Data collected from 2007 Cases

Data collected from 2007 Cases

2008
Annual Cancer
Report

Chairman’s Report
THE BELLEVUE HOSPITAL
I am pleased to introduce the report for The Bellevue Hospital (TBH)
Cancer Program for the calendar year 2008. TBH is proud to offer
“Quality Care, Close to Home,” and its Cancer Program, as part of their
ongoing community commitment.
The Bellevue Hospital’s Cancer Program has been serving the
community since the 1980’s and has been an approved cancer hospital by
the American College of Surgeons since 1986. Treatment at a Commission
on Cancer approved hospital assures patients are receiving care at an
institution committed to quality.
The Cancer Program at The Bellevue Hospital continues to hold
monthly Cancer Conference meetings. Physicians representing surgery,
pathology, diagnostic radiology, radiation oncology and medical oncology
are required to attend each conference. Physicians discuss the diagnosis
and treatment options available to cancer patients.
The Cancer Committee provides leadership for The Bellevue
Hospital’s Cancer Program in goal setting as well as planning, initiating,
implementing, evaluating and improving all cancer-related activities. The
American Cancer Society works closely with the Cancer Committee in a
joined commitment in addressing the needs of our patient population.
Representatives from the ACS regularly attend the Cancer Committee
meetings, providing valuable information about programs and resources
available to the public. The Cancer Committee continues to meet quarterly
during the calendar year.
The following activities highlight the goals and accomplishments of
The Bellevue Hospital Cancer Program for the year:
The Relay for Life program; “Kick Some Butt” campaign to
discourage smoking in high school students; Colorectal Cancer Awareness
Education; as well as Community screenings for prostate and skin cancers.
The Bellevue Hospital was also a major sponsor of the Breast Cancer
Conference held at Kalahari Resort in October 2007 & 2008. This event
had an outstanding turn out as was well received by those who attended.
We are looking forward to continued success in our efforts to provide
comprehensive quality care to our patients and the community.
James E. Fanning, M.D.
*2008 Report using 2007 data.
1

2008 Cancer Registry Report
THE BELLEVUE HOSPITAL
The primary goal of the Cancer Registry is to collect and maintain
complete and accurate data on cancer patients diagnosed and/or treated at
The Bellevue Hospital (TBH). Cancer Registry data assists the medical
staff to evaluate clinical outcomes and improve the quality of care of
their cancer patients. The Electronic Registry Services, Inc. (ERS) software
provides an efficient method for entering data collected in the registry
database.
The reference year of the cancer registry is January 1, 1993. A total
of 1718 cases have been entered into the database. There were 130 analytic
cases for 2007 accessioned into the cancer registry database. The
six most common cancer sites accessioned for 2007 at TBH were breast,
bladder, skin, thyroid, lung and colon.
The five most common cancer sites accessioned in 2007 at The
Bellevue Hospital were bladder (30), prostate (21), breast (19), and colon
and lung (7 cases each).
TBH Top Five Analytical Sites
No. Cases
30
25
20
15
10
5
0
Bladder Prostate Breast Colon Lung
2

Top Five Female Cancer Sites 2007
The most prevalent site of cancer in the female population was breast
cancer. A total of 18 patients were diagnosed with breast cancer. The
second leading incidence of cancer in females was bladder (7 cases)
melanoma and thyroid occupied third and fourth place with 5 cases each.
Colon and lung occupied fifth and six places with 4 each.
Breast
Bladder
Skin
Thyroid
Lung
Colon
No. Cases
0 2 4 6 8 10 12 14 16 18
Top Five Male Cancer Sites 2007
The most prevalent site of cancer in the male
population was bladder 23 cases. The second
leading incidence of cancer in males was
prostate 21 cases. Colon, lung, and melanoma
occupied third, fourth and fifth with 5 cases
each. Esophageal cancer was sixth with 3 cases
diagnosed in 2007.
Bladder
Prostate
Colon
Lung
Melanoma
Esophagus
No. Cases
0 2 4 6 8 10 12 14 16 18 20
3

TBH Age at Diagnosis
The majority of patients diagnosed with cancer at The Bellevue Hospital
in 2007 were within the age group of 70-79. The second most common
age for diagnosis was 60-69.
107
Patients
MALE
FEMALE
20
21
18
16
14
16
17
15
15
12
13
10
8
6
4
7
6
7 7
2
0
2
0 1 1 0 1 1
0
0-19 20-29 30-39 40-49 50-59 60-69 70-79 80-89 90+
Age Groups
AJCC Staging 2007 Analytic Cases by Gender
The most frequent stage at diagnosis for 2007 male patients was Stage II.
Females were most commonly diagnosed in Stage I.
No. Cases
MALE
FEMALE
4
30
25
20
15
10
5
0
29
18
16
14
9
4
4 2 2
4
3
3
Stage 0 Stage I Stage II Stage III Stage IV Stage Unk

