The effect of the introduction of ICD-10 on cancer mortality trends in England and Wales

Size: px
Start display at page:

Download "The effect of the introduction of ICD-10 on cancer mortality trends in England and Wales"

Transcription

1 The effect of the introduction of ICD-10 on cancer mortality trends in Anita Brock, Clare Griffiths and Cleo Rooney, Offi ce for INTRODUCTION From January 2001 deaths in have been coded to the Tenth Revision of the International Classification of Diseases (ICD-10), although cancer incidence data have been coded to ICD-10 since This is the first change in ICD revision used to code mortality data in since 1979, and the most important International change in codes since Although a deliberate broadening of the application of ICD-9 selection rule 3 by OPCS (now ONS) from 1984 to 1992 also had an impact on mortality statistics. 1 Information on the main changes in classification between ICD-9 and ICD-10, and changes to the mortality coding rules (including selection rule 3) have been published by ONS. 1 3 These are summarised in Boxes 1 and 2. Previous work has shown that the main changes that affect the assignment of deaths to malignant and non-malignant neoplasms are: This article examines changes in deaths assigned to malignant and non-malignant neoplasms resulting from the introduction of ICD-10 in. In particular the Government s target of reducing mortality rates from malignant cancers on those aged under 75. The main changes are highlighted and the article explains how data can be adjusted to take account of these changes so that trends in mortality rates over time can be analysed. the new interpretation of selection rule 3, which affects neoplasms Chapter II as a whole and some specific sites; the introduction of new codes for mesothelioma and Kaposi s sarcoma; a new code for malignant neoplasms of independent (primary) multiple sites; the transfer of deaths previously coded to Chapter IV (diseases of the blood and blood-forming organs) in ICD-9 to codes in Chapter II specifically to non-malignant neoplasms in ICD-10; the transfer of deaths between malignant melanoma and other malignant skin cancer; and a gain in deaths coded to malignant neoplasms of lymphoid, haematopoietic and related tissue in ICD-10. 7

2 This article looks specifically at the effect of the introduction of ICD-10 on deaths assigned to malignant neoplasm by site, and to non-malignant neoplasms, in more detail. Neoplasms accounted for a quarter of all deaths in between 1993 and The Government has set a number of health targets, one of which is to reduce malignant cancer death rates in those aged under 75. Monitoring progress towards this target depends on having comparable mortality trend data. Box one Main changes in ICD-10 including selection rule 3 ICD-10 represents the greatest change in the ICD in over 50 years. The main changes are: Box two Bridge coding study: methods To understand trends in cause-specifi c mortality spanning the change from ICD-9 to ICD-10, we need to measure the impact of this change on the number of deaths attributed to different causes of death. This is done using bridge coding, that is coding a sample of death certificates independently to both ICD-9 and ICD-10, and comparing the resulting underlying causes of death. The fi rst step in this process is to identify equivalent codes or code groups in the two revisions which represent the same causes. In most cases this is not contentious, and the same groupings have been used by various authors and national statistics offi ces. The fi rst character of each code is now alphabetic rather than numeric this has enabled the expansion of the number of codes to provide for recently recognised conditions and more detail about common diseases. Some diseases and groups of conditions have been moved between broad groups (ICD Chapters) to reflect current ideas of aetiology and pathology. There have been several changes to the rules governing selection of the underlying cause of death. There are now only 5 rules instead of 9. The changes in the application of rule 3 have the biggest impact. This rule allows a condition which is reported in either Part I or II of the death certifi cate to take precedence over the condition selected using the other coding rules if the latter is obviously a direct consequence of that condition. In ICD-10 the list of conditions affected by rule 3 is more clearly defined than in ICD-9 and is also broader in scope. This internationally agreed interpretation is used in the automated coding software produced by the National Centre for Health Statistics (NCHS) in the USA, used in, Scotland and an increasing number of other countries. The impact of this is to reduce the number of deaths assigned to conditions such as pneumonia and to increase the number of deaths assigned to chronic debilitating diseases. In England and Wales, about 20 per cent of deaths mention pneumonia so the effect of this rule change is large. The results are then presented as comparability ratios of the numbers of deaths assigned to a given disease or group of diseases in the two revisions. These are simply the ratio of the number of deaths coded to a cause in ICD-10 to the number coded to the equivalent cause in ICD-9. They measure the net effect of all changes to a particular cause of death, so if the comparability ratio equals 1 this means there is no net effect. A comparability ratio of more than 1 means a net gain has occurred, and less than 1 means a net loss. Confi dence intervals have also been produced for these ratios; the method used to do this has been described elsewhere. 2 These comparability ratios can then be used to adjust comparisons of cause-specifi c mortality rates. In, all deaths registered in 1999 were bridge coded and comparability ratios with confi dence intervals were produced. 2 They should not be used before 1993, as ONS used a different interpretation of the rules to select the underlying cause of death from the international interpretation from 1984 to For a particular cause, the number of deaths coded to the equivalent cause in ICD-9 in the years being compared should be multiplied by the comparability ratio in order to give an expected number of deaths which would have been coded to this cause in ICD-10. The ratio can also be applied directly to rates, to give an expected rate. Age-specifi c ratios have been produced for three broad age groups under 75, and 85 and over. These are only presented in this article where there is a signifi cant difference in the comparability ratios by age. Table 1 Comparability ratios for selected causes of death by broad age band and sex, 1999 Age group Females Under and over All ages ICD-10 code ICD-9 code Name 10/9 ratio 10/9 ratio 10/9 ratio 10/9 ratio C00 D Neoplasms * * * * C00 C Malignant neoplasms * * * * C Breast cancer * * * C81 C Cancer of lymphoid, haematopoietic and related tissue * * * * D00 D Non-malignant neoplasms * * * * Males Under and over All ages ICD-10 code ICD-9 code Name 10/9 ratio 10/9 ratio 10/9 ratio 10/9 ratio C00 D Neoplasms * * * * C00 C Malignant neoplasms * * * * C Cancer of larynx * * * C Prostate cancer * * * C81 C Cancer of lymphoid, haematopoietic and related tissue * * * * D00 D Non-malignant neoplasms * * * * 8

3 RESULTS All neoplasms Overall mortality from neoplasms (Chapter II of the ICD) increased by 3.3 per cent (almost 4,500 additional deaths) when ICD-10 was used to code cause of death instead of ICD-9. This increase varies by age, with rates in older age groups generally being affected more than those at ages under 75. Table 1 shows the comparability ratios by age group for the main neoplasms for which an age-specific pattern was evident. Three-quarters of these additional deaths had previously been coded to Chapter VIII diseases of the respiratory system and a fifth coded to Chapter IV diseases of the blood and blood-forming organs. The vast majority of deaths previously coded to respiratory diseases were pneumonia deaths that are affected by the new interpretation of rule 3. These deaths were dispersed throughout the neoplasm chapter. Almost all of the deaths previously coded to the blood diseases chapter, however, came from one specific code ICD other diseases of blood and blood-forming organs. These were all coded to non-malignant neoplasms in ICD-10. Although over 99 per cent of deaths coded to neoplasms in ICD-9 were also coded to neoplasms in ICD-10, there was a small percentage that were coded to other causes. Table 2 Malignant neoplasms a) Number of deaths coded as due to malignant neoplasms in ICD-10 (C00 C97), and their underlying cause of death chapter in ICD-9, 1999 ICD-9 code Number of deaths % of total deaths Malignant neoplasms , Respiratory diseases , Non malignant neoplasms Circulatory diseases Other causes All malignant neoplasm deaths in ICD , b) Number of deaths coded as due to malignant neoplasms in ICD-9 ( ), and their underlying cause of death chapter in ICD-10, 1999 ICD-10 code Number of deaths % of total deaths Malignant neoplasms C00 C97 133, Non malignant neoplasms D00 D Respiratory diseases J00 J Circulatory diseases I00 I Other causes All malignant neoplasm deaths in ICD-9 133, Comparability ratio 1.023* Table 3 Non-malignant neoplasms a) Number of deaths coded as due to non-malignant neoplasms in ICD-10 (D00 D48), by their underlying cause of death chapter in ICD-9, 1999 ICD-9 code Number of deaths % of total deaths Non-malignant neoplasms , Diseases of the blood and blood-forming organs Respiratory diseases Malignant neoplasms Other causes All non-malignant neoplams deaths in ICD-10 3, b) Number of deaths coded as due to non malignant neoplasms in ICD-9 ( ), by their underlying cause of death chapter in ICD-10, 1999 ICD-10 code Number of deaths % of total deaths Non-malignant neoplasms D00 D48 1, Malignant neoplasms C00 C Congenital malformations Q00 Q Other causes All non-malignant neoplasm deaths in ICD-9 2, Comparability ratio 1.675* 9

