2007 Cancer Annual_prod5 - St. Joseph Medical Center

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The Cancer Institute Cancer Liason Physician Annual Report (continued) questions that we have argued about without clear data other than a few series involving a handful of patients before the database was created. I believe that this orchard is definitely ripe for the picking and that the data should be accessed by all who are interested. On an institutional level, our data is very useful in that we can measure our performance against others and we can measure our compliance with standards set by the CoC. Four standards are being scrutinized (three for breast cancer and one for colon) through eQuIPs (Electronic Quality Improvement Packets). An example is a standard that calls for administering radiation therapy to patients under 70 years of age after breastconserving therapy for breast cancer. The challenge is that, in addition to offering the treatment, the documentation has to be available to our tumor registrars and that information has to be entered into the NCDB. I encourage everyone to cooperate with our registry staff by providing complete information. There is a strong push in Washington to tie physician and hospital reimbursement into meeting these standards (P4P). A year ago, I was asked to perform the CLP role and I accepted it because, with limited knowledge of its details, I thought it was a “good” thing to do. As the year passed and I became more familiar with the role’s details, I began to appreciate what a worthwhile endeavor this is, and I have found it a very fulfilling experience. I want to acknowledge the dedication of the many physicians who, in addition to providing high quality care, supply the registry with stage and survival data on their patients; the tumor registry staff who work collecting and entering the data and the hospital leadership that continues their strong commitment to our Cancer Institute. What are the CLP and CoC objectives for next year? The areas of interest for CLPs as determined at the last meeting of the CoC are: quality improvement, advocacy, ACS partnership, clinical trials and comprehensive cancer control. The CoC defined an objective for next year around each focus area, and here are the objectives: • Facilitate the utilization of eQuIP to promote quality care for breast and colorectal cancer • Work with the American Cancer Society Cancer Action Network (ACS-CAN) in the area of legislative and regulatory advocacy • Bring ACS staff to the Cancer Committee table and facilitate ACS interaction with the cancer program staff • Increase enrollment of patients into clinical trials by championing implementation and recruitment • Present the state cancer plan to the Cancer Committee and define ways to become involved 6 | ST. JOSEPH MEDICAL CENTER sjmcmd.org
Cancer Institute Registry Activity Data Analysis 2006 Five Most Frequent Cancer Sites The most frequently diagnosed cancer at St. Joseph in 2006 was Breast, which represented 19.0% of our cases. Prostate was the second most often diagnosed cancer at St. Joseph during this same time period, accounting for 16.1% of our 2006 caseload. Colorectal diagnosis represented 11.8%, followed by Lung/Bronchus, which comprised 11.0% of the annual cases. Skin was the fifth most diagnosed cancer at 7.6%. Breast Prostate Colorectal Lung/Bronchus 11.8% 11.0% 16.1% 19.0% Skin 7.6% 0 5 10 15 20 Source: St. Joseph Cancer Institute Registry Follow-Up Follow-up activity affords the opportunity to collect information about additional treatment and aids in the identification of those patients with cancer who have had local recurrence, metastases or who have been diagnosed with an additional primary cancer. Follow-up letters to physicians also serve as a reminder to contact patients they may not have seen in the past year. The St. Joseph Cancer Institute Registry currently has 9,039 cases under active follow-up, with an average follow-up rate of 94.3%. St. Joseph Follow-Up Rate 2006 Total number of cases under active follow-up: 9,039 Total number of cases with current follow-up data: 8,521 (94.3%) Staging The American College of Surgeons Commission on Cancer mandates that all newly diagnosed cancer cases be American Joint Committee on Cancer (AJCC) TNM-staged at initial diagnosis by the managing physician. The AJCC TNM staging system is a classification scheme used to assess the extension and growth of a tumor, involvement of lymph nodes and metastasis to any distant site at the time of diagnosis. This staging system was developed to provide consistency in cancer care and give physicians important information necessary to choose the most appropriate treatment interventions. AJCC Stage at Diagnosis ST. JOSEPH MEDICAL CENTER 2006 FIVE MOST FREQUENT SITES Source: St. Joseph Cancer Institute Registry Stage 0 Stage I Stage II Stage III Stage IV Unknown Lung/ Breast Prostate Colorectal Bronchus Skin 17.6% 0% 14.8% 0% 37.8% 42.9% 0% 27.3% 32.6% 46.7% 23.9% 80.6% 22.7% 7.1% 6.7% 7.8% 12.9% 25.8% 19.0% 5.5% 3.4% 3.2% 6.3% 27.0% 0% 4.4% 3.2% 3.1% 14.3% 3.3% Stage 0 – Carcinoma in situ – an early form of carcinoma. Stage I – Localized to one part of the body. Stage II – Involves regional lymph nodes. Stage III – Locally advanced. Stage IV – Metastasized or spread to other organs throughout the body. 2007 THE CANCER INSTITUTE ANNUAL REPORT | 7
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2007 Cancer Annual_prod5 - St. Joseph Medical Center

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