Tumor Registry 2011
The mission of the Duke Tumor Registry is to contribute to the knowledge of cancer prevention, diagnosis and treatment and to contribute to improvements in cancer patient management through the collection of complete, accurate and timely cancer data and by ongoing follow up of patients. The registry provides cancer incidence, treatment, and outcome information and trend data for administrative planning and marketing, development of support programs, quality improvement and research activities. Data are submitted to the North Carolina Central Cancer Registry in compliance with state reporting requirements to support statewide improvements in cancer detection and treatment.
Our primary customers are:
- Administrators/Directors (Planning & Development of New Programs)
- Center for Cancer Survivorship (Survivor Events, Education Events, Support Programs)
- Researchers (Case Finding for New Studies; Follow Up for ongoing studies)
- North Carolina Central Cancer Registry (State-mandated reporting)
- Outside Registries (Request Diagnostic, Treatment, Follow Up Information)
Duke Tumor Registry Staff
Eileen J. Morgan, MPA, CTR
Director, Duke & Durham Regional Tumor Registry
919-684-0330
Iris A. Katz, BA, CTR
Data Specialist
919-257-9487 Data & Research Requests
Tumor Registrars
Shelley S. Alvey
Deborah A. Belvin
Kathy E. Bess, BA, CTR
Debra J. Carroll, CTR
Michelle N. Chatman, AA, CTR
Lisa D. Gimber, AA, RHIT, CTR
Christy K. Hall, AAS, CTR
Sathya N. Kasala, BS, CTR
Deborah L. Mangum, BSW
Administrative Clerk
Denea J. Labajetta, R.T.
Volume Trends by Type of Case (PDF 17 KB)
In 2011 more than eighty-one percent (81%) of the patients first seen at Duke were “Newly Diagnosed” (Analytic) at the time of their first visit (n=5129). Of those “Newly Diagnosed” patients, 47% (n=2427) were first diagnosed at Duke and 53% (n=2702) were diagnosed elsewhere and then referred to Duke for part of their initial treatment. Patients are often referred to Duke for services not available in their home community (specialized surgical and radiation procedures and clinical trials); many come simply because of the Duke’s reputation for excellence in cancer care.
In 2011 nineteen percent (19%) of the patients had “Recurrent” disease (Non-Analytic) when they first came to Duke. These patients often come to Duke for clinical trials that offer them hope for improved survival and quality of life.
Primary Site Distribution for All Cases 1st Seen at Duke in 2011
A total of 6309 cases (including non-malignant CNS tumors) diagnosed and/or treated at Duke Hospital and Clinics were added to the registry database for the year 2011. Eighty-one percent (81%) are Analytic cases (Newly Diagnosed); 53% of the Analytic cases were diagnosed elsewhere and referred to Duke for all or part of their initial treatment. Non-Analytic patients (about 19% of all cases) come to Duke for treatment after initial treatment failure or with recurrent disease.
The most common types of cases seen in 2011 were: Prostate/GU, Digestive, Brain & CNS, Hema/Lymphatic*, Respiratory and Breast.
* Hema/Lymphatic (n=767) includes: Lymphoma, Myeloma, Leukemia and Other Hematologic.
2011 Analytic Case Profile (Analytic = Newly Diagnosed at First Visit to Duke)
Analytic cases (n=5129) are patients either initially diagnosed at Duke or Newly Diagnosed elsewhere who are referred to Duke for all or part of their initial treatment. Fifty-three percent (53%) of the Analytic cases were referrals to Duke for treatment. (Patients who come to Duke only for a 2nd opinion consult are not entered into the registry database.)
The most common types of Analytic cases are Prostate/GU, Digestive, Respiratory, Brain & CNS, Breast and Hema/Lymphatic*.
* Hema/Lymphatic (n=526) includes: Lymphoma, Myeloma, Leukemia and Other Hematologic.
2011 Non-Analytic Case Profile (Non-Analytic = Recurrent Disease at First Visit to Duke)
Non-Analytic cases (n=1180) were diagnosed elsewhere and received all of their initial treatment prior to coming to Duke. Treatment at Duke is either for initial treatment failure (progression of disease) or recurrent disease. Non-Analytic cases also include cases diagnosed at autopsy.
The most common Non-Analytic cases are Hema/Lymphatic*, Prostate/GU, Brain & CNS, Digestive, Breast and Respiratory.