4 Deaths coded to malignant neoplasms increased by 2.3 per cent in ICD- 10. Table 2 shows the number of deaths coded to malignant neoplasms in both ICD-9 and ICD-10. The effect of the new interpretation of rule 3 can be seen in the number of deaths that were previously coded to respiratory diseases in ICD-9 almost 3,000 (2.2 per cent of total malignant neoplasm deaths) in ICD-10. Nearly 200 deaths previously coded to other and unspecified classifications within non-malignant neoplasms, were subsequently coded to site unspecified malignant neoplasm codes in ICD-10. When these data were examined by age the new interpretation of rule 3 was seen to increase with age as the number of deaths previously coded to respiratory diseases (specifically pneumonia) was much higher in older ages. However, the proportion of deaths previously coded to non-malignant neoplasms decreased with age. Although over 99 per cent of deaths coded to malignant neoplasms in ICD-9 were also coded to malignant neoplasms in ICD-10, there was a small percentage that were coded to other causes (Table 2b). The number of deaths coded to non-malignant neoplasms increased by 68 per cent in ICD-10. Most of the extra deaths coded to nonmalignant neoplasms in ICD-10 came from ICD other diseases of the blood and blood-forming organs and were coded to D46 myelodysplastic syndromes (81 per cent) and D47.1 chronic myeloproliferative disease (17 per cent) in ICD-10 (Table 3a). These diseases, in which production of selected blood cell lines increases out of control, have been moved to Chapter II neoplasms to reflect their classification as blood cell neoplasms, rather than merely disorders of bone marrow. Of the deaths previously coded to malignant neoplasms a third were coded to 191 brain cancer in ICD-9. These were coded to neoplasm of uncertain behaviour of brain in ICD-10. Intracranial neoplasms can lead to death through their effects on the surrounding brain without showing any of the characteristic features of malignant tumours (invasion into other tissues, spread to lymph nodes and metastasis to distant sites). The ICD-10 classification reflects their benign morphology. As with malignant neoplasms, the effect of the new interpretation of rule 3 can also be seen and was found to be agespecific. Nearly 89 per cent of deaths coded to non-malignant neoplasms in ICD-9 were also coded to these sites in ICD-10. However, 9 per cent of deaths coded to these sites in ICD-9 were coded to malignant neoplasms in ICD-10. These deaths were associated with a broad range of cancer sites in ICD-10, with a fifth being coded to C80 malignant neoplasm without specification of site and just under a fifth to C71 malignant neoplasm of brain. Cancers by site The three most common malignant neoplasm mortality sites are breast (18 per cent of all cancers between 1993 and 2002), lung (17 per cent) and colorectal (11 per cent) in females, and lung (27 per cent), prostate (12 per cent) and colorectal (11 per cent) in males. Female breast, prostate and colorectal cancer all gained deaths in ICD-10 whereas the number of lung cancer deaths fell. The cancer sites with better survival tended to be affected by the new interpretation of rule 3 more than cancer sites with low survival. In these cases a cancer, for which the patient was treated many years before death, may be recorded in Part II of the death certificate, but be selected in preference to pneumonia recorded in Part I. Female breast cancer (C50) There was a 2.7 per cent increase in the number of deaths with an underlying cause of female breast cancer in ICD-10. Most of the increase in deaths coded to breast cancer in ICD-10 came from deaths which were previously coded as pneumonia, as a result of the new interpretation of rule 3 (Table 4a). There were also a small number of deaths coded as female breast cancer in ICD-9 which were not coded to this site in ICD-10 (Table 4b). These were mostly transferred to C97 cancer of multiple primary independent sites or to other cancer sites (mainly C80 unspecified site). This may also reflect high survival rates and advanced age at death, with patients living long enough to develop second independent cancers before they die. When these data were examined by age (see Table 1) it could be seen that this effect was age-specific, with the ratios increasing with age. Table 4 Female breast cancer a) Number of deaths coded as due to female breast cancer in ICD-10 (C50), by their underlying cause of death in ICD-9, 1999 ICD-9 code Number of deaths % of total deaths Female breast cancer , Bronchopneumonia and pneumonia, organism unspecified Other malignant neoplasms x Other causes All female breast cancer deaths in ICD-10 11, b) Number of deaths coded as due to female breast cancer in ICD-9 (174), by their underlying cause of death in ICD-10, 1999 ICD-10 code Number of deaths % of total deaths Female breast cancer C50 11, Malignant neoplasm of multiple independent primary site C Other malignant neoplasms C00 D96 xc Non-malignant neoplasms D00 D Other causes All female breast cancer deaths in ICD-9 11, Comparability ratio 1.027* 10

5 Prostate cancer (C61) There was a 3.8 per cent increase in the number of deaths with an underlying cause of prostate cancer as a result of changing to ICD-10. Most of the increase in deaths coded to prostate cancer in ICD-10 came from deaths previously coded as pneumonia (Table 5a). As prostate cancer has a relatively high survival rate this is mainly an effect of the new interpretation of rule 3. There were also a small number of deaths which were coded as prostate cancer in ICD-9 which were not coded to this site in ICD-10 (Table 5b). As with female breast cancer, most of these were transferred to C97 cancer of multiple independent primary sites or to other cancer sites (mainly C80 unspecified site). The incidence of prostate cancer rises very steeply with age, and large proportions of older men may die with prostate cancer. This may include many who die from another cancer in a different organ system. When these data were examined by age (see Table 1) it could be seen that this effect was age-specific, with the ratios increasing with age. Lung cancer (C33 C34) There was a decrease of 0.4 per cent in the numbers of deaths with an underlying cause of lung cancer in ICD-10. This decrease is mainly a consequence of deaths previously coded as cancer of lung in ICD-9 being coded as C97 cancer of multiple independent primary site as Table 5 Prostate cancer a) Number of deaths coded as due to prostate cancer in ICD-10 (C61), by their underlying cause of death in ICD-9, 1999 ICD-9 code Number of deaths % of total deaths Prostate cancer 185 8, Bronchopneumonia and pneumonia, organism unspecified Other malignant neoplasms x Other causes All prostate cancer deaths in ICD-10 8, b) Number of deaths coded as due to prostate cancer in ICD-9 (185), by their underlying cause of death in ICD-10, 1999 ICD-10 code Number of deaths % of total deaths Prostate cancer C61 8, Malignant neoplasm of multiple independent primary site C Other malignant neoplasms C00 C96, xc Non-malignant neoplasms D00 D Other causes All prostate cancer deaths in ICD-9 8, Comparability ratio 1.038* Table 6 Lung cancer a) Number of deaths coded as due to lung cancer in ICD-10 (C33-C34), by their underlying cause of death in ICD-9, 1999 ICD-9 code Number of deaths % of total deaths Lung cancer , Bronchopneumonia and pneumonia, organism unspecified Other causes All lung cancer deaths in ICD-10 29, b) Number of deaths coded as due to lung cancer in ICD-9 (162), by their underlying cause of death in ICD-10, 1999 ICD-10 code Number of deaths % of total deaths Lung cancer C33 C34 28, Other malignant neoplasms C00 C96 xc33 C Malignant neoplasm of multiple independent primary site C Mesothelioma C Non-malignant neoplasms D00 D Other causes All lung cancer deaths in ICD-9 29, Comparability ratio 0.996* 11

6 a new code C45 mesothelioma or as other cancer sites (mainly C80 unspecified site) (Table 6b). Only a small proportion of deaths coded as lung cancer in ICD-10 came from deaths coded as pneumonia in ICD-9 (Table 6a). This reflects high fatality, with only 20 per cent of lung cancer patients surviving a year 4 and most dying directly from the cancer. No significant pattern by age was found. Deaths coded to C80 unspecified site are mainly cases for which the certifier stated that the primary site was unknown. However, it also includes certificates with more than one tumour site mentioned, with no indication whether one is primary and the other secondary, or with site(s) described as metastatic without specifying whether to or from the stated site(s). Colorectal cancer (C18 C21) A previous analysis 3 examined colon and rectum separately and found that colon cancer (C18) increased by 1.6 per cent and rectal cancer (C19 C21) increased by 1.2 per cent in ICD-10. As the two sites are very close to each other and invasive neoplasms often spread from one site to the other they have been analysed together as colorectal cancer (C18 C21) in this article. There was a 1.5 per cent increase in the number of deaths coded as colorectal cancer as a whole in ICD-10. The increase in the number of deaths coded as colon, rectal and colorectal cancer in ICD-10 came from deaths that were previously coded as pneumonia (Table 7a). As with the other sites examined above there were also a small number of deaths which were coded as colon or rectal cancer in ICD-9 which were not coded as these sites in ICD-10 (Table 7b). Most of these were coded as C97 cancer of multiple independent primary site or to other cancer sites (mainly C26 other and ill-defined digestive organs and C80 unspecified site). There was some interchange as deaths previously coded to colon cancer in ICD-9 were coded to rectal cancer in ICD-10 but not vice versa. This is mainly due to changes in indexing of vaguely specified or overlapping sites. No significant pattern in comparability ratios was found by age. Mesothelioma (C45) A specific code for mesothelioma was introduced in ICD-10. In ICD- 9, mesothelioma was coded to the exact organ site, if specified, for mortality. Cancer registries, using the International Classification of Table 7 Colorectal cancer Number of deaths a) Number of deaths coded as due to colorectal cancer in ICD-10 (C18 21), by their underlying cause of death in ICD-9, 1999 ICD-9 code Colon Rectal Colorectal Colon, rectal or colorectal cancer ,709 4,600 14,324 Bronchopneumonia and pneumonia, organism unspecified Other causes All colorectal cancer deaths in ICD-10 10,038 4,740 14,778 Number of deaths b) Number of deaths coded as due to colorectal cancer in ICD-9 ( ), by their underlying cause of death in ICD-10, 1999 ICD-10 code Colon Rectal Colorectal Colon, rectal or colorectal cancer C18 C21 9,709 4,600 14,324 Malignant neoplasm of multiple independent primary site C Other causes All colorectal cancer deaths in ICD-9 9,880 4,684 14,564 Comparability ratio 1.016* 1.012* 1.015* Table 8 Number of deaths coded as due to mesothelioma in ICD-10 (C45), by their underlying cause of death in ICD-9, 1999 ICD-9 code Number of deaths % of total deaths Cancer without specification of site Cancer of pleura Lung cancer Cancer of peritoneum Other malignant neoplasms Other causes All mesothelioma deaths in ICD-10 1,

