2014 Annual Cancer
Program Report
Table of Contents
Chairman’s Comments……………………………………………….….1
Cancer Registry report…………………………………………………..2
Tumor Conferences……………………………………………………..3
Gender Distribution Compared to State/Nat’l Figures ….………..……4
County of Residence at Diagnosis………………………………….…..5
Top Ten Sites by Gender ………………………………………….….6
A summary of cancer screenings………………………………………7-11
On behalf of the Cancer Committee of Floyd Memorial Hospital and Health Services, we present to
you the annual report that covers data through 2014. Our cancer program offers patients a full
range of advanced diagnostic and treatment services along with support services via our
rehabilitation department, home health services, nutritional support provided by a dedicated
dietician, palliative care, pastoral care, psychosocial care provided by a dedicated social worker,
support group, survivorship care program, and patient navigators. We hope you view this program
as a resource for education and patient care.
Our patients came from 20 surrounding counties in the states of Indiana and Kentucky as well as
Tennessee in 2014. Lung cancer has been our most commonly diagnosed malignancy, and given
our location, we have seen relatively more lung cancer cases in males and females, as compared to
the state and national averages. We have also seen a higher volume of breast cancers than the rest
of Indiana and the U.S.
Our Breast Program achieved accreditation by the National Accreditation Program for Breast
Centers, a division of the American College of Surgeons, in 2013. Additionally, our Cancer
Program was re-accredited with commendation status by the Commission on Cancer, also a division
of the American College of Surgeons in 2013. Both programs are due for survey again in 2016.
Respectfully submitted,
David Stapp, M.D.
Chairman, Cancer Committee
1
Cancer Registry
The Cancer Registry is a computerized center responsible for the collection, management, and
analysis of data on patients diagnosed with, or treated for, a malignant disease. The registrars
collect demographic information including age, gender, race, date of birth, residence, and smoking
history. Also collected are: medical history, diagnostic findings including method of diagnosis,
primary site, cell type, extent of disease, therapy and follow-up information.
The information that is collected is reported, according to federal law and with confidentiality, to
the state registry at the Indiana State Department of Health and to the National Cancer Data Base.
Data is utilized by local, state, and national cancer agencies in making important health decisions to
maximize public health funds for screening and education programs. The information collected is
also a valuable tool used by physicians and researchers in the area of etiology, diagnosis, and
treatment. The follow-up information collected serves as a reminder to patients and physicians to
schedule regular checkups, and provides survival and disease-free intervals.
In addition to providing information required by law, the registry also maintains the
documentation necessary for cancer program accreditation by the American College of Surgeons’
Commission on Cancer and accreditation by the American College of Surgeons’ National
Accreditation Program for Breast Centers. Both programs are due for survey again in 2016.
The registrars also coordinate Cancer Committee meetings quarterly, conduct site-related quality
studies, collaborate with physicians for quality control of registry data, and plan/staff Tumor
Conferences.
In 2014, there were a total of 701 cases entered into the registry including 629 newly diagnosed
cases and 72 cases of recurrent disease. A total of 8,705 newly diagnosed cases have been
accessioned since our reference date, January 1, 1997. The total percentage of current follow-up
since our reference date is 87.06% exceeding our target of 80%, and current follow-up for the most
recent five years is 90.89%, exceeding our goal of 90%.
The registrars are required to attend continuing education activities. Each year they attend local
and state meetings and participate in Commission on Cancer and/or North American Association of
Central Cancer Registries’ webinars. It is the goal of the certified registrars to attend a national
meeting at least once every three years.
Finally, the Cancer Registry staff is interested in community service and cancer prevention.
Staff served on the Floyd County Relay for Life Committee. They provide data for grants to
support programs for the underserved/underinsured in our community.
The Cancer Registry is located in the Lower Level of the Cancer Center of Indiana and is staffed
by Jill Aemmer, C.T.R.; Shirley Edlin; Sharon Isaacs, C.T.R.; and Michele Hoskins, B.A., C.T.R.
For more information or to request data, please call 981-6605 or 949-5541.
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What is a Tumor Conference?
Tumor conferences are designed to improve the care of patients with cancer by providing
multidisciplinary treatment planning. Twice monthly, a group of physicians including surgeons,
medical oncologists, radiation oncologists, radiologists, pathologists, primary care, palliative care or
other sub-specialties gather with other health care professionals to discuss the cancer cases seen at
Floyd Memorial Hospital.
We offer two types of tumor conferences, a facility-wide multidisciplinary Tumor Board where all
types of cancer are discussed, and, a site-specific Breast Conference. These conferences adhere to
specific guidelines set by the American College of Surgeons’ Commission on Cancer and the
National Accreditation Program for Breast Centers. The goal is to present at least 15% of the
analytic cases, or those cases diagnosed and/or receiving all or part of their care at Floyd Memorial
Hospital.