* Hema/Lymphatic (n=241) includes: Lymphoma, Myeloma, Leukemia and Other Hematologic.
All 2011 Cases by Primary Site
| Table 1 Duke University Hospital--Cases 1st Seen in 2011 | ||||
| Class of Case | Percent | |||
|
Primary Site |
Analytic |
Non- |
Total |
of Total |
|
LIP |
3 |
0 |
3 |
0.0 |
|
TONGUE |
43 |
1 |
44 |
0.7 |
|
SALIVARY GLANDS |
10 |
2 |
12 |
0.2 |
|
FLOOR OF MOUTH |
5 |
0 |
5 |
0.1 |
|
GUM & OTHER MOUTH |
20 |
1 |
21 |
0.3 |
|
NASOPHARYNX |
10 |
1 |
11 |
0.2 |
|
TONSIL |
24 |
2 |
26 |
0.4 |
| OROPHARYNX | 4 | 0 | 4 | 0.1 |
| HYPOPHARYNX | 7 | 1 | 8 | 0.1 |
| OTHER ORAL CAVITY & PHARYNX | 4 | 0 | 4 | 0.1 |
| TOTAL Oral & Pharynx | 130 | 8 | 138 | 2.2 |
| ESOPHAGUS | 62 | 7 | 69 | 1.1 |
| STOMACH | 72 | 12 | 84 | 1.3 |
| SMALL INTESTINE | 45 | 6 | 51 | 0.8 |
| CECUM | 27 | 11 | 38 | 0.6 |
| APPENDIX | 10 | 4 | 14 | 0.2 |
| ASCENDING COLON | 18 | 19 | 37 | 0.6 |
| HEPATIC FLEXURE | 10 | 2 | 12 | 0.2 |
| TRANSVERSE COLON | 22 | 4 | 26 | 0.4 |
| SPLENIC FLEXURE | 6 | 1 | 7 | 0.1 |
| DESCENDING COLON | 9 | 6 | 15 | 0.2 |
| SIGMOID COLON | 30 | 20 | 50 | 0.8 |
| LARGE INTESTINE, NOS | 5 | 8 | 13 | 0.2 |
| Total COLON, EXCL RECTUM | 137 | 75 | 212 | 3.4 |
| RECTOSIGMOID JUNCTION | 16 | 4 | 20 | 0.3 |
| RECTUM | 91 | 27 | 118 | 1.9 |
| Total RECTUM & RECTOSIGMOID | 107 | 31 | 138 | 2.2 |
| ANUS,ANAL CANAL,ANORECTUM | 17 | 2 | 19 | 0.3 |
| LIVER | 73 | 4 | 77 | 1.2 |
| INTRAHEPATIC BILE DUCT | 26 | 6 | 32 | 0.5 |
| Total LIVER & INTRAHEPATIC BILE DUCT | 99 | 10 | 109 | 1.7 |
| GALLBLADDER | 13 | 2 | 15 | 0.2 |
| OTHER BILIARY | 29 | 5 | 34 | 0.5 |
| PANCREAS | 172 | 16 | 188 | 3.0 |
| RETROPERITONEUM | 7 | 1 | 8 | 0.1 |
| PERITONEUM,OMENTUM,MESENTERY | 4 | 1 | 5 | 0.1 |
| OTHER DIGESTIVE ORGANS | 3 | 0 | 3 | 0.0 |
| TOTAL Digestive System | 767 | 168 | 935 | 15.0 |
| Table 1 Duke University Hospital--Cases 1st Seen in 2011 (cont.) | ||||
| Class of Case | Percent | |||
| Primary Site | Analytic | Non- Analytic |
Total | of Total |
| NOSE,NASAL CAV & MIDDLE EAR | 7 | 1 | 8 | 0.1 |
| LARYNX | 34 | 1 | 35 | 0.6 |
| LUNG & BRONCHUS | 558 | 92 | 650 | 10.4 |
| PLEURA | 27 | 5 | 32 | 0.5 |
| TRACHEA, MEDIASTINUM & HEART | 4 | 2 | 6 | 0.1 |
| TOTAL Respiratory System | 630 | 101 | 731 | 11.7 |
| TOTAL Bones & Joints | 20 | 8 | 28 | 0.4 |
| TOTAL Soft Tissue | 75 | 12 | 87 | 1.4 |
| MELANOMAS -- SKIN | 370 | 55 | 425 | 6.8 |
| OTHER NON-EPITHELIAL SKIN | 30 | 6 | 36 | 0.6 |
| TOTAL Skin | 400 | 61 | 461 | 7.4 |
| TOTAL Breast | 558 | 120 | 678 | 10.9 |
| CERVIX UTERI | 35 | 3 | 38 | 0.6 |
| CORPUS UTERI | 186 | 8 | 194 | 3.1 |
| UTERUS, NOS | 4 | 2 | 6 | 0.1 |