7 Diseases for Oncology, were able to code incident cases of mesothelioma to specific codes for morphology and site. The sites most often affected are the pleura (the lining of the chest cavity and lungs) and the peritoneum (the lining of the abdominal cavity and organs). However, certifiers often did not specify the site, or specify that the mesothelioma involved the lung. Mesothelioma is largely due to inhaling asbestos fibres but the cancer does not appear until approximately 10 to 40 years after first inhalation. The number of mesothelioma deaths is rising steeply, reflecting historical patterns of occupational exposure. 5 Most of the deaths coded as C45 in ICD-10 during 1999 (see Box 2) occurred in men, two thirds of which occurred in those aged under 75. Table 8 shows the number of deaths coded as mesothelioma in ICD-10 according to where these deaths were coded in ICD-9. Over half of the deaths were coded as ICD cancer of unspecified site and a third were coded as ICD cancer of the pleura. Not all of the deaths coded to these sites in ICD-9 were coded to mesothelioma in ICD-10, however. Kaposi s sarcoma (C46) There were seven deaths in 1999 which mentioned Kaposi s sarcoma (C46 in ICD-10) on the death certificate. Only one of these deaths also mentioned HIV and this was coded as the underlying cause for this death in both ICD-9 and ICD-10 which accords with ICD rules. The remainder had code other malignant neoplasm of skin as the underlying cause of death in ICD-9 and Kaposi s sarcoma as the underlying cause of death in ICD-10. Kaposi s sarcoma is associated with HIV infection in young men but a rarer form of the disease (not associated with HIV) affects older adult men. Previous research has shown that doctors sometimes omit mention of HIV/AIDS and AIDSrelated illnesses on death certificates, because of the stigma involved. 6 The numbers of deaths from Kaposi s sarcoma reported here are almost certainly an underestimate of its true contribution to mortality in Statistics on AIDS-related illness reported to the Communicable Disease Surveillance Centre (CDSC) are more complete. 8 Multiple independent primary tumours (C97) A new code (C97) was introduced in ICD-10 to code deaths that are certified as due to two or more cancers. In ICD-9, if there was no indication of which cancer was primarily responsible for the death on the death certificate the first site mentioned was selected as the underlying cause, unless it was a site at which metastases commonly occurred, and the other was not. 9 In ICD-10, selection of the primary site is not determined by order of entry on to the death certificate. So, when two primary sites from different organ systems are listed in Part I of the death certificate, and it is not clear which was responsible for the death, the underlying cause is coded to C97. Table 9 shows numbers of deaths coded as C97 in ICD-10 by their underlying cause of death codes in ICD- 9. These deaths were coded to a variety of cancer sites in ICD-9 and five per cent were previously coded to pneumonia. When these deaths were analysed by cancer site mentioned on the death certificate, nearly 60 per cent of deaths had 3 or more independent primary sites mentioned, and 12 per cent had 4 or more. Of deaths with two independent primary sites mentioned (410 deaths) the most common combinations were prostate and bladder (11 per cent of deaths with two independent primary sites mentioned), colon and prostate (3 per cent) and breast and colon (2 per cent). Of deaths with three independent primary sites mentioned (453 deaths), the most common were always two cancer sites in combination with code C80 cancer without specification of site. The most common pairs of cancer sites appearing with code C80 were prostate and bladder (7 per cent of deaths with three independent primary sites mentioned), lung and prostate, and lung and breast (4 per cent each), colon and prostate, and colon and breast, and breast and ovary (3 per cent each). Malignant melanoma (C43) and other malignant neoplasm of skin (C44) There was a decrease of 3.9 per cent in the number of deaths coded as malignant melanoma when ICD-10 was used instead of ICD-9. The decrease mainly occurs because deaths previously coded as malignant melanoma in ICD-9 were coded instead as C44 other malignant neoplasm of skin to new code C97 neoplasm of multiple independent primary sites or to other cancer sites in ICD-10 (Table 10b). Only a small proportion of the deaths coded as malignant melanoma in ICD-10 were coded to pneumonia in ICD-9 (Table 10a). The number was not sufficient to counterbalance the number coded to other conditions. Table 9 Number of deaths coded to multiple independent primary site tumour in ICD-10 (C97), by their underlying cause of death in ICD-9, 1999 ICD-9 code Number of deaths % of all deaths coded to C97 Female breast cancer Prostate cancer Bladder cancer Lung cancer Colon cancer Bronchopneumonia and pneumonia, organism unspecified Non-Hodgkin s lymphoma Ovarian cancer Stomach cancer Kidney cancer Rectal cancer Leukaemia Cancer of connective tissue Cancer of ill-defined sites within digestive organs Malignant melanoma Oesophageal cancer Tongue cancer Other malignant neoplasm sites Other causes All deaths coded to multiple independent primary tumour in ICD

8 Table 10 Malignant melanoma a) Number of deaths coded as due to malignant melanoma in ICD-10 (C43), by their underlying cause of death in ICD-9, 1999 ICD-9 code Number of deaths % of total deaths Malignant melanoma 172 1, Bronchopneumonia and pneumonia, organism unspecified Other malignant neoplasms x Other causes All malignant melanoma deaths in ICD-10 1, b) Number of deaths coded as due to malignant melanoma in ICD-9 (172), by their underlying cause of death in ICD-10, 1999 ICD-10 code Number of deaths % of total deaths Malignant melanoma C43 1, Other malignant neoplasm of skin C Malignant neoplasm of multiple independent primary sites C Other malignant neoplasms Other causes All malignant melanoma deaths in ICD-9 1, Comparability ratio 0.961* Table 11 Other malignant neoplasm of skin a) Number of deaths coded as due to other malignant neoplasm of skin in ICD-10 (C44), by their underlying cause of death in ICD-9, 1999 ICD-9 code Number of deaths % of total deaths Other malignant neoplasm of skin Bronchopneumonia and pneumonia, organism unspecified Malignant melanoma Other malignant neoplasms Other causes All other malignant neoplasm of skin deaths in ICD b) Number of deaths coded as due to other malignant neoplasm of skin in ICD-9 (174), by their underlying cause of death in ICD-10, 1999 ICD-10 code Number of deaths % of total deaths Other malignant neoplasm of skin C Cancer of other and ill-defined sites C Cancer without specification of site C Kaposi s sarcoma C Cancer of multiple independent primary sites C Other malignant neoplasms Other causes All other malignant neoplasm of skin deaths in ICD Comparabilty ratio 1.097* 14

