Complete Indicator Profile - Cancer Mortality Rate - All (HA2020 Leading Health Indicator: 1)

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State of Alaska

Complete Indicator Profile of Cancer Mortality Rate - All (HA2020 Leading Health Indicator: 1)

Definition

Rate of mortality from all cancers per 100,000 population.

Numerator

Number of deaths due to cancer for a specific time period in the resident population.

Denominator

Mid-year resident population for a specific time period.

Data Interpretation Issues

Cancer cases are invasive, except for special instances such as bladder cancers that include in situ. Mortality rates may vary from source to source. This may be due to using provisional data or using different population databases. The Alaska Bureau of Vital Statistics uses population estimates provided by the State Demographer in the Research and Analysis Section of the Alaska Department of Labor and Workforce Development. In contrast, the cancer mortality rates provided by the Alaska Cancer Registry use population estimates provided by the Surveillance, Epidemiology, and End Results Program (SEER) of the National Cancer Institute.

Why Is This Important?

Although there have been declines in the death rates for cancer overall over the past decade, cancer remains the leading cause of mortality among all Alaskans and among Alaska Native people. Cancer mortality represents an important public health concern not only because of the burden of cancer among the population, but because there are effective means for cancer prevention and for the early detection and treatment of cancer. Monitoring cancer mortality rates is an important way to assess efforts being made to prevent and treat cancer, including screening efforts. Several other HA2020 leading health indicators are related to this objective because they monitor risk factors associated with cancer, such as tobacco use, physical activity, and diet.

Healthy People Objective C-1:

Reduce the overall cancer death rate
U.S. Target: 160.6 deaths per 100,000 population
State Target: Healthy Alaskans 2020 Target: 162.0 per 100,000 population

What Is Being Done?

The Alaska Department of Health and Social Services initiated the Alaska Comprehensive Cancer Control Program (CCCP), a statewide partnership whose goal is to reduce the burden of cancer. The mission of the CCCP is to lower cancer incidence and mortality in Alaska through collaborative efforts directed toward cancer prevention and control. As a result of this planning process, objectives and strategies have been developed by community partners regarding the early detection of cervical, lung, prostate, skin, breast, ovarian, and colorectal cancers as well as the promotion of physical activity, healthy eating habits, and smoking cessation and prevention.

Evidence-based Practices

As part of the Healthy Alaskans 2020 health improvement process, groups of Alaskan subject matter experts met over a period of months in a rigorous review process to identify and prioritize strategies to address the 25 health priorities. Public health partners around the state are aligning work around these approaches adapted to Alaska's unique needs.

Strategy 1:
Increase breast, cervical and colorectal cancer screening.

Evidence Base:
Screening increases the chances of detecting certain cancers early, when they are most likely to be curable. Increasing screening rates will reduce the rate of deaths due to cancer in those cancers that can be screened for (breast, cervical and colorectal cancer). Currently 61% of Alaskans have been screened for colorectal cancer, 72% for breast cancer and 81% for cervical cancer (Alaska BRFSS 2010).

Sources:
Recommendations of the U.S. Preventive Services Task Force: http://archive.ahrq.gov/professionals/clinicians-providers/guidelines-recommendations/guide2012/abstract.htm
The Community Guide: http://www.thecommunityguide.org/index.html

Strategy 2:
Increase participation in clinical trials.

Evidence Base:
Participation in clinical trials promotes the development of new cancer treatments and expands the number of options available to a cancer patient. Clinical trials also offer opportunities to try potentially effective new treatments. More effective diagnostic and treatment options will reduce cancer incidence and mortality. Only modest gains have been achieved in cancer mortality since 1993. Successful development of new cancer therapies requires translation of laboratory observations into the clinic, with clinical trials representing the application of the scientific method to this process. Fewer than 5% of adult cancer patients enroll in clinical trials.

Sources:
ClinicalTrials.gov: http://www.clinicaltrials.gov

Strategy 3:
Increase use of patient navigation for improving access to cancer screening, timely diagnosis and treatment, and palliative care.

Evidence Base:
Successful patient navigation supports those diagnosed with suspected cancers by eliminating barriers to timely screening, treatment, and supportive care of cancer and other chronic diseases. When implemented at the organizational level within a community, it results in increased efficiencies and improved screening rates.

Sources:
Harold P. Freeman Patient Navigation Institute: http://www.hpfreemanpni.org/our-model/

Other Program Information

Strategy 1:
Increase breast, cervical and colorectal cancer screening.