The patient’s medical history is given, and radiological studies are reviewed along with pathology
slides. There is an opportunity in these conferences for the patient care team to discuss the
treatment plan face-to-face while reviewing the nationally accepted treatment guidelines.
The following primary cancer sites were discussed at conferences in 2014:
Anal canal
GE junction
Prostate
Appendix
Intrahepatic bile duct
Recto-sigmoid
Bladder
Kidney
Rectum
Bone marrow
Larynx
Skin
Brain
Liver
Small intestine
Breast
Lymph node
Soft tissue
Cervix
Lung
Thymus
Colon
Maxillary sinus
Tongue
Conjunctiva
Meninges
Unknown primary
Esophagus
Ovary
Uterus
Fallopian tube
Pancreas
Vertebral body
Gallbladder
Parotid
Physicians participating in the 2014 program:
Dr. Deepak Azad
Dr. Daniel Altman
Dr. Douglas Berg
Dr. Matthew Bertke
Dr. Naveed Chowhan
Dr. John Clayton
Dr. Bethany Cox
Dr. Christopher Day
Dr. Yasoda Devabhaktuni
Dr. Michael Doyle
Dr. Scott Duncan
Dr. Neal Dunlap
Dr. William Fortner
Dr. Moataz El-Ghamry
Dr. William Garner
Dr. Kendall Goldschmidt
Dr. Lanny Gore
Dr. Mary Harty
Dr. Matthew Henning
Dr. Walter Jones
Dr. Ajay Kandra
Dr. Syed Kazmi
Dr. Kay Lowney
Dr. Mohammad Majd
Dr. Richard Medley
Dr. Mana Moghadamfalahi
Dr. Matthew Nett
Dr. Roseline Okeke
Dr. Edsel Reed
Dr. James Rizzo
Dr. Kevin Serey
Dr. Craig Silverman
Dr. David Stapp
Dr. Jeffrey Weiss
Dr. Kevin White
Dr. Brian Worm
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2014 Cancers in Females
Floyd Memorial Hospital*
Indiana**
National***
Breast
37%
28%
29%
Lung
19%
14%
13%
Colon
6%
7%
6%
Thyroid
5%
4%
6%
Pancreas
3%
3%
3%
2014 Cancers in Males
Floyd Memorial Hospital*
Indiana**
National***
Lung
29%
17%
14%
Colon
7%
7%
5%
Prostate
6%
19%
26%
Urinary bladder
5%
7%
7%
Stomach
3%
2%
2%
Our incidence of female breast cancer increased 7% when compared to 2013 data, perhaps related to our
accredited breast program, aggressive screening, and coordination by our Breast Nurse Navigator. Of
interest, our incidence of female lung cancers had risen 5% over 2012 numbers but has remained stable in
2014 at this facility as well as in Indiana and at the state level. Our incidence of male lung cancers seen at
Floyd Memorial have risen 8% when compared to 2013 data, and are still much higher when compared to
state and national figures. The increase could be related to our aggressive screening program and
coordination of care by our Lung Navigator. Our lower volume of prostate and urinary bladder cancers
likely reveals a change in practice patterns and not a true lower incidence.
*FMHHS data based on 2014 figures.
**State data courtesy of Indiana State Department of Health and is based on 2013 data.
***National data courtesy of CA-A Journal for Clinicians, 2015.
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2014 County of Residence at Diagnosis
0.14%
0.43%
0.29%
0.71%
0.14%
4.28%
19.54%
38.94%
12.41%
0.14%
3.71%
0.29%
1.28%
14.41%
A total of 96.71% of our patients who have cancer are from Indiana counties; 0.14% is from unknown
counties. A total of 3.00 % of our patients resided in Kentucky counties. There was a total of 0.14% of
patients from Tennessee.
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Standard 1.8 Monitoring Community Outreach in Cancer-Related HCI Events
Individual Event Report Summary
Date: January 1, 2014 – December 31, 2014
Event Name: Colon Cancer Screening Program
Screening Type: Occult Blood Screening Kits
Location: Kits provided at various locations in our region
Target Population: Adults, at-risk individuals
Number Screened YTD: 23
How was the need determined for this outreach activity?
Floyd County, Indiana, has a high risk of deaths related to colon cancer. Information for this can be found at the
Floyd County Health Needs Assessment, floydfoundation.org
List the nationally accepted, evidence-based guidelines that directed this activity.
The CDC recommends annual FOBT (fecal occult blood testing) for adults over the age of 50.
http://www.cdc.gov/cancer/colorectal/basic_info/screening/guidelines.htm
http://www.uspreventiveservicestaskforce.org/uspstf/uspscolo.htm
Discuss the mechanism in place to ensure follow-up of all positive findings identified through the activity.