9 The number of deaths coded to other malignant neoplasm of skin increased by 9.7 per cent. Most of the increase in deaths coded to other malignant neoplasm of skin in ICD-10 came from deaths that were previously coded to pneumonia and to malignant melanoma in ICD-9 (Table 11a). There were also a significant number of deaths which were coded to other malignant neoplasm of skin in ICD-9 which were not coded to this site in ICD-10 (Table 11b). Most of these were coded to other and ill-defined sites or cancer without specification of site, but some deaths were assigned to Kaposi s sarcoma. No significant pattern by age was seen for either malignant melanoma or other malignant neoplasm of skin. Cancer of lymphoid, haematopoietic and related tissue (C81 C96) There was a 5.1 per cent increase in deaths coded to these conditions in ICD-10. Most of the increase in deaths coded to cancer of lymphoid, haematopoietic and related tissue in ICD-10 came from deaths previously coded as pneumonia, but also because deaths from Waldenstrom s macroglobulinaemia, a disease previously classified in Chapter III endocrine, nutritional and metabolic diseases in ICD-9, were coded to the neoplasms chapter in ICD-10 (Table 12a). This reflects a change in the index assignment for macroglobulinaemia from ICD to ICD-10 C88.0. There was also a small number of deaths which were coded to these diseases in ICD-9 which were coded elsewhere in ICD-10 (Table 12b). Most of these were moved to C97 cancer of multiple independent primary sites, but there was also movement from leukaemia in ICD- 9 ( ) to myelodysplastic syndromes in ICD-10 (D46) which is classified under non-malignant neoplasms. When these data were examined by age (see Table 1) it could be seen that this effect was agespecific, with the ratios increasing with age. Within this disease group, deaths from leukaemia and multiple myeloma were most affected. The numbers of deaths coded to both diseases increased by over 5 per cent in ICD-10. Most of these deaths were coded as pneumonia in ICD-9, but all of the deaths previously coded as hairy cell leukaemia (ICD excluded from the leukaemia group) and some deaths from other lymphomas (ICD ) were coded to leukaemia in ICD-10, whilst all of the deaths previously coded to neoplasms of plasma cells (ICD plasma cell neoplasm of uncertain behaviour) were coded to multiple myeloma. GOVERNMENT TARGET ON MORTALITY FROM CANCER The Government set a target in its Our Healthier Nation strategy to reduce mortality rates from malignant cancer among those aged under 75 by at least two-fifths by 2010 (compared with the rate for ). 10 In any assessment of progress against the Government s target for these diseases, adjustment is needed to the baseline figure to account for the change in ICD revision. The comparability ratios for people aged under 75 are for males and for females. Although the impact on the rate is small, it is important to examine trends against the corrected baseline. Table13 shows the age-standardised mortality rate by sex for the 20 most common malignant neoplasm sites adjusted, where necessary, to be comparable with ICD-10, from 1993 to Rates have been directly age-standardised to the European Standard population. Table 12 Cancer of lymphoid, haematopoietic and related tissue a) Number of deaths coded as due to malignant neoplasm of lymphoid, haematopoietic and related tissue in ICD-10 (C81 C96), by their underlying cause of death in ICD-9, 1999 ICD-9 code Number of deaths % of total deaths Cancer of lymphoid, haematopoietic and related tissue , Bronchopneumonia and pneumonia, organism unspecified Endocrine, nutritional and metabolic diseases Other malignant neoplasms Non-malignant neoplasms Other causes All cancer of lymphoid, haematopoietic and related tissue deaths in ICD-10 10, b) Number of deaths coded as due to malignant neoplasm of lymphoid, haematopoietic and related tissue in ICD-9 ( ), by their underlying cause of death in ICD-10, 1999 ICD-10 code Number of deaths % of total deaths Cancer of lymphoid, haematopoietic and related tissue C81 C96 9, Malignant neoplasm of multiple independent primary site C Myelodysplastic syndrome D Other non-malignant neoplasm D00 D48 xd Other malignant neoplasms Other causes All cancer of lymphoid, haematopoietic and related tissue deaths in ICD-9 10, Comparability ratio 1.051* 15

10 Table 13 Age-standardised mortality rates by most common cancer death site, adjusted for change in ICD, ICD codes Age-standardised rate per 100,000 to the European standard population (adjusted where comparability ratio is significant) Rank Rank Site ICD-10 ICD All ages as of as of comparability ratio Males 1 1 Lung C33 C * 2 2 Prostate C * 3 3 Colorectal C18 C * 4 5 Oesophagus C * 5 4 Stomach C * 6 7 Pancreas C Bladder C Non-Hodgkins lymphoma C82 C85 200, Leukaemia C91 C * Kidney, except renal pelvis C Brain C n/a Mesothelioma C45 n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a Liver and intrahepatic bile ducts C Multiple myeloma C * Lip and mouth C00 C Other digestive C * Malignant melanoma C * Larynx C * 19 n/a Multiple independent primary sites C97 n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a Connective and other soft tissue C47, C Non-malignant neoplasms D00 D * Malignant neoplasms C00 C * Neoplasms C00 D * Females 1 1 Breast C * 2 2 Lung C33 C * 3 3 Colorectal C18 C * 4 4 Ovary C Pancreas C Oesophagus C Stomach C Non-Hodgkins lymphoma C82 C85 200, Leukaemia C91 C * Bladder C * Uterus C54 C55 179, * Brain C Multiple myeloma C * Other digestive C * Kidney, except renal pelvis C Cervix uteri C Liver and intrahepatic bile ducts C * Malignant melanoma C * Lip and mouth C00 C * Other female genital C51 C52, C Non-malignant neoplasms D00 D * Malignant neoplasms C00 C * Neoplasms C00 D * 16

11 DISCUSSION This article has presented detailed information on the impact of introducing ICD-10 on the analysis of trends in mortality from cancer as a whole and of specific sites. This is particularly important as deaths from neoplasms account for a quarter of all deaths in annually. The main findings of the analysis were that the number of deaths assigned to all malignant neoplasms increased by over 2.3 per cent as a result of the introduction of ICD-10 and the number of deaths assigned to non-malignant neoplasms increased by 68 per cent. Most of the increase for all malignant neoplams came from deaths previously coded to pneumonia, which is as an effect of the new interpretation of rule 3 on selection of the underlying cause of death. The increases were greater in deaths at higher ages. Most of the increased numbers of deaths assigned to non-malignant neoplasms came from deaths previously coded as diseases of the blood and blood-forming organs (mainly from ICD ). Not all malignant cancer sites had increased numbers of deaths coded to them in ICD-10. The numbers of deaths from cancer of the lung, brain, liver, lip and mouth, and melanoma of skin in men, and lung, ovary, pancreas, cervix, liver, lip and mouth, and melanoma of skin in women, all decreased in ICD-10. In ICD-10, there is a statistically significant increase in the number of deaths assigned to malignant cancer in those aged under 75 of around 1 per cent. In any assessment of progress against the Government s target for these diseases, adjustment is needed to the baseline figure to ensure comparability. When monitoring the impact of specific interventions, it is important to take account of the impact of ICD-10 on each cancer. REFERENCES 1. Rooney C and Devis T (1996) Mortality trends by cause of death in : the impact of introducing automated cause coding and related changes in Population Trends 86, Rooney C, Griffiths C and Cook L (2002) The implementation of ICD-10 for cause of death coding some preliminary results from the bridge coding study. Health Statistics Quarterly 13, Office for (2002) Report: Results of the ICD-10 bridge coding study, Health Statistics Quarterly 14, Quinn M, Babb P, Brock A, Kirby L and Jones J (2001) Cancer Trends in , TSO: London. 5. Health and Safety Executive (2003) Mesothelioma mortality in Great Britain: estimating the future burden, HSE Books: Suffolk. 6. McCormick A (1994) The impact of human immunodeficiency virus on the population of. Population Trends 76, Brock A, Griffiths C (2003) Trends in the mortality of young adults aged in, 1961 to Health Statistics Quarterly 19, Communicable Disease Surveillance Centre (2002) HIV and AIDS in the UK in An update: November 2002, CDSC: London. 9. World Health Organization (1977) Manual of the International Statistical Classification of Diseases, Injuries and Causes of Death. Volume 1, Pg , WHO: Geneva. 10. Department of Health (1999) White Paper, Saving Lives: Our Healthier Nation, TSO: London. Key fi ndings There was an overall increase of 3.3 per cent (4,500 deaths) in deaths assigned to neoplasms as a result of ICD-10 replacing ICD-9. The number of deaths assigned to malignant neoplasms increased by 2.3 per cent (3,000 deaths), mostly as a result of the new interpretation of selection rule 3 to deaths previously coded as due to pneumonia. However, the number of deaths assigned to non-malignant neoplasms increased by 68 per cent (1,400 deaths). Most of this increase came from deaths previously assigned to other diseases of the blood and blood-forming organs ICD In those aged under 75, the number of deaths assigned to malignant neoplasms increased by per cent for males and per cent for females as a result of introducing ICD

Chapter I Overview Chapter Contents

Chapter I Overview Chapter Contents Chapter I Overview Chapter Contents Table Number Contents I-1 Estimated New Cancer Cases and Deaths for 2005 I-2 53-Year Trends in US Cancer Death Rates I-3 Summary of Changes in Cancer Incidence and Mortality

More information

Number. Source: Vital Records, M CDPH

Number. Source: Vital Records, M CDPH Epidemiology of Cancer in Department of Public Health Revised April 212 Introduction The general public is very concerned about cancer in the community. Many residents believe that cancer rates are high

More information

Cancer in Ireland 2013: Annual report of the National Cancer Registry

Cancer in Ireland 2013: Annual report of the National Cancer Registry Cancer in 2013: Annual report of the National Cancer Registry ABBREVIATIONS Acronyms 95% CI 95% confidence interval APC Annual percentage change ASR Age standardised rate (European standard population)

More information

Singapore Cancer Registry Annual Registry Report Trends in Cancer Incidence in Singapore 2009 2013. National Registry of Diseases Office (NRDO)