| OVARY | 100 | 17 | 117 | 1.9 |
| VAGINA | 18 | 0 | 18 | 0.3 |
| VULVA | 43 | 1 | 44 | 0.7 |
| OTHER FEMALE GENITAL ORGANS | 8 | 3 | 11 | 0.2 |
| TOTAL Female Genital System | 394 | 34 | 428 | 6.9 |
| PROSTATE | 463 | 131 | 594 | 9.5 |
| TESTIS | 12 | 5 | 17 | 0.3 |
| PENIS | 14 | 1 | 15 | 0.2 |
| OTHER MALE GENITAL ORGANS | 1 | 0 | 1 | 0.0 |
| TOTAL Male Genital System | 490 | 137 | 627 | 10.0 |
| URINARY BLADDER | 85 | 27 | 112 | 1.8 |
| KIDNEY & RENAL PELVIS | 193 | 34 | 227 | 3.6 |
| URETER | 4 | 1 | 5 | 0.1 |
| OTHER URINARY ORGANS | 7 | 1 | 8 | 0.1 |
| TOTAL Urinary System | 289 | 63 | 352 | 5.6 |
| TOTAL Eye & Orbit | 53 | 3 | 56 | 0.9 |
| BRAIN | 417 | 159 | 576 | 9.2 |
| CRANIAL NERVES & OTHER NERVES | 162 | 36 | 198 | 3.2 |
| TOTAL Brain & Other Nervous System | 579 | 195 | 774 | 12.4 |
| THYROID | 110 | 8 | 118 | 1.9 |
| OTHER ENDOCRINE INCL THYMUS | 64 | 13 | 77 | 1.2 |
| TOTAL Endocrine System | 174 | 21 | 195 | 3.1 |
| Table 1 Duke University Hospital--Cases 1st Seen in 2010 (cont.) | ||||
| Class of Case | Percent | |||
| Primary Site | Analytic |
Non- |
Total | of Total |
| HODGKIN LYMPHOMA | 24 | 17 | 41 | 0.7 |
| Total HODGKIN LYMPHOMA | 24 | 17 | 41 | 0.7 |
| NODAL NHL | 127 | 47 | 174 | 2.8 |
| EXTRANODAL NHL | 77 | 33 | 110 | 1.8 |
| Total NHL | 204 | 80 | 284 | 4.5 |
| TOTAL Lymphomas | 228 | 97 | 325 | 5.2 |
| TOTAL Myeloma | 107 | 36 | 143 | 2.3 |
| ACUTE LYMPHOCYTIC | 25 | 7 | 32 | 0.5 |
| CHRONIC LYMPHOCYTIC | 26 | 28 | 54 | 0.9 |
| OTHER LYMPHOCYTIC | 0 | 2 | 2 | 0.0 |
| Total LYMPHOCYTIC Leukemia | 51 | 37 | 88 | 1.4 |
| ACUTE MYELOID | 70 | 26 | 96 | 1.5 |
| ACUTE MONOCYTIC | 5 | 4 | 9 | 0.1 |
| CHRONIC MYELOID | 17 | 15 | 32 | 0.5 |
| OTHER MYELOID/MONOCYTIC | 1 | 1 | 2 | 0.0 |
| Total MYELOID & MONOCYTIC Leukemia | 93 | 46 | 139 | 2.2 |
| OTHER ACUTE LEUKEMIA | 2 | 1 | 3 | 0.0 |
| ALEUKEMIC, SUBLEUKEMIC | 5 | 5 | 0.1 | |
| Total OTHER Leukemia | 7 | 1 | 8 | 0.1 |
| TOTAL Leukemias | 151 | 84 | 235 | 3.8 |
| OTHER Hematologic (MDS etc) | 40 | 24 | 64 | 1.0 |
| TOTAL Ill-Defined & Unknown Primary | 44 | 8 | 52 | 0.8 |
| GRAND TOTAL | 5129 | 1180 | 6309 | 100.0 |
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Duke University Hospital – Newly Diagnosed Cases 1st Seen in 2011 compared with ACS Estimates of Incidence for 2011
NOTE: Because 53% of the newly diagnosed patients first seen at Duke were referred to us for specialized treatments which may not be available in their home community, the most common sites seen at Duke are different than national incidence norms. Variances from the national norms are common in every research institution.