All participants are mailed their results along with a letter recommending follow up with their primary care
physician. They are given a number to call if they do not have a primary physician.
Evaluate the effectiveness of access and referral processes.
Occult blood screening kits are available at many of FMHHS’ community events. In addition, they can be picked up
for free at the front desk of our Cancer Center of Indiana.
What is the overall summary of this event?
Year to date, 23 people have participated in this free screening.
Submitted by _____Rebecca Didelot MSN, RN________________
Date__August 4, 2015____
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Standard 1.8 Monitoring Community Outreach in Cancer-Related HCI Events
2014 Lung Cancer Screening Program
Dates: January 1, 2014 – December 31, 2014
Event Name: Lung Cancer CT Cancer Screenings
Screening Type: Cat Scan of lungs for those who qualify
Location: FMHHS Radiology
Target Population: Smokers or ex-smokers, 50 years of age or older, family history of lung cancer, asbestos or
other chemical exposure
Number Screened: 212
How was the need determined for this outreach activity?
Floyd County has high number of deaths related to lung cancer according to the community health needs
assessment (found at floydfoundation.org). This screening is intended to catch early stage lung disease among
those who are at a high risk for developing lung cancer.
List the nationally accepted, evidence-based guidelines that directed this activity.
The National Cancer Institute promotes lung cancer screenings. Studies have shown a 20% reduction in lung
cancer deaths among those who received early screenings.
See http://www.cancer.gov/cancertopics/screening/lung
Discuss the mechanism in place to ensure follow-up of all positive findings identified through the activity.
Participants are responsible for their own follow-up. Results are forwarded to their family physician or physician
of preference. All results are discussed with patient same day of service. A Radiologist will discuss directly with
any patient with positive results. All patients are given a copy of report for their records same day service.
Evaluate the effectiveness of access and referral processes.
Participants learn of this screening through a multitude of media methods, including the semi-monthly
newsletter, “Healthscope,” which reaches over 100,000 households.
Medical records are kept as are any normal medical procedures. The patients’ physician has access to these.
In 2014, the lung cancer screening program has been overseen by Mindi Burch, the Lung Health Navigator for
FMHHS. We expect to see an increase in the numbers of those screened as well as a more comprehensive follow
up process in place for the patients.
Number of Patients with suspicious results: 38
Number of follow-up appointments (Drs. Kandra, Bousamra, Draw, Kakarlapudi, Manchi, Lohano) : 62
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Number of follow-up chest CT scans: 21
Number of follow-up MRI scans: 7
Number of follow-up Ultrasound scans: 5
Number of PET/CT scans: 8
Number of surgical resections: 5 (four positive for lung cancer, one for reactive histoplasmosis)
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Standard 1.8 Monitoring Community Outreach in Cancer-Related HCI Events
Individual Event Report Summary
Date: January 1, 2014 – December 31, 2014
Event Name: Community Skin Cancer Screenings
Screening Type: Skin Cancer Screenings provided by certified Dermatologists
Location: Floyd County: YMCA, Cancer Center of Indiana
Target Population:
adults
Number Screened: 112
How was the need determined for this outreach activity?
According to the National Cancer Institute, non-melanoma skin cancer is the most common cancer in the United
States. These screenings were provided to help detect early cancer as well as heighten awareness and education
regarding skin cancer prevention.
List the nationally accepted, evidence-based guidelines that directed this activity.
The National Cancer Institute as well as the American Academy of Dermatology both recommend skin cancer
screenings provided by certified dermatologists.
Discuss the mechanism in place to ensure follow-up of all positive findings identified through the activity.
When a dermatologist documents that a screening patient should receive a biopsy or further evaluation or
treatment, the patient must sign the following statement, “I understand that I have a possible cancerous or
precancerous condition that requires a follow-up examination. I also understand that it is my responsibility to
arrange for a follow-up examination with a dermatologist of my choice, and that any follow-up examination or
treatment that I may receive is not sponsored, endorsed, or guaranteed by the American Academy of
Dermatology.” We have a 100% completion rate for patient’s signing this statement when required.
Evaluate the effectiveness of access and referral processes.
All patients, regardless of screening outcome, are given a list of contact information for all area certified
dermatologists.
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What is the overall summary of this event?
Results from the three (2) 2014 skin cancer screenings indicate how effective this event is for the region.
Total Screened
Possible Basal Cell Carcinoma
Possible Squamous Cell Carcinoma
Possible Melanoma
Biopsy Recommended
112
7
1
5
20
Submitted by _________Rebecca MSN, RN_____________
Date_August 4, 2015__
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