Oncology Report
THE BELLEVUE HOSPITAL
The average follow-up rate for The Bellevue Hospital (TBH) registry
is 91% for the last five years, and 88% overall since the reference date of
January 1, 1993. The Commission on Cancer (CoC) requires a minimum
90% follow up rate for all patients for the last five years in the registry
database and 80% follow up rate overall for all patients in the registry
database since our reference date of 1993. These rates exceed the
CoC standards, which are in place to allow for meaningful survival data
analysis.
Data was submitted on a monthly basis to the Ohio Cancer Incidence
Surveillance System (OCISS), the central registry for the state of Ohio.
The registry also participated in the CoC’s National Cancer Database
(NCDB) “Call For Data” which included mandatory transmission of
required years of data. This data is used to allow cancer care comparison
on a national level. In 2006, the CoC opened their web-based tool called
the Survey Application Record (SAR) to be available for updates on CoC
program standard compliance at any time throughout the years between
survey.
The cancer registry program at TBH is staffed through CHAMPS
Oncology Data Services (ODS), a business affiliate of The Center for
Health Affairs in Cleveland, Ohio. ODS utilizes a team approach which
includes a Certified Tumor Registrar(s) and a management team with
training as Commission on Cancer (CoC) Consultants. This provides
TBH with effective quality maintenance of cancer statistical reporting
and up-to-date program consulting.
Continuing education is a priority for cancer registrars, as it is for all
medical personnel. The registrar (CTR) attended the 2008 NCRAAnnual
Conference in Minneapolis, MN and the 2007 and 2008 OCRA State
Meetings.
The reports in this publication show The Bellevue Hospital’s
experience during 2008. The statistical information displayed represents
only a small portion of the data available in the Cancer Registry. The
medical and administrative staffs are encouraged to contact the Cancer
Registry for data reports to provide assistance in improving the care of
cancer patients. We look forward to the future in continuing to support
and enhance the Cancer Program at The Bellevue Hospital.
Lori Adams, RHIT, CTR
Oncology Data Specialist
5

2007 Cancer Cases at The Bellevue Hospital By Site
Primary Site Total Sex AJCC Stage
Analytic M F 0 I II III IV Unk N/A
All Sites 130 75 55 25 32 35 9 5 21 3
Oral Cavity 2 2 0 0 1 0 1 0 0 0
Esophagus 3 3 0 0 0 0 0 0 3 0
Stomach 1 1 0 0 0 0 0 0 1 0
Colon 7 4 3 0 4 0 0 20 1 0
Rectum 3 1 2 0 0 1 0 0 2 0
Pancreas 2 0 2 0 0 0 0 1 1 0
Larynx 2 2 0 1 1 0 0 0 0 0
Lung/Bronchus 7 4 3 0 0 0 2 1 4 0
Multiple Myeloma 1 0 1 0 0 0 0 0 0 1
Connect/Soft Tissue 1 1 0 0 0 1 0 0 0 0
Melanoma 9 4 5 3 6 0 0 0 0 0
Other Skin 1 0 1 0 0 0 1 0 0 0
Breast 19 1 18 3 9 2 1 1 3 0
Cervix Uteri 1 0 1 0 0 0 0 0 1 0
Corpus Uteri 2 0 2 0 0 0 0 0 2 0
Ovary 2 0 2 0 1 0 0 0 1 0
Prostate 21 21 0 0 1 19 1 0 0 0
Testis 2 2 0 0 2 0 0 0 0 0
Other Male 1 1 0 0 1 0 0 0 0 0
Bladder 30 23 7 18 3 9 0 0 0 0
Thyroid 7 2 5 0 3 1 1 0 2 0
Other Endocrine 1 0 1 0 0 0 0 0 0 1
Non-Hodgkin’s 4 2 2 0 0 2 2 0 0 0
Unknown Primary 1 1 0 0 0 0 0 0 0 1
6

2002 - 2006
Breast Cancer
Site Study

Breast Cancer
AJCC Staging at Diagnosis
TBH vs. NCDB
The most frequent stage designation for patients at The Bellevue Hospital
was Stage 1, which represents 50% of patient diagnosed in 2006 and
2007. The increase in Stage 1 breast cancer cases may be a reflection of
better diligence on behalf of Bellevue physicians and providing the public
with information on the importance of screenings.
Stage 0 Stage I Stage II Stage III Stage IV Stage Unk
TBH 14.0% 50.0% 14.0% 11.0% 4.0% 7.0%
NCDB 18.2% 38.2% 27.8% 7.9% 3.3% 4.6%
Percent %
TBH
NCDB
50
50.0
45
40
35
38.2
30
25
20
15
10
5
0
27.8
18.2
14.0
14.0
11.0
7.9
7.0
4.0
4.6
3.3
Stage 0 Stage I Stage II Stage III Stage IV Stage Unk
Source: NCDB, CoC, ACoS,
Benchmark Reports, v9.0-10/08/08.
The Bellevue Hospital cases diagnosed 2007.
9