Geographic Referral Patterns
State/County Residence of All patients first seen at Duke in 2011:
Overall, 77% of the patients first seen at Duke in 2011 reside in North Carolina. The top six counties of residence were: Durham, Wake, Orange, Cumberland, Robeson and Alamance counties. Of the patients who reside outside North Carolina (23%), the top six states were: Virginia, South Carolina, Florida, West Virginia, Georgia and Tennessee.
Insert NC-County map here.
Insert map of states here.
State/County Residence of Analytic patients first seen at Duke in 2011:
Eighty percent (80%) of the Analytic patients (Newly Diagnosed) reside in North Carolina. The top six counties of residence were: Durham, Wake, Orange, Cumberland, Robeson and Alamance counties. Of the patients who reside outside North Carolina (20%), the top six states were: Virginia, South Carolina, Florida, West Virginia, Georgia and Tennessee.
State/County Residence of Non-Analytic patients first seen at Duke in 2011:
North Carolina residents represent only 64% of the Non-Analytic patients who come to Duke for treatment of progression or recurrent disease. This is a significant difference from Analytic patients, 77% of whom come from North Carolina. For Non-Analytic patients the top six counties of residence were: Wake, Durham, Guilford, Mecklenburg, Cumberland and New Hanover counties. Of the patients who reside outside North Carolina, the top six states were: Virginia, South Carolina, Florida, Georgia, Tennessee and West Virginia.
Duke University Hospital--Newly Diagnosed Cases 1st Seen in 2010 Compared with American Cancer Society Estimates of Incidence for 2011 (pdf 74 KB)
State/County Residence of Analytic patients first seen at Duke in 2010:
Seventy-nine percent (79%) of the Analytic patients (newly diagnosed) reside in North Carolina. The top six counties of residence were: Durham, Wake, Orange, Alamance, Cumberland and Robeson counties. Of the patients who reside outside North Carolina (21%), the top six states were: Virginia, South Carolina, Florida, West Virginia, Georgia and Tennessee.
State/County Residence of Non-analytic patients first seen at Duke in 2010:
North Carolina residents represent only 60% of the non-analytic patients who come to Duke for treatment of progression or recurrent disease. This is a significant difference from analytic patients, 75% of whom come from North Carolina. For non-analytic patients the top six counties of residence were: Wake, Durham, Mecklenburg, Guilford, Cumberland and Orange counties. Of the patients who reside outside North Carolina, the top six states were: Virginia, South Carolina, Georgia, Florida, West Virginia and Tennessee.
Glossary
Analytic = Newly Diagnosed at First Visit to Duke
Cancer/tumor either initially diagnosed at Duke or newly diagnosed elsewhere and referred to Duke for all or part of their initial treatment
Non-Analytic = Recurrent Disease at First Visit to Duke
Cancer/tumor diagnosed elsewhere and received all initial treatment prior to coming to Duke. Treatment at Duke is either for initial treatment failure (progression of disease) or recurrent disease. Non-Analytic cases also include cases diagnosed at autopsy.
References
Cancer Statistics, 2012 (CA-A Cancer Journal for Clinicians, 2012; 62:10-29)
Commission on Cancer, Cancer Program Standards 2012. American College of Surgeons, Chicago, IL.
International Classification of Diseases for Oncology, 3rd Edition, World Health Organization, 2001.
AJCC Cancer Staging Manual, 7TH Edition, American Joint Committee on Cancer, Chicago, IL. Published by Springer-Verlag, New York, NY, 2010.
Cancer Statistics - Links
American Cancer Society – CA-A Cancer Journal for Clinicians (on-line)
(Cancer Statistics in January/February or March/April issue each year)
http://caonline.amcancersoc.org/
Commission on Cancer of the American College of Surgeons
http://www.facs.org/cancer/index.html
International Association of Cancer Registries
http://www.iacr.com.fr/
National Cancer Data Base
http://www.facs.org/cancer/ncdb/index.html
National Program of Cancer Registries (NPCR)
http://www.cdc.gov/cancer/npcr/index.htm
NCI – State Cancer Profiles
http://statecancