Update on the Belgian Cancer Registry, breast cancer data... Belgian Breast Meeting 3-4/10/2008 Liesbet Van Eycken
Overview Introduction, history of the BCR Breast Cancer Incidence - Mortality Europe Belgium Flanders
History cancer registration in Belgium 1955 Obligatory health insurance social disease 1983 NKR-RNC 1994 AKR/LIKAR 2002 CIV IACR Flemish Network 1950 1960 1970 1980 1990 2000 2003 KB MOC - KB normen onco basiszorg en progr 2005: -STOP NCR
Belgian Cancer Registry Founded 1/7/2005 Collaboration between physicians, autorities and health insurances 12/2006: Health Law, art. 39: Kankerregister- Registre du Cancer Autorisation to use the national number Description of data transfer and pathways Clinical pathway (moc non moc) Pathology and Hematology pathway Cancer Plan March 2008 All cancers MOC Data manager funding in the hospital...
Actual Data sources Belgian Cancer Registry Hospitals: Oncol Care MOC non-moc Pathology labs Haematology Health Insurances Belgian Cancer Registry
CANCER IN EUROPE, 2006 3.191.600 new cancer cases 53% males 47% females 1.703.000 cancer deaths 56% males 44% females Ferlay J et al, Ann Onc 2007, doi:10.1093/annonc/mdl498
Cancer incidence and mortality, estimates 2006 EUROPE Incidence (n) Total: 3.191.600 Mortality (n) Total: 1.703.000 Breast: 429.900 Colorectal: 412.900 Lung: 386.300 Prostate: 346.000 Lung: 334.800 Colorectal: 207.000 Breast: 131.900 Stomach: 118.200 Ferlay J et al, Ann Onc 2007, doi:10.1093/annonc/mdl498
2004, Breast Cancer, Belgium: 9.406 new cases Borstkanker in België, 2004 Absolute aantallen 1400 Aantallen / 100.000 500,0 1200 1000 450,0 400,0 350,0 800 300,0 250,0 600 200,0 400 200 150,0 100,0 50,0 0 00-05- 10-15- 20-25- 30-35- 40-45- 50-55- 60-65- 70-75- 80-85+ Leeftijdscategorie 0,0 Absolute aantallen Aantallen / 100.000
Breast Cancer, 2004 Belgium 9.406 Flemish Region 5.374 Walloon region 3.101 Brussels region 931 57% 33% 10%
Breast Cancer, Age standardised incidence, 2004 breast Wallonië Brussel Vlaanderen 0 20 40 60 80 100 120 140 160 180 ESR (n/100,000)
n/100,000 Breast cancer, 2004, Age specific incidence 700,0 600,0 500,0 400,0 300,0 Flemish Region Walloon Region Brussels Region 200,0 100,0 0,0 00-05- 10-15- 20-25- 30-35- 40-45- 50-55- 60-65- 70-75- 80-85+ age
Reasons? Methodology? Check (Wall-Bxl) Administrative procedures? Prevalent cases? Result check: >3.000 cases: change of 2,2%! Influence screening programs (timing)? Risk factors? Next years?...
ESR (Aantallen / 100.000) Breast Cancer: evolution of age stand. incidence rates Flemish Region Flanders: evolution of age standardised incidence rates (3 age categories) 450 400 350 300 250 200 150 100 50 0 1997 1998 1999 2000 2001 2002 2003 2004 2005 Jaar 0-49 50-69 70+ alle leeftijden
Flemish Region, Breast Cancer: evolution of incidence and mortality per age category <50 y 50-69y 70+ ESR (N/100.000) Borstkanker in Vlaanderen, Leeftijdscategorie 0-49 Mortaliteit versus incidentie ESR (N/100.000) Borstkanker in Vlaanderen, Leeftijdscategorie 50-69 Mortaliteit versus incidentie ESR (N/100.000) Borstkanker in Vlaanderen, Leeftijdscategorie 70+ Mortaliteit versus incidentie 450 450 450 400 400 400 350 350 350 300 300 300 250 250 250 200 200 200 150 150 150 100 100 100 50 50 50 0 2000 2001 2002 2003 2004 Jaar Incidentie Mortaliteit 0 2000 2001 2002 2003 2004 Jaar Incidentie Mortaliteit 0 2000 2001 2002 2003 2004 Jaar Incidentie Mortaliteit
gestandaardiseerd cijfer (1/100.000 inw.) Breast cancer mortality, Flemish Region, 1994-2004 40-69 years: breast cancer is the most important cause of death Direct Gestandaardiseerde sterfte door borstkanker. Vlaams Gewest. Betrouwbaarheidsintervallen BG 50 48 ASR OG 46 Linear (ASR) 44 42 40 38 y = -0,7776x + 47,125 R 2 = 0,7776 36 34 32 30 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004
Flemish Region, breast cancer: 5y relative survival per stage Borstkanker in Vlaanderen: Relatieve overleving per stadium, 1997-2001 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% 0 12 24 36 48 60 Maand I II III IV X
ESR (Aantallen / 100.000) Breast Cancer, all ages, flemish region: stage distribution Breast Cancer, all ages: stage distribution, 1997-2005 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% 1997 1998 1999 2000 2001 2002 2003 2004 2005 Jaar IV III II I
ESR (Aantallen / 100.000) Breast Cancer, 50-69 years, flemish region: stage distribution Breast cancer, 50-69 years: stage distribution, 1997-2005 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% 1997 1998 1999 2000 2001 2002 2003 2004 2005 Jaar IV III II I
Europe: 5-year relative survival, 1995-1999 Eurocare-4 F. Berrino et al. 2007
Europe, breast cancer: 5-year relative survival, 1995-1999 Eurocare-4 F. Berrino et al. 2007
5 year relative survival, all cancers, 1995-1999 TNEH
Conclusion Breast Cancer High incidence in Belgium Differences in incidence in the Belgian regions Further investigations! TNM evolution? Mortality decreasing over time Survival data comparable with the European results Up to a cancer registry for Belgium with useful data for health care workers, autorities, research, etc...
Thank you! And... Thank you Cancer Registry team!