Singapore Cancer Registry Annual Registry Report Trends in Cancer Incidence in Singapore 2009 2013. National Registry of Diseases Office (NRDO) Singapore Cancer Registry Annual Registry Report Trends in Cancer Incidence in Singapore 2009 2013 National Registry of Diseases Office (NRDO) Released November 3, 2014 Acknowledgement This report was

More information

Table 2.2. Cohort studies of consumption of alcoholic beverages and cancer in special populations

Table 2.2. Cohort studies of consumption of alcoholic beverages and cancer in special populations North America Canada Canadian 1951 Schmidt & Popham (1981) 1951 70 9 889 alcoholic men, aged 15 years, admitted to the clinical service of the Addiction Research Foundation of Ontario between Death records

More information

Description Code Recommendation Description Code. All natural death 001-799 IPH All natural death A00-R99

Description Code Recommendation Description Code. All natural death 001-799 IPH All natural death A00-R99 Natural death Description Code Recommendation Description Code All natural death 001-799 IPH All natural death A00-R99 Infectious and parasitic diseases 001-139 CDC, EUROSTAT, CBS & VG Infectious and parasitic

More information

Cancer in Cumbria Jennifer Clay Public Health Intelligence Analyst November 2008 www.cumbria.nhs.uk

Cancer in Cumbria Jennifer Clay Public Health Intelligence Analyst November 2008 www.cumbria.nhs.uk Cancer in Cumbria Jennifer Clay Public Health Intelligence Analyst November 2008 www.cumbria.nhs.uk 2 Table of contents: Summary... 4 Introduction..6 Cancer Incidence 7 Cancer Mortality....13 Cancer Survival

More information

Cancer in Wales. People living longer increases the number of new cancer cases

Cancer in Wales. People living longer increases the number of new cancer cases Welsh Cancer Intelligence and Surveillance Unit, Health Intelligence Division, Public Health Wales Iechyd Cyhoeddus Cymru Public Health Wales Am y fersiwn Gymraeg ewch i Cancer in Wales A summary report

More information

Hospital-Based Tumor Registry. Srinagarind Hospital, Khon Kaen University

Hospital-Based Tumor Registry. Srinagarind Hospital, Khon Kaen University Hospital-Based Tumor Registry Srinagarind Hospital, Khon Kaen University Statistical Report 2012 Cancer Unit, Faculty of Medicine Khon Kaen University Khon Kaen, Thailand Tel & Fax:+66(43)-202485 E-mail:

More information

C a nc e r C e nter. Annual Registry Report

C a nc e r C e nter. Annual Registry Report C a nc e r C e nter Annual Registry Report 214 214 Cancer Registry Report Larraine A. Tooker, CTR Please note that the 214 Cancer Registry Annual Report is created in 214, but it reflects data on cases

More information

Cancer in Northeastern Pennsylvania: Incidence and Mortality of Common Cancers

Cancer in Northeastern Pennsylvania: Incidence and Mortality of Common Cancers Cancer in Northeastern Pennsylvania: Incidence and Mortality of Common Cancers Samuel M. Lesko, MD, MPH Medical Director Karen Ryczak, RN Surveillance Coordinator November 2015 334 Jefferson Avenue, Scranton,

More information

The Ontario Cancer Registry moves to the 21 st Century

The Ontario Cancer Registry moves to the 21 st Century The Ontario Cancer Registry moves to the 21 st Century Rebuilding the OCR Public Health Ontario Grand Rounds Oct. 14, 2014 Diane Nishri, MSc Mary Jane King, MPH, CTR Outline 1. What is the Ontario Cancer

More information

DELRAY MEDICAL CENTER. Cancer Program Annual Report

DELRAY MEDICAL CENTER. Cancer Program Annual Report DELRAY MEDICAL CENTER Cancer Program Annual Report Cancer Statistical Data From 2010 TABLE OF CONTENTS Chairman s Report....3 Tumor Registry Statistical Report Summary...4-11 Lung Study.12-17 Definitions

More information

A research briefing paper by Macmillan Cancer Support

A research briefing paper by Macmillan Cancer Support A research briefing paper by Macmillan Cancer Support Introduction Key findings 3 People with cancer are surviving longer 4 Median survival time has seen dramatic improvement for some cancers 5 Median

More information

Estimated New Cases of Leukemia, Lymphoma, Myeloma 2014

Estimated New Cases of Leukemia, Lymphoma, Myeloma 2014 ABOUT BLOOD CANCERS Leukemia, Hodgkin lymphoma (HL), non-hodgkin lymphoma (NHL), myeloma, myelodysplastic syndromes (MDS) and myeloproliferative neoplasms (MPNs) are types of cancer that can affect the

More information

NEOPLASMS C00 D49. Presented by Jan Halloran CCS

NEOPLASMS C00 D49. Presented by Jan Halloran CCS NEOPLASMS C00 D49 Presented by Jan Halloran CCS 1 INTRODUCTION A neoplasm is a new or abnormal growth. In the ICD-10-CM classification system, neoplastic disease is classified in categories C00 through

More information

Investigating Community Cancer Concerns--Deer Park Community Advisory Council, 2008

Investigating Community Cancer Concerns--Deer Park Community Advisory Council, 2008 Investigating Community Cancer Concerns--Deer Park Community Advisory Council, 2008 David R. Risser, M.P.H., Ph.D. David.Risser@dshs.state.tx.us Epidemiologist Cancer Epidemiology and Surveillance Branch

More information

Cancer in Western Australia: Incidence and mortality 2003 and Mesothelioma 1960-2003

Cancer in Western Australia: Incidence and mortality 2003 and Mesothelioma 1960-2003 Cancer in Western Australia: Incidence and mortality 2003 and Mesothelioma 1960-2003 A report of the Western Australian Cancer Registry Health Data Collections, Information Collection and Management Department

More information

CHAPTER 2. Neoplasms (C00-D49) March 2014. 2014 MVP Health Care, Inc.

CHAPTER 2. Neoplasms (C00-D49) March 2014. 2014 MVP Health Care, Inc. Neoplasms (C00-D49) March 2014 2014 MVP Health Care, Inc. CHAPTER SPECIFIC CATEGORY CODE BLOCKS C00-C14 Malignant neoplasms of lip, oral cavity and pharynx C15-C26 Malignant neoplasms of digestive organs

More information

CANCER SURVIVAL IN QUEENSLAND, 2002

CANCER SURVIVAL IN QUEENSLAND, 2002 CANCER SURVIVAL IN QUEENSLAND, 2 Danny Youlden Michael Coory Health Information Branch Queensland Health 147-163 Charlotte Street Brisbane QLD Postal Address: GPO Box 48 Brisbane QLD 1 AUSTRALIA Telephone:

More information

Table 1. Underlying causes of death related to alcohol consumption, International Classification of Diseases, Ninth Revision

Table 1. Underlying causes of death related to alcohol consumption, International Classification of Diseases, Ninth Revision ONS - Defining alcohol-related deaths Note: This document was used for discussion with selected topic experts between November 2005 and January 2006. Release on National Statistics website: 18 July 2006

More information

Table of Contents. I. Executive Summary... 1. A. Summary of our Findings... 1. II. Background... 2. III. Methodology... 4. IV. Key Data Sources...

Table of Contents. I. Executive Summary... 1. A. Summary of our Findings... 1. II. Background... 2. III. Methodology... 4. IV. Key Data Sources... Table of Contents I. Executive Summary... 1 A. Summary of our Findings... 1 II. Background... 2 III. Methodology... 4 IV. Key Data Sources... 6 A. WCIS Data... 6 B. SEER Data... 8 V. Discussion of NIOSH

More information

Cancer incidence and mortality patterns in Europe: Estimates for 40 countries in 2012

Cancer incidence and mortality patterns in Europe: Estimates for 40 countries in 2012 an Journal of Cancer (2013) 49, 1374 1403 Available at www.sciencedirect.com journalhomepage:www.ejcancer.info Cancer incidence and mortality patterns in : Estimates for 40 countries in 2012 J. Ferlay

More information

Section 8» Incidence, Mortality, Survival and Prevalence

Section 8» Incidence, Mortality, Survival and Prevalence Section 8» Incidence, Mortality, Survival and Prevalence 8.1. Description of Statistics Reported This section focuses on the regional distribution of cancer with data derived from the BC Cancer Registry

More information

CANCER EXPLAINED. Union for International Cancer Control Union Internationale Contre le Cancer

CANCER EXPLAINED. Union for International Cancer Control Union Internationale Contre le Cancer MEDIA FACTSHEET CANCER EXPLAINED What is cancer? Cancer is a disease which occurs when changes in a group of normal cells within the body lead to uncontrolled growth causing a lump called a tumour; this

More information

BRAIN TUMOUR RESEARCH FUNDING FLOWS

BRAIN TUMOUR RESEARCH FUNDING FLOWS BRAIN TUMOUR RESEARCH FUNDING FLOWS Ellen Harries, Iona Joy v London, April 2013 (updated) CONTENTS 1 Research brief and headline findings 2 Research funding for cancer 3 Brain tumour funding compared

