidence from 2002 to 2003 reflects the abrupt decrease in menopausal hormone use after the Women’s Health Initiative study reported its association with increased breast cancer risk [5,6].

The coverage and quality of cancer surveillance data have improved greatly over time. The current system of cancer registration in the US involves hospital registries, which furnish data for the evaluation of care within the hospital, and population‐based registries, which are usually associated with state health departments or related institutions. Hospital registries also serve as the primary data source for central state registries. The cancer registrar carries the major responsibility for data collection and other day‐to‐day registry operations [7]. As patients are increasingly being diagnosed and treated in outpatient settings, case finding by cancer registrars at central registries has expanded to other medical facilities, including physician offices, pathology laboratories, and freestanding treatment centers.

Registry operations and the quality of the data collected by the registrar are guided by standards established by the Commission on Cancer (CoC) of the American College of Surgeons, the Surveillance, Epidemiology, and End Results (SEER) Program of the National Cancer Institute (NCI), the National Program of Cancer Registries (NPCR) of the Centers for Disease Control and Prevention (CDC), the American Joint Committee on Cancer (AJCC), and the North American Association of Central Cancer Registries (NAACCR).

Surveillance, Epidemiology, and End Results Program

The NCI’s SEER Program was established as a result of the National Cancer Act of 1971, which mandated the collection, analysis, and dissemination of data to aid in the prevention, treatment, and diagnosis of cancer in the US [8]. Case ascertainment began on January 1, 1973. The original catchment area, known as SEER 9, covered 9% of the US population and included registries in five states (Connecticut, Iowa, New Mexico, Utah, and Hawaii) and four metropolitan areas (Detroit, Michigan; San Francisco–Oakland, California; Atlanta, Georgia; and Seattle–Puget Sound, Washington). The SEER 9 data are the only source for long‐term, population‐based cancer incidence and survival trends in the US. The SEER program expanded over time to include 18 registries covering 28% of the population, including 26% of African Americans, 38% of Hispanics, 44% of American Indians and Alaska Natives, 50% of Asians, and 67% of Hawaiian/Pacific Islanders [9]. Since its inception, quality control has been an integral component of the SEER program, which is considered the gold standard for cancer registration around the world. Cancer incidence and survival data from SEER and cancer mortality data from the National Center for Health Statistics are published annually in the SEER Cancer Statistics Review.

National Program of Cancer Registries

In 1992, Congress enacted the Cancer Registries Amendment Act to establish the NPCR at the CDC [10]. At the time this legislation was passed, 10 states had no cancer registry and most states with registries lacked the resources necessary to achieve minimum reporting standards. Toda...