Action 1:
Conduct community education around cancer screening through evidence based
interventions. Examples include:
National Breast and Cervical Cancer Early Detection Program (NBCCEDP) Activities:
1) Outreach to rarely/never screened women utilizing paycheck stuffers and worksite presentations on Breast and Cervical Cancer Health Check (BCHC) programs
2) Outreach to underserved populations (those living in poverty, English as a second language) utilizing YWCA/BCHC Outreach ToolKit
3) Identify and provide outreach to regions with lowest statewide screening rates Colorectal Cancer Screening activities:
4) Present on colorectal cancer screening at professional and community conferences and meetings
5) Develop promotional videos by Alaskans who have been screened for colorectal cancer and make them available statewide through www.alaskacolonhealth.com

Key Partners:
Alaska Native Tribal Health Consortium, Community Health Services (CHS), Cancer Programs
American Cancer Society
Arctic Slope Native Association, Screening for Life
Southcentral Foundation, Screening and Prevention Programs
SouthEast Alaska Regional Health Consortium, Breast and Cervical Health Program
Alaska Dept. of Health and Social Services (DHSS), Comprehensive Cancer Control Program
Municipality of Anchorage, Health and Human Services
Alaska DHSS, Breast and Cervical Health Check Program
Yukon Kuskokwim Health Corporation, Breast and Cervical Health Check Program



Related Indicators

Relevant Population Characteristics

The risk of developing cancer increases with increasing age.

Related Relevant Population Characteristics Indicator Profiles:


Related Health Care System Factors Indicator Profiles:


Risk Factors

Increasing age is a risk factor for developing cancer.

Related Risk Factors Indicator Profiles:




Graphical Data Views

Cancer mortality rate, all ages (age-adjusted), all Alaskans, Alaska Natives, and U.S., 2001-2020

::chart - missing::

Alaska Comparisons Year Cancer mortality per 100,000 population
Record Count: 50
All Alaskans 2000 209.6
All Alaskans 2001 193.3
All Alaskans 2002 191.2
All Alaskans 2003 190.2
All Alaskans 2004 186.5
All Alaskans 2005 171.7
All Alaskans 2006 178.7
All Alaskans 2007 184.0
All Alaskans 2008 180.9
All Alaskans 2009 184.5
All Alaskans 2010 176.1
All Alaskans 2011 173.9
All Alaskans 2012 163.4
All Alaskans 2013 167.9
Alaska Natives 2000 239.3
Alaska Natives 2001 255.5
Alaska Natives 2002 251.5
Alaska Natives 2003 248.7
Alaska Natives 2004 275.2
Alaska Natives 2005 212.0
Alaska Natives 2006 243.7
Alaska Natives 2007 274.6
Alaska Natives 2008 223.2
Alaska Natives 2009 251.2
Alaska Natives 2010 238.9
Alaska Natives 2011 238.9
Alaska Natives 2012 240.8
Alaska Natives 2013 272.5
U.S. 2000 199.6
U.S. 2001 196.5
U.S. 2002 194.3
U.S. 2003 190.9
U.S. 2004 186.8
U.S. 2005 185.1
U.S. 2006 181.8
U.S. 2007 179.3
U.S. 2008 176.4
U.S. 2009 173.5
U.S. 2010 172.8
U.S. 2011 169.0
U.S. 2012 166.5
U.S. 2013 163.2
Healthy Alaskans Goal 2013 162.0
Healthy Alaskans Goal 2014 162.0
Healthy Alaskans Goal 2015 162.0
Healthy Alaskans Goal 2016 162.0
Healthy Alaskans Goal 2017 162.0
Healthy Alaskans Goal 2018 162.0
Healthy Alaskans Goal 2019 162.0
Healthy Alaskans Goal 2020 162.0

Data Notes

Age-adjusted to U.S. 2000 population.

Number of deaths due to cancer defined as International Classification of Diseases (ICD)-9 codes 140-208 and ICD-10 codes C00-C97) as the underlying cause of death among residents during a calendar year.

Cancer is not a single disease, but rather numerous diseases with different causes, risks, and potential interventions. Interpretation of increases or decreases in cancer mortality can be made only by examination of specific types of cancers. Because certain cancers have a long latency period, years might pass before changes in behavior or clinical practice patterns affect cancer mortality. In addition, certain cancers are not amenable to primary prevention or screening.   Alaska/Alaska Native - Alaska Bureau of Vital Statistics
U.S. - Centers for Disease Control and Prevention - National Center for Health Statistics - Mortality Data Release Series

Data Sources

  • Alaska Bureau of Vital Statistics, Division of Public Health, Department of Health and Social Services
  • National Center for Health Statistics



Cancer Death Rate, Alaska and U.S., 2000-2013

::chart - missing::