More information

Chapter 15 Multiple myeloma

Chapter 15 Multiple myeloma Chapter 15 Multiple myeloma Peter Adamson Summary In the UK and in the 199s, multiple myeloma accounted for around 1 in 8 diagnosed cases of cancer and 1 in 7 deaths from cancer. There was relatively little

More information

Ovarian Cancer. in Georgia, 1999-2003. Georgia Department of Human Resources Division of Public Health

Ovarian Cancer. in Georgia, 1999-2003. Georgia Department of Human Resources Division of Public Health Ovarian Cancer in Georgia, 1999-23 Georgia Department of Human Resources Division of Public Health Acknowledgments Georgia Department of Human Resources......B. J. Walker, Commissioner Division of Public

More information

Cancer in Norway 2008

Cancer in Norway 2008 Cancer in Norway 8 Cancer incidence, mortality, survival and prevalence in Norway Special issue: The Janus Serum Bank From sample collection to cancer research Cancer in Norway 8 Editor-in-chief: Freddie

More information

AUSTRALIAN VIETNAM VETERANS Mortality and Cancer Incidence Studies. Overarching Executive Summary

AUSTRALIAN VIETNAM VETERANS Mortality and Cancer Incidence Studies. Overarching Executive Summary AUSTRALIAN VIETNAM VETERANS Mortality and Cancer Incidence Studies Overarching Executive Summary Study Study A u s t ra l i a n N a t i o n a l S e r v i c e V i e t n a m Ve t e ra n s : M o r t a l i

More information

PROTOCOL OF THE RITA DATA QUALITY STUDY

PROTOCOL OF THE RITA DATA QUALITY STUDY PROTOCOL OF THE RITA DATA QUALITY STUDY INTRODUCTION The RITA project is aimed at estimating the burden of rare malignant tumours in Italy using the population based cancer registries (CRs) data. One of

More information

THE CANCER CENTER 2013 ANNUAL REPORT CONTAINING 2012 STATISTICS

THE CANCER CENTER 2013 ANNUAL REPORT CONTAINING 2012 STATISTICS THE CANCER CENTER 2013 ANNUAL REPORT CONTAINING 2012 STATISTICS Northside Medical Center Cancer Committee Mission Statement It is the mission of the Cancer Committee to evaluate and monitor the care of

More information

David Feltl, M.D., Ph.D., MBA. Structure and organization of cancer care in the Czech Republic. Assessment of outputs and outcomes.

David Feltl, M.D., Ph.D., MBA. Structure and organization of cancer care in the Czech Republic. Assessment of outputs and outcomes. David Feltl, M.D., Ph.D., MBA Structure and organization of cancer care in the Czech Republic. Assessment of outputs and outcomes. Contents Cancer epidemiology in the Czech Republic National oncology program

More information

Cancer Incidence and Survival By Major Ethnic Group, England, 2002-2006

Cancer Incidence and Survival By Major Ethnic Group, England, 2002-2006 national cancer intelligence network Cancer Incidence and Survival By Major Ethnic Group, England, 00-006 info.cancerresearchuk.org/cancerstats www.ncin.org.uk Cancer Incidence and Survival By Major Ethnic

More information

Statistics fact sheet

Statistics fact sheet Statistics fact sheet Fact sheet last updated January 2015 EXTERNAL VERSION Macmillan Cancer Support Page 1 of 10 Macmillan and statistics Statistics are important to Macmillan because they help us represent

More information

The recommendations made throughout this book are by the National Health and Medical Research Council (NHMRC).

The recommendations made throughout this book are by the National Health and Medical Research Council (NHMRC). INTRODUCTION This book has been prepared for people with bowel cancer, their families and friends. The first section is for people with bowel cancer, and is intended to help you understand what bowel cancer

More information

Work-Related Disease in New Zealand

Work-Related Disease in New Zealand LABOUR AND COMMERCIAL ENVIRONMENT Work-Related Disease in New Zealand The state of play in 2010 MB 12548 AUG 13 Ministry of Business, Innovation and Employment (MBIE) Hīkina Whakatutuki Lifting to make

More information

Statistical Report on Health

Statistical Report on Health Statistical Report on Health Part II Mortality Status (1996~24) Table of Contents Table of Contents...2 List of Tables...4 List of Figures...5 List of Abbreviations...6 List of Abbreviations...6 Introduction...7

More information

Non-covered ICD-10-CM Codes for All Lab NCDs

Non-covered ICD-10-CM Codes for All Lab NCDs Non-covered ICD-10-CM s for All Lab NCDs This section lists codes that are never covered by Medicare for a diagnostic lab testing service. If a code from this section is given as the reason for the test,

More information

Mortality statistics and road traffic accidents in the UK

Mortality statistics and road traffic accidents in the UK Mortality statistics and road traffic accidents in the UK An RAC Foundation Briefing Note for the UN Decade of Action for Road Safety In 2009 2,605 people died in road traffic accidents in the UK. While

More information

2012 CANCER PROGRAM ANNUAL REPORT

2012 CANCER PROGRAM ANNUAL REPORT MERCY REGIONAL CANCER CENTER 2012 CANCER PROGRAM ANNUAL REPORT Using 2011 Data Mercy Regional Cancer Center When you have cancer, you might think first of treatments chemotherapy and radiation. You want

More information

in Australia an overview 2012

in Australia an overview 2012 Cancer in Australia an overview 212 Cancer in Australia: an overview, 212 presents the latest available information on incidence, mortality, survival, prevalence, burden of cancer, hospitalisations and

More information

Cancer Statistics, 2013

Cancer Statistics, 2013 CA CANCER J CLIN 2013;63:11 30 Cancer Statistics, 2013 Rebecca Siegel, MPH 1 ; Deepa Naishadham, MA, MS 2 ; Ahmedin Jemal, DVM, PhD 3 Each year, the American Cancer Society estimates the numbers of new

More information

Table 16a Multiple Myeloma Average Annual Number of Cancer Cases and Age-Adjusted Incidence Rates* for 2002-2006

Table 16a Multiple Myeloma Average Annual Number of Cancer Cases and Age-Adjusted Incidence Rates* for 2002-2006 Multiple Myeloma Figure 16 Definition: Multiple myeloma forms in plasma cells that are normally found in the bone marrow. 1 The plasma cells grow out of control and form tumors (plasmacytoma) or crowd

More information

Cancer is the leading cause of death for Canadians aged 35 to 64 and is also the leading cause of critical illness claims in Canada.

Cancer is the leading cause of death for Canadians aged 35 to 64 and is also the leading cause of critical illness claims in Canada. Underwriting cancer In this issue of the Decision, we provide an overview of Canadian cancer statistics and the information we use to make an underwriting decision. The next few issues will deal with specific

More information

General Rules SEER Summary Stage 2000. Objectives. What is Staging? 5/8/2014

General Rules SEER Summary Stage 2000. Objectives. What is Staging? 5/8/2014 General Rules SEER Summary Stage 2000 Linda Mulvihill Public Health Advisor NCRA Annual Meeting May 2014 National Center for Chronic Disease Prevention and Health Promotion Division of Cancer Prevention

More information

NCI Community Cancer Centers Program Program Overview Ascension Health St. Vincent Indianapolis Hospital

NCI Community Cancer Centers Program Program Overview Ascension Health St. Vincent Indianapolis Hospital A. Name and location of hospital:, Indianapolis, IN B. Name of cancer center: St. Vincent Oncology Center C. Identify PI and key personnel with contact information for each pilot focus areas: a. Disparities

More information

Chapter 2: Health in Wales and the United Kingdom

Chapter 2: Health in Wales and the United Kingdom Chapter 2: Health in Wales and the United Kingdom This section uses statistics from a range of sources to compare health outcomes in Wales with the remainder of the United Kingdom. Population trends Annual

More information

CANCER IN CALIFORNIA

CANCER IN CALIFORNIA CANCER IN CALIFORNIA A N OV E R V I E W O F CA L I FO R N I A S RECENT CA N C E R I N C I D E N C E A N D M O R TA L I T Y 1988-2009 STAT I S T I CS Searching for Causes & Cures KEN MADDY CALIFORNIA CANCER

More information

Critical Illness with Term Assurance

Critical Illness with Term Assurance AIG Life Critical Illness with Term Assurance Our comprehensive Critical Illness with Term Assurance delivers more value and quality to the customer and their family than ever before. It is designed to

More information

1 Introduction. What is ovarian cancer?

1 Introduction. What is ovarian cancer? 1 Introduction Ovarian cancer is often referred to as a challenging cancer. Unlike breast and cervical cancer, no effective tests are currently available for population-based screening for ovarian cancer

