Monitoring Cancer Outcomes Across the Continuum

Monitoring Cancer Outcomes Across the Continuum: Data Synthesis and Analysis for the District of Columbia

Rebecca Anhang Price
Janice C. Blanchard
Racine Harris
Teague Ruder
Carole Roan Gresenz
Copyright Date: 2012
Published by: RAND Corporation
Pages: 85
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  • Book Info
    Monitoring Cancer Outcomes Across the Continuum
    Book Description:

    This report synthesizes and analyzes available data regarding cancer-related outcomes among District of Columbia residents, highlighting key findings and data gaps across the continuum of cancer prevention, treatment, and outcomes and noting variability across subgroups of District residents.

    eISBN: 978-0-8330-7947-3
    Subjects: Health Sciences, History

Table of Contents

  1. Front Matter
    (pp. i-i)
  2. Preface
    (pp. ii-ii)
  3. Table of Contents
    (pp. iii-iii)
  4. Summary
    (pp. iv-viii)

    To help inform future priority-setting by the DC Cancer Consortium (DCCC) and other entities concerned with the burden of cancer in the District of Columbia, as well as local government policymaking around cancer more broadly, this report synthesizes available data (including information in published reports, as well as the results of new data analyses) regarding cancer-related outcomes among District residents. A comprehensive understanding of cancer in the District requires information across the continuum of cancer prevention, treatment, and outcomes, and, moreover, an understanding of the variability in these outcomes for different subgroups of District residents, such as those defined by...

  5. Acknowledgments
    (pp. ix-ix)
  6. Abbreviations
    (pp. x-x)
  7. 1. Introduction
    (pp. 1-3)

    The American Cancer Society estimates that approximately 2,980 new cases of cancer will be diagnosed in the District of Columbia in 2012 and that 1,010 District residents will die of the disease (American Cancer Society, 2012).¹ Cancer is the second leading cause of death in the District of Columbia; approximately one in five deaths is due to cancer (District of Columbia Department of Health, 2009).

    The District of Columbia Department of Health (DOH), in an effort to meet a federal mandate to address the burden of cancer in the District, established the DC Cancer Coalition in 2001. The Coalition later...

  8. 2. Setting the Context: Sociodemographics and Health Care Access in the District
    (pp. 4-11)

    In this chapter, we lay the context for the remainder of the report by profiling the sociodemographic and health care access characteristics of District residents. We report findings for the District overall and by geographic catchment areas within the District. Sociodemographic descriptions are based on data from the 2000 and 2010 decennial censuses and the annual ACS.⁴ Section 2.1 illustrates the geography of the District. Section 2.2 presents sociodemographic characteristics of District residents by ward and over time. Section 2.3 highlights migration into and out of the District from neighboring states. Section 2.4 presents data on factors that facilitate access...

  9. 3. Primary and Secondary Cancer Prevention
    (pp. 12-20)

    This chapter synthesizes and analyzes information about primary and secondary cancer prevention behaviors among District residents. Primary prevention refers to avoidance of cancer risk factors, such as smoking, and participation in cancer protective factors, such as regular physical activity; secondary prevention refers to routine screening to detect cancer before signs or symptoms appear.

    We use available data from the BRFSS and the National Immunization Survey (NIS) to provide information about current rates of primary and secondary prevention behaviors among District residents and compare those to U.S. rates. For measures derived from BRFSS, we depict rates of these behaviors among District...

  10. 4. Cancer Incidence and Mortality
    (pp. 21-27)

    In this chapter, we describe cancer incidence and mortality in the District (United States Department of Health and Human Services, 2012). We use age-adjusted data from the Centers for Disease Control and Prevention (CDC) WONDER database, which uses the United States Cancer Statistics (USCS) database, the source for official federal statistics on cancer incidence and mortality. The USCS’s cancer incidence data are derived from cancer registries, including the DC Cancer Registry, that gather high-quality data. The USCS’s cancer mortality statistics are derived from the CDC’s National Vital Statistics System (NVSS).¹³

    We also present data obtained from the CDC and National...

  11. 5. Use of Cancer Treatment Services in the District
    (pp. 28-34)

    In this chapter, we describe use of cancer treatment services in the District. Our primary data source is the National Cancer Data Base (NCDB), a national, hospital-based cancer registry jointly sponsored by the American College of Surgeons’ Commission on Cancer (CoC) and the American Cancer Society. The database includes approximately 70 percent of all newly diagnosed cases of cancer in the United States from more than 1,500 facilities accredited by the CoC. Registrars record all available diagnostic and treatment information from patients’ inpatient and outpatient medical records at the CoC-accredited facility.¹⁹ The NCDB contains standardized data on patient demographics, including...

  12. 6. Capacity for Delivering Cancer Care in the District
    (pp. 35-47)

    In this chapter, we discuss issues related to capacity for delivering care across the cancer care continuum, with a specific focus on District residents who are uninsured, covered by public insurance, and enrolled in the DC Alliance. These residents comprise approximately one in five people living in the District (Washington Post and Kaiser Family Foundation, 2011).

    Our data sources include the Area Resource File (ARF) from the U.S. Department of Health and Human Services Health Resources and Services Administration; prior reports on health care, cancer care, and palliative and end-of-life care in the District (Lurie, Gresenz, et al., 2008; Lurie,...

  13. 7. Summary and Conclusion
    (pp. 48-53)

    This report synthesizes available data regarding cancer-related outcomes among District residents with the goals of providing a basis for future priority-setting by entities concerned with the burden of cancer in the District and informing local government policymaking around cancer more broadly. Several key findings emanate from our synthesis and analyses of available data, as outlined below.

    In 2010, 6.5 percent of adult District residents reported that they lacked health insurance coverage, compared with 15.1 percent of adults across the United States.

    Although District adults reported significantly fewer barriers to health care access than adults nationwide, access to health care providers...

  14. References
    (pp. 54-57)
  15. Appendix A. Additional Figure and Tables
    (pp. 58-70)
  16. Appendix B. List of Stakeholders Interviewed
    (pp. 71-71)
  17. Appendix C. Semistructured Guide for Stakeholder Interviews
    (pp. 72-74)