Geog: Alaska vs. U.S. Year Rate per 100,000 (age-adjusted) Lower Limit Upper Limit Numer- ator Denom- inator
Record Count: 28
All Alaskans 2000 209.6 198.2 221.0 708 626,932
All Alaskans 2001 193.3 182.5 204.1 680 632,716
All Alaskans 2002 191.2 180.4 202.0 712 641,729
All Alaskans 2003 190.2 179.6 200.8 732 649,466
All Alaskans 2004 186.5 176.1 196.9 723 659,653
All Alaskans 2005 171.7 161.7 181.7 723 667,146
All Alaskans 2006 178.7 168.7 188.7 781 674,583
All Alaskans 2007 184.0 173.9 194.2 837 680,169
All Alaskans 2008 180.9 171.0 190.9 856 686,818
All Alaskans 2009 184.5 174.5 194.5 891 697,828
All Alaskans 2010 176.1 166.3 185.9 880 710,231
All Alaskans 2011 173.9 164.3 183.5 935 723,424
All Alaskans 2012 163.4 154.2 172.6 923 731,827
All Alaskans 2013 167.9 158.4 177.3 1,015 736,399
U.S. 2000 199.6 553,091 281,421,906
U.S. 2001 196.5 553,768 284,968,955
U.S. 2002 194.3 557,271 287,625,193
U.S. 2003 190.9 556,902 290,107,933
U.S. 2004 186.8 553,888 292,805,298
U.S. 2005 185.1 559,312 295,516,599
U.S. 2006 181.8 559,888 298,379,912
U.S. 2007 179.3 562,875 301,231,207
U.S. 2008 176.4 565,469 304,093,966
U.S. 2009 173.5 567,628 306,771,529
U.S. 2010 172.8 574,743 308,745,538
U.S. 2011 169.0 576,691 311,591,917
U.S. 2012 166.5 582,623 313,914,040
U.S. 2013 163.2 584,881 316,128,839

Data Notes

Age-adjusted to U.S. 2000 population.

Number of deaths due to cancer defined as International Classification of Diseases (ICD)-9 codes 140-208 and ICD-10 codes C00-C97) as the underlying cause of death among residents during a calendar year.

Cancer is not a single disease, but rather numerous diseases with different causes, risks, and potential interventions. Interpretation of increases or decreases in cancer mortality can be made only by examination of specific types of cancers. Because certain cancers have a long latency period, years might pass before changes in behavior or clinical practice patterns affect cancer mortality. In addition, certain cancers are not amenable to primary prevention or screening.   The International Classification of Diseases has been revised approximately every ten years since 1900. The latest revision, ICD-10, was implemented in 1999 replacing ICD-9, the standard since 1979. ICD-10 differs from ICD-9 in several respects. ICD-10 is far more detailed with about 8,000 categories compared with 5,000 in ICD-9. Some of the coding rules and rules for selecting the underlying cause of death have also been changed. These changes create discontinuities in cause-of-death statistics and are critical to the interpretation of mortality trends. Comparability ratios have been created for many cause-of-death classifications in order to reduce the impact of these changes but caution should be used when interpreting trends across the Ninth and Tenth ICD revisions.



Cancer mortality rate, all ages (age-adjusted), by Public Health Region 2009-2013 (5-year average)

::chart - missing::

Alaska Public Health Regions Rate per 100,000 (age-adjusted) Lower Limit Upper Limit Numer- ator Denom- inator
Record Count: 7
Anchorage - Mat-Su 167.0 161.3 172.7 2,375 1,933,707
Gulf Coast 164.9 152.4 177.5 621 397,970
Interior 174.5 163.5 185.5 636 564,565
Northern 254.3 227.0 281.5 194 131,927
Southeast 172.1 158.5 185.6 569 365,305
Southwest 202.9 183.5 222.3 228 206,235
Statewide 172.6 168.3 176.9 4,642 3,599,709


Data Notes

Age-adjusted to U.S. 2000 population.

Number of deaths due to cancer defined as International Classification of Diseases (ICD)-9 codes 140-208 and ICD-10 codes C00-C97) as the underlying cause of death among residents during a calendar year.

Cancer is not a single disease, but rather numerous diseases with different causes, risks, and potential interventions. Interpretation of increases or decreases in cancer mortality can be made only by examination of specific types of cancers. Because certain cancers have a long latency period, years might pass before changes in behavior or clinical practice patterns affect cancer mortality. In addition, certain cancers are not amenable to primary prevention or screening.