More information

Frequently Asked Questions About Ovarian Cancer

Frequently Asked Questions About Ovarian Cancer Media Contact: Gerri Gomez Howard Cell: 303-748-3933 gerri@gomezhowardgroup.com Frequently Asked Questions About Ovarian Cancer What is ovarian cancer? Ovarian cancer is a cancer that forms in tissues

More information

CANCER INCIDENCE RATES IN NORTHEASTERN MINNESOTA. MCSS Epidemiology Report 99:2. September 1999

CANCER INCIDENCE RATES IN NORTHEASTERN MINNESOTA. MCSS Epidemiology Report 99:2. September 1999 CANCER INCIDENCE RATES IN NORTHEASTERN MINNESOTA MCSS Epidemiology Report 99: September 999 Minnesota Cancer Surveillance System Chronic Disease And Environmental Epidemiology Section Minnesota Department

More information

Mužík J., Dušek L., Blaha M., Klika P. Institute of Biostatistics and Analyses, Masaryk University, Brno, Czech republic

Mužík J., Dušek L., Blaha M., Klika P. Institute of Biostatistics and Analyses, Masaryk University, Brno, Czech republic Hospital-based data in regional and local strategies optimizing CRC control and management: real-world outcomes of the Czech National Cancer Control Programme Mužík J., Dušek L., Blaha M., Klika P. Institute

More information

Finnish Cancer Registry Institute for Statistical and Epidemiological Cancer Research. Survival ratios of cancer patients by area in Finland

Finnish Cancer Registry Institute for Statistical and Epidemiological Cancer Research. Survival ratios of cancer patients by area in Finland Survival ratios of cancer patients by area in Finland Pages 2 14 present the relative survival ratios for patients diagnosed in 2005 2012 and followed-up in 2010 2012 (see Methods p. 15) on different university

More information

Munich Cancer Registry

Munich Cancer Registry Munich Cancer Registry Survival Selection Matrix Homepage Deutsch Munich Cancer Registry at Munich Cancer Center Marchioninistr. 15 Munich, 81377 Germany http://www.tumorregister-muenchen.de/en Cancer

More information

Gateshead Joint Strategic Needs Assessment 2012 Data Annex Chapter 6: Cancer

Gateshead Joint Strategic Needs Assessment 2012 Data Annex Chapter 6: Cancer Gateshead Joint Strategic Needs Assessment 2012 Data Annex Chapter 6: Cancer Gateshead Joint Strategic Needs Assessment 2012 Data Annex Chapter 6 Cancer This Annex to the Gateshead Joint Strategic Needs

More information

2.5m. THe Rich PiCtuRE. 340,000 getting cancer for the first time. Living with cancer. 163,000 dying from cancer 94,000. Around.

2.5m. THe Rich PiCtuRE. 340,000 getting cancer for the first time. Living with cancer. 163,000 dying from cancer 94,000. Around. THe Rich PiCtuRE Other cancers 1,100,000 Around 340,000 getting cancer for the first time Lung 72,000 Colorectal 290,000 Breast 691,000 Prostate 330,000 2.5m Living with cancer 66% aged 65+ Around 163,000

More information

52,929,390 paid out in critical illness claims in the first six months of 2013*

52,929,390 paid out in critical illness claims in the first six months of 2013* Critical Illness Report (January to June 2013) 52,929,390 paid out in critical illness claims in the first six months of 2013* 66 % Cancer 12 % Heart Attack 9 % Other 3 % Benign Brain Tumour 4 % Multiple

More information

The Burden of Cancer in Asia

The Burden of Cancer in Asia P F I Z E R F A C T S The Burden of Cancer in Asia Medical Division PG283663 2008 Pfizer Inc. All rights reserved. Printed in USA/December 2008 In 2002, 4.2 million new cancer cases 39% of new cases worldwide

More information

La sopravvivenza dei tumori maligni nei confronti internazionali: anticipazione della diagnosi o modifica del decorso naturale della malattia?

La sopravvivenza dei tumori maligni nei confronti internazionali: anticipazione della diagnosi o modifica del decorso naturale della malattia? La sopravvivenza dei tumori maligni nei confronti internazionali: anticipazione della diagnosi o modifica del decorso naturale della malattia? Paola Pisani Registro Tumori Infantili Piemonte Università

More information

COST OF SKIN CANCER IN ENGLAND MORRIS, S., COX, B., AND BOSANQUET, N.

COST OF SKIN CANCER IN ENGLAND MORRIS, S., COX, B., AND BOSANQUET, N. ISSN 1744-6783 COST OF SKIN CANCER IN ENGLAND MORRIS, S., COX, B., AND BOSANQUET, N. Tanaka Business School Discussion Papers: TBS/DP05/39 London: Tanaka Business School, 2005 1 Cost of skin cancer in

More information

LOWEST DEATH RATE EVER RECORDED. Last year there were 14,400 deaths registered in Northern Ireland, a decrease of 3% from

LOWEST DEATH RATE EVER RECORDED. Last year there were 14,400 deaths registered in Northern Ireland, a decrease of 3% from STATISTICS PRESS NOTICE: DEATHS IN NORTHERN IRELAND (2009) LOWEST DEATH RATE EVER RECORDED 9:30am Thursday, 25 March 2010 Last year there were 14,400 deaths registered in Northern Ireland, a decrease of

More information

New Zealand mortality statistics: 1950 to 2010

New Zealand mortality statistics: 1950 to 2010 Contents New Zealand mortality statistics: 1950 to 2010 Purpose 1 Overview of mortality in New Zealand 2 Deaths, raw numbers and age-standardised rates, total population, 1950 to 2010 2 Death rates from

More information

Indices of Morbidity and Mortality. Sukon Kanchanaraksa, PhD Johns Hopkins University

Indices of Morbidity and Mortality. Sukon Kanchanaraksa, PhD Johns Hopkins University This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike License. Your use of this material constitutes acceptance of that license and the conditions of use of materials on this

More information

Incorrect Analyses of Radiation and Mesothelioma in the U.S. Transuranium and Uranium Registries Joey Zhou, Ph.D.

Incorrect Analyses of Radiation and Mesothelioma in the U.S. Transuranium and Uranium Registries Joey Zhou, Ph.D. Incorrect Analyses of Radiation and Mesothelioma in the U.S. Transuranium and Uranium Registries Joey Zhou, Ph.D. At the Annual Meeting of the Health Physics Society July 15, 2014 in Baltimore A recently

More information

Cancer Survival in New Jersey 1979-2005

Cancer Survival in New Jersey 1979-2005 Cancer Survival in New Jersey 1979-2005 Cancer Epidemiology Services Public Health Services Branch New Jersey Department of Health Chris Chris e, Governor Kim Guadagno, Lt. Governor Mary E. O Dowd, MPH

More information

Cancer incidence and mortality in Europe, 2004

Cancer incidence and mortality in Europe, 2004 Original article Annals of Oncology 16: 481 488, 2005 doi:10.1093/annonc/mdi098 Cancer incidence and mortality in Europe, 2004 P. Boyle* & J. Ferlay International Agency for Research on Cancer, Lyon, France

More information

Chapter 7. Classification and coding of neoplasms

Chapter 7. Classification and coding of neoplasms Chapter 7. Classification and coding of neoplasms C. S. Muirl and C. Percy2 International Agency for Research on Cancer, 150 cours Albert-Thomas, 69372 Lyon Cidex 08, France 2National Cancer Institute,

More information

Childhood cancer incidence and mortality in Canada

Childhood cancer incidence and mortality in Canada Catalogue no.82-624 X ISSN 1925-6493 Health at a Glance Childhood cancer incidence and mortality in Canada by Lawrence Ellison and Teresa Janz Release date: September 22, 215 How to obtain more information

More information

Cancer Statistics, 2015

Cancer Statistics, 2015 Cancer Statistics, 2015 Rebecca L. Siegel, MPH 1 *; Kimberly D. Miller, MPH 2 ; Ahmedin Jemal, DVM, PhD 3 Each year the American Cancer Society estimates the numbers of new cancer cases and deaths that

More information

This module consists of four units which will provide the user a basic knowledge of cancer as a disease.

This module consists of four units which will provide the user a basic knowledge of cancer as a disease. Module 5: What is Cancer? This module consists of four units which will provide the user a basic knowledge of cancer as a disease. After completing this module, cancer abstractors will be able to: Define

More information

Lung Cancer: More than meets the eye

Lung Cancer: More than meets the eye Lung Cancer Education Program November 23, 2013 Lung Cancer: More than meets the eye Shantanu Banerji MD, FRCPC Presenter Disclosure Faculty: Shantanu Banerji Relationships with commercial interests: Grants/Research

More information

Immunohistochemical differentiation of metastatic tumours

Immunohistochemical differentiation of metastatic tumours Immunohistochemical differentiation of metastatic tumours Dr Abi Wheal ST1. TERA 3/2/14 Key points from a review article written by Daisuke Nonaka Intro Metastatic disease is the initial presentation in

More information

LifeProtect. Cancer Cover. For Intermediary Use Only

LifeProtect. Cancer Cover. For Intermediary Use Only LifeProtect Cancer Cover For Intermediary Use Only There are few families in Ireland that have been unaffected by cancer. In fact, 1 in 3 men and 1 in 4 women in Ireland* will suffer from cancer at some

More information

The role of cancer registries

The role of cancer registries The role of cancer registries 17.1 Aims of cancer registries The cancer registry is an organization for the systematic collection, storage, analysis, interpretation and reporting of data on subjects with

More information

Prostate cancer statistics

Prostate cancer statistics Prostate cancer in Australia The following material has been sourced from the Australian Institute of Health and Welfare Prostate cancer incorporates ICD-10 cancer code C61 (Malignant neoplasm of prostate).