Breast Cancer
Age at Diagnosis By Gender
TBH vs. NCDB
The majority of patients diagnosed in the years 2006 and 2007 with
breast cancer at The Bellevue Hospital fell in the 60-69 age group.
The second most common age group at diagnosis was 50-59 years
of age. This trend is statistically similar to NCDB data.
TBH
Total
Female
NCDB
Total
Female
16-29 0.0% 0.4%
30-39 0.0% 4.5%
40-49 17.9% 18.4%
50-59 21.4% 25.4%
60-69 28.6% 22.0%
70-79 21.4% 18.8%
80 + 10.7% 9.6%
90 + 0.0% 0.9%
TOTAL 100.0% 100.0%
Source: NCDB, CoC, ACoS,
Benchmark Reports, v9.0-10/08/08.
The Bellevue Hospital cases diagnosed 2006-2007.
10

Breast Cancer
Five Year Survival by AJCC Stage
TBH vs. NCDB
The five year observed survival rate by stage for breast cancer when
reviewing the data, is comparable to national averages. Stage 1 survival
is slightly lower than the national average; this may reflect age and
co-morbidity factors.
Stage 0 Stage I Stage II Stage III Stage IV All Stages
TBH 100.0% 79.6% 80.8% 100.0% 40.0% 83.2%
NCDB 94.9% 90.7% 81.8% 56.1% 18.4% 83.5%
Percent %
TBH
NCDB
100
100
100
90
94.9
90.7
80
79.6
80.8 81.8
83.2 83.5
70
60
50
56.1
40
30
40.0
20
10
18.4
0
Stage 0 Stage I Stage II Stage III Stage IV All Stages
Source: 2008 National Cancer Data Base/
Commission on Cancer 10/08/08.
The Bellevue Hospital cases diagnosed 1999-2003.
11

Breast Cancer
Treatment by AJCC Stage
TBH vs. NCDB
PERCENTAGE - %
STAGE 0
TREATMENT
TBH NCDB
STAGE I
TBH NCDB
STAGE II
TBH NCDB
STAGE III
TBH NCDB
STAGE IV
TBH NCDB
Unknown
TBH NCDB
Surgery Only 25.0 46.3 14.3 26.1 50.0 21.0 33.3 13.2 0.0 5.2 0.0 33.6
Surgery & Radiation 25.0 24.9 7.1 17.1 0.0 5.1 0.0 2.6 0.0 2.2 50.0 8.4
Surgery & Chemo 0.0 0.6 0.0 6.2 0.0 19.9 0.0 21.5 0.0 9.6 0.0 8.7
Surg, Rad, & Chemo 0.0 0.4 14.3 7.4 25.0 18.1 0.0 26.4 0.0 5.6 0.0 4.9
Surg, Rad & Hormone 25.0 16.3 35.7 24.5 0.0 7.5 0.0 3.5 0.0 3.6 0.0 5.7
Surgery & Hormone 25.0 7.3 14.3 9.3 0.0 6.4 0.0 2.9 0.0 4.1 0.0 5.1
Surg/Chemo/Rad/Horm 0.0 0.1 14.3 4.5 0.0 11.8 0.0 17.0 100.0 2.5 0.0 2.3
Surg/Chemo/Horm 0.0 0.2 0.0 2.1 25.0 6.1 33.3 3.6 0.0 2.6 0.0 1.6
Other Treatment 0.0 0.8 0.0 1.1 0.0 3.0 33.3 7.8 0.0 51.0 50.0 8.0
No Treatment 0.0 3.1 0.0 1.2 0.0 1.2 0.0 1.6 0.0 13.7 0.0 21.6
TOTAL 0.0% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100%
Source: NCDB, CoC, ACoS, Benchmark Reports, v9.0-10/08/08.
The Bellevue Hospital cases diagnosed 2006-2007.
12

2008 Cancer Committee
THE BELLEVUE HOSPITAL
Lori Adams, RHIT, CTR
Cancer Registry
James Fanning, M.D.
Cancer Committee Chairman, Oncology
Melanie Grillis, D.O.
Pathology
Marty Hohman, L.S.W.
Social Services
Cheryl Irons Holliker, R.N.
Coordinator, Cancer Conference
Philip Hutchison, D.O.
Cancer Liaison, General Surgery
Brenda Mileto, RHIT, CTR
Cancer Registry
Marvin W. Rettig
Administration
Marianne Schoen, RHIT, CTR
Quality Management/Improvement
Khalid Siddiqui, M.D.
Radiation Oncology
Kim Stults, R.N.
Department of Education
Charles Valone, Jr., D.O.
Community Outreach Coordinator, Internal Medicine
Jo Ann Ventura
Marketing
Larry Von Kuster, M.D.
Pathology
David West, M.D.
Radiology
13

Notes

419.483.4040
Cancer Registry . . . . . . . . . . . . . . . . . . . .Ext. 4636
Social Services . . . . . . . . . . . . . . . . . . . .Ext. 4254
Nutritional Services . . . . . . . . . . . . . . . .Ext. 4214
Pathology . . . . . . . . . . . . . . . . . . . . . . . .Ext. 4328
Mission Statement
We CARE for patients as members of our family.
We work to heal the sick, treat the injured, and prevent illness.
We protect the trust of our community and employees,
to be a progressive, quality health care organization.
---Our primary goal is and always will be---
to CARE.
THE BELLEVUE HOSPITAL
1400 West Main Street
Bellevue, OH 44811
419.483.4040
www.bellevuehospital.com