Data Sources

ABVS Alaska Bureau of Vital Statistics, Division of Public Health, Department of Health and Social Services


Cancer mortality rate, all ages (age-adjusted), Alaska Natives, white, and all Alaskans, 2000-2013

::chart - missing::

Race: AK Native, White, Alaska Year Rate per 100,000 (age-adjusted) Lower Limit Upper Limit Numer- ator Denom- inator
Record Count: 42
Alaska Native 2000 239.3 210.1 268.6 125 107,929
Alaska Native 2001 255.5 225.5 285.4 141 108,430
Alaska Native 2002 251.5 221.9 281.1 143 109,873
Alaska Native 2003 248.7 219.5 277.9 141 111,314
Alaska Native 2004 275.2 244.6 305.8 153 112,356
Alaska Native 2005 212.0 185.3 238.6 134 113,773
Alaska Native 2006 243.7 215.3 272.2 159 114,977
Alaska Native 2007 274.6 244.4 304.8 180 115,421
Alaska Native 2008 223.2 196.0 250.4 154 115,969
Alaska Native 2009 251.2 222.6 279.8 173 117,974
Alaska Native 2010 238.9 211.3 266.5 178 120,433
Alaska Native 2011 238.9 211.6 266.1 177 122,603
Alaska Native 2012 240.8 213.3 268.2 181 122,817
Alaska Native 2013 272.5 243.3 301.7 213 123,154
White 2000 205.4 192.3 218.6 531 460,021
White 2001 184.7 172.3 197.0 497 463,075
White 2002 182.9 170.7 195.0 522 468,097
White 2003 184.4 172.2 196.5 549 472,059
White 2004 174.6 162.9 186.4 530 478,660
White 2005 164.9 153.5 176.2 528 482,786
White 2006 173.2 161.4 184.9 581 487,277
White 2007 170.1 158.5 181.6 599 490,232
White 2008 175.4 163.7 187.2 635 493,820
White 2009 181.3 169.5 193.0 671 499,690
White 2010 165.7 154.5 176.9 631 507,457
White 2011 165.5 154.4 176.7 685 514,503
White 2012 154.8 144.0 165.5 672 518,807
White 2013 151.1 140.5 161.7 710 520,501
All Alaskans 2000 209.6 198.2 221.0 708 626,932
All Alaskans 2001 193.3 182.5 204.1 680 632,716
All Alaskans 2002 191.2 180.4 202.0 712 641,729
All Alaskans 2003 190.2 179.6 200.8 732 649,466
All Alaskans 2004 186.5 176.1 196.9 723 659,653
All Alaskans 2005 171.7 161.7 181.7 723 667,146
All Alaskans 2006 178.7 168.7 188.7 781 674,583
All Alaskans 2007 184.0 173.9 194.2 837 680,169
All Alaskans 2008 180.9 171.0 190.9 856 686,818
All Alaskans 2009 184.5 174.5 194.5 891 697,828
All Alaskans 2010 176.1 166.3 185.9 880 710,231
All Alaskans 2011 173.9 164.3 183.5 935 723,424
All Alaskans 2012 163.4 154.2 172.6 923 731,827
All Alaskans 2013 167.9 158.4 177.3 1,015 736,399

Data Notes

Age-adjusted to U.S. 2000 population.

Number of deaths due to cancer defined as International Classification of Diseases (ICD)-9 codes 140-208 and ICD-10 codes C00-C97) as the underlying cause of death among residents during a calendar year.

Cancer is not a single disease, but rather numerous diseases with different causes, risks, and potential interventions. Interpretation of increases or decreases in cancer mortality can be made only by examination of specific types of cancers. Because certain cancers have a long latency period, years might pass before changes in behavior or clinical practice patterns affect cancer mortality. In addition, certain cancers are not amenable to primary prevention or screening.


References and Community Resources

Alaska Comprehensive Cancer Control Program @ http://dhss.alaska.gov/dph/Chronic/Pages/Cancer/comprehensive.aspx
Susan G. Komen Foundation @ www.komen.org
American Cancer Society @ www.cancer.org
National Cancer Institute @ www.cancer.gov
Centers for Disease Control and Prevention @ www.cdc.gov
American Society of Clinical Oncology @ www.asco.org

More Resources and Links

Alaska and national goals may be found at the following sites:

Maps of health indicators for various subdivisions of Alaska may be found at the following site:

Evidence-based community health improvement ideas and interventions may be found at the following sites:

Additional indicator data by state and county may be found on these Websites:

Medical literature can be queried at the PubMed website.

For an on-line medical dictionary, click on this Dictionary link.

Page Content Updated On 08/19/2015, Published on 08/19/2015
The information provided above is from the Alaska Department of Health and Social Services' Center for Health Data and Statistics, Alaska Indicator-Based Information System for Public Health (Ak-IBIS) web site (http://ibis.dhss.alaska.gov). The information published on this website may be reproduced without permission. Please use the following citation: "Retrieved Sat, 29 August 2015 17:29:33 from Alaska Department of Health and Social Services, Center for Health Data and Statistics, Alaska Indicator-Based Information System for Public Health web site: http://ibis.dhss.alaska.gov".

Content updated: Wed, 19 Aug 2015 14:16:06 AKDT