More information

Cancer Screening and Early Detection Guidelines

Cancer Screening and Early Detection Guidelines Cancer Screening and Early Detection Guidelines Guillermo Tortolero Luna, MD, PhD Director Cancer Control and Population Sciences Program University of Puerto Rico Comprehensive Cancer Center ASPPR Clinical

More information

SUPPLEMENTARY NOTES. Personal General Insurance (4 th Edition) Date Of Issue: 1 October 2014

SUPPLEMENTARY NOTES. Personal General Insurance (4 th Edition) Date Of Issue: 1 October 2014 SUPPLEMENTARY NOTES Personal General Insurance (4 th Edition) Date Of Issue: 1 October 2014 The following amendments have NOT been incorporated in the Study Guide. They should be marked up in the Study

More information

Cancer incidence, mortality and survival by site for 14 regions of the world. Colin D Mathers Cynthia Boschi-Pinto Alan D Lopez Christopher JL Murray

Cancer incidence, mortality and survival by site for 14 regions of the world. Colin D Mathers Cynthia Boschi-Pinto Alan D Lopez Christopher JL Murray Cancer incidence, mortality and survival by site for 14 regions of the world. Colin D Mathers Cynthia Boschi-Pinto Alan D Lopez Christopher JL Murray Global Programme on Evidence for Health Policy Discussion

More information

Munich Cancer Registry

Munich Cancer Registry Munich Cancer Registry Survival Selection Matrix Homepage Deutsch Munich Cancer Registry at Munich Cancer Center Marchioninistr. 15 Munich, 81377 Germany http://www.tumorregister-muenchen.de/en Cancer

More information

Diagnosis and Treatment of Common Oral Lesions Causing Pain

Diagnosis and Treatment of Common Oral Lesions Causing Pain Diagnosis and Treatment of Common Oral Lesions Causing Pain John D. McDowell, DDS, MS University of Colorado School of Dentistry Chair, Oral Diagnosis, Medicine and Radiology Director, Oral Medicine and

More information

Total Cost of Cancer Care by Site of Service: Physician Office vs Outpatient Hospital

Total Cost of Cancer Care by Site of Service: Physician Office vs Outpatient Hospital Total Cost of Cancer Care by Site of Service: Physician Office vs Outpatient Hospital Prepared by Avalere Health, LLC Page 2 Executive Summary Avalere Health analyzed three years of commercial health plan

More information

R E X C A N C E R C E N T E R. Annual Report 2012. Rex Cancer Care Committee 2012 On behalf of the Rex Cancer Center & Rex Health Care

R E X C A N C E R C E N T E R. Annual Report 2012. Rex Cancer Care Committee 2012 On behalf of the Rex Cancer Center & Rex Health Care R E X C A N C E R C E N T E R Annual Report 2012 Rex Cancer Care Committee 2012 On behalf of the Rex Cancer Center & Rex Health Care An American College of Surgeons Commission on Cancer Accredited Comprehensive

More information

DEFINING DISEASE TYPES I, II AND III

DEFINING DISEASE TYPES I, II AND III Background document provided by the WHO Secretariat 14 November 2012 DEFINING DISEASE TYPES I, II AND III The CEWG was tasked with framing its analysis around disease Types that were first introduced by

More information

Progressive Care Insurance for life A NEW TYPE OF INSURANCE

Progressive Care Insurance for life A NEW TYPE OF INSURANCE Progressive Care Insurance for life A NEW TYPE OF INSURANCE New Progressive Care from Sovereign Progressive Care is a type of insurance that is new to New Zealand. It s not a traditional all-or-nothing

More information

5 Burden of disease and injury

5 Burden of disease and injury 5 Burden of disease and injury 5.1 Overview In this chapter, we present the results of the Australian Burden of Disease and Injury Study for the total disease burden measured in by age, sex and cause for

More information

Health Status. Health. Higher social groups report best health

Health Status. Health. Higher social groups report best health Focus on Health paints a picture of the health of people living in Britain. It includes information on broad measures of health, mortality, risk factors, some preventive measures and service provision.

More information

An Introduction to Cancer and Basic Cancer Vocabulary

An Introduction to Cancer and Basic Cancer Vocabulary An Introduction to Cancer and Basic Cancer Vocabulary Marc B. Garnick, MD Beth Israel Deaconess Medical Center Harvard Medical School, Boston Medical Director Cancer Programs Northeast Hospital Corporation,

More information

Community Health Assessment 2012

Community Health Assessment 2012 Community Health Assessment 2012 Licking County Health Department 675 Price Road Newark, Ohio 43055 www.lickingcohealth.org Assessment Commissioned By: R. Joseph Ebel, RS, MS, MBA Health Commissioner Assessment

More information

Pathology ICD-10-CM Coding Tip Sheet Overview of Key Chapter Updates for Pathology and Top 25 codes

Pathology ICD-10-CM Coding Tip Sheet Overview of Key Chapter Updates for Pathology and Top 25 codes Pathology ICD-10-CM Coding Tip Sheet Overview of Key Chapter Updates for Pathology and Top 25 codes Chapter 2 Neoplasms (C00-D49) Classification improvements Code expansions Significant expansions or revisions

More information

Final Report Australian Firefighters Health Study. Summary

Final Report Australian Firefighters Health Study. Summary Final Report Australian Firefighters Health Study Summary School of Public Health & Preventive Medicine Faculty of Medicine, Nursing and Health Sciences December 2014 STUDY TEAM Monash University Principal

More information

Cancer Facts & Figures for African Americans 2013-2014

Cancer Facts & Figures for African Americans 2013-2014 Cancer Facts & Figures for African Americans 213-214 Contents Cancer Statistics 1 Selected Cancers 1 Cancer Prevention & Early Detection 14 Screening Guidelines for the Early Detection of Cancer in Average-risk

More information

Canadian Cancer Statistics

Canadian Cancer Statistics Canadian Cancer Statistics 2010 Special Topic: End-of-Life Care www.cancer.ca PRODUCED BY: CANADIAN CANCER SOCIETY, STATISTICS CANADA, PROVINCIAL/ TERRITORIAL CANCER REGISTRIES, PUBLIC HEALTH AGENCY OF

More information

Report series: General cancer information

Report series: General cancer information Fighting cancer with information Report series: General cancer information Eastern Cancer Registration and Information Centre ECRIC report series: General cancer information Cancer is a general term for

More information

43,303,919 paid out in critical illness claims in the first six months of 2012*

43,303,919 paid out in critical illness claims in the first six months of 2012* Critical Illness Claims Report 43,303,919 out in critical illness claims in the first six months of 2012* 60 % Cancer 16 % Heart Attack 10 % Other 3 % Benign Brain Tumour 5 % Multiple Sclerosis 6 % Stroke

More information

Cancer in Norway 2011

Cancer in Norway 2011 Cancer in Norway 11 Cancer incidence, mortality, survival and prevalence in Norway Special issue: NORDCAN Cancer data from the Nordic countries Cancer in Norway 11 Editor-in-chief: Inger Kristin Larsen

More information

NHS Barking and Dagenham Briefing on disease linked to Asbestos in Barking & Dagenham

NHS Barking and Dagenham Briefing on disease linked to Asbestos in Barking & Dagenham APPENDIX 1 NHS Barking and Dagenham Briefing on disease linked to Asbestos in Barking & Dagenham 1. Background 1.1. Asbestos Asbestos is a general name given to several naturally occurring fibrous minerals

More information

Our Facility. Advanced clinical center with the newest and highly exact technology for treatment of patients with cancer pencil beam

Our Facility. Advanced clinical center with the newest and highly exact technology for treatment of patients with cancer pencil beam PTC Czech The main goal of radiotherapy is to irreversibly damage tumor cells, whereas the cells of healthy tissue are damaged only reversibly or not at all. Proton therapy currently comes closest to this

More information

Selected Health Status Indicators DALLAS COUNTY. Jointly produced to assist those seeking to improve health care in rural Alabama

Selected Health Status Indicators DALLAS COUNTY. Jointly produced to assist those seeking to improve health care in rural Alabama Selected Health Status Indicators DALLAS COUNTY Jointly produced to assist those seeking to improve health care in rural Alabama By The Office of Primary Care and Rural Health, Alabama Department of Public

More information