The Burden of Cancer and an
Action Plan for Change in
Monroe County
January 2013
Byron Kennedy, MD, PhD, MPH
Deputy Director of Health
Monroe County, NY
1
Leading Causes of Death
Percentage of all Deaths, Monroe County
2007-2009
2004-2006
HEART
25.3
CANCER
24.3
CANCER
24.3
HEART
23.8
STROKE
6.2
STROKE
5.2
CHR LOWER
RESPIRATORY DIS
4.3
CHR LOWER
RESPIRATORY DIS
4.3
ALZHEIMER'S
3.6
UNINTENTIONAL
INJURIES
3.1
PNEUMONIA/FLU
3.2
PNEUMONIA/FLU
UNINTENTIONAL
INJURIES
2.9
ALZHEIMER'S
0
10
20
30
40
% of all deaths
Source: Vital Records, MCDPH
50
3
2.8
0
10
20
30
40
% of all deaths
50
Cancer and Heart Disease: Number of Deaths
Monroe County, 1994-2010
2500
Number of Deaths
2000
1500
1000
500
0
Cancer
Source: Vital Records, MCDPH
Heart
Cancer Mortality
5 Year Average Annual Age Adjusted Rates
Monroe County 1976-2009
350
300
Rate per 100,000
250
200
150
100
50
0
1976-1979
1980-1984
1985-1989
Females
Source: Cancer Registry, 2005-2009, NYSDOH
1990-1994
Males
1995-1999
2000-2004
2005-2009
Cancer Incidence
5 Year Average Annual Age Adjusted Rates
Monroe County 1976-2009
700
600
Rate per 100,000
500
400
300
200
100
0
1976-1979
1980-1984
1985-1989
Females
Source: Cancer Registry, 2005-2009, NYSDOH
1990-1994
Males
1995-1999
2000-2004
2005-2009
Deaths Due to Cancer & New Cancer Diagnoses
Average Annual Numbers
Monroe County, 2005-2009
• 1,504 deaths
• 4,252 new cases
Source: Cancer Registry, 2005-2009, NYSDOH
Leading Causes of Cancer Deaths
Average annual Number of deaths, 2005-2009
•
•
•
•
•
Lung - 416
Colorectal – 132
Pancreatic – 104
Breast – 103
Prostate - 69
Source: Cancer Registry, 2005-2009, NYSDOH
7.1
Monroe County
4.0
14618
14610
14622
14616
14580
14534
14612
14514
14450
14626
14624
14617
14420
14543
14526
14607
14445
14606
14586
14623
14625
14609
14615
14472
14559
14621
14611
14620
14468
14467
14464
14428
14608
14546
14605
14619
14604 and 14614
14613
0.0
Source: Vital Records, MCDPH
2.0
4.0
5.0
Premature Death from Cancer:
5.8
5.9
Years of Potential Life Lost
6.0
6.0
Before Age 75 (YPLL)
6.2
6.2
By Zip Code, 2007-2009
6.2
6.3
6.3
6.5
6.5
6.9
7.0
7.1
7.1
7.2
7.2
7.4
7.7
7.8
7.9
8.1
8.1
8.2
8.3
8.4
8.6
8.7
8.7
8.9
10.2
10.8
11.0
11.4
12.5
12.9
6.0
8.0
10.0
12.0
14.0
Premature Death from Cancer:
Years of Potential Life Lost Before Age 75 (YPLL)
Monroe County, 2007-2009
14
12.3
11.9
African American/Black
Hispanic
12
10
8
6.3
6
4
2
0
White
Source: Vital Records, MCDPH
Cancer Risk Behaviors and Screening
Monroe County, 2006
Monroe White
County
African
Latino
American
Current Smoker
18%
16%
27%
34%
Obesity
27%
24%
39%
37%
<5 fruits/vegetables per day
80%
78%
88%
90%
No leisure-time physical
activity in the past month
15%
11%
33%
36%
Source: Monroe County Adult Health Survey, 2006
Mammography Rates
Managed Care, 2011
The percentage of women between the ages of 40 and 69 who had a mammogram
during the measurement year or the year prior.
Source: Managed Care Performance Report, 2012, , data from 2011
Pap Smear
Managed Care, 2011
The percentage of women between the ages of 24 and 64 who had a Pap test
within the measurement year or the two years prior
Source: Managed Care Performance Report, 2012, , data from 2011
Colorectal Cancer Screening
Managed Care, 2011
100
70
Percent
75
50
49
46
Excellus
Medicaid
MVP
Medicaid
68
65
53
25
0
NYS
Excellus
MVP
NYS
Medicaid Commercial Commercial Commercial
The percentage of adults, ages 50 to 75 years, who had appropriate screening for
colorectal cancer.
Source: Managed Care Performance Report, 2012, , data from 2011
We can reduce the burden of
Cancer in Monroe County!
There is no limit
to what we can
accomplish as
long as no one
gets the credit.
Action Plan To
Reduce the Burden of Cancer
in Monroe County
About the Plan
• Started with NYS Cancer Control Plan as the Foundation
• Committee identified priority areas
• The plan is a starting point for addressing cancer burden
• Four focus areas:
• Awareness
• Prevention
• Screening
• Support Services
Awareness
• Media and events during national cancer months
• Focus on cancers in which there is good evidence
about prevention and screening
•
•
•
•
•
Breast - October
Lung - November
Cervical - January
Colorectal - March
Skin - May
• Build upon efforts underway
Prevention
• Promote smoke free policies
– Workplaces grounds
– College campuses
– Municipalities
**Reasons:
– Lung cancer is the leading cause of cancer deaths
– 90% of lung cancers are smoking related
Screening
• Identify best strategies to increase colorectal
cancer screening rates.
**Reasons:
– Colorectal cancer 2nd leading cause of cancer deaths
– If everyone were screened, could prevent 60% of
deaths due to CRC (CDC)
Support Services for those with Cancer
• Determine if existing services meeting the needs
of patients, especially African American and
Latino residents.
• Develop a plan to best meet needs
**Reasons:
– Financial, social/emotional, burdens of cancer
– Some face transportation issues
Next Steps
• Multiple cancer awareness and media events
will occur throughout the calendar year to
reinforce key messages.
• A colorectal cancer screening committee will
be formed to assess community needs.
• A cancer support services committee will be
formed to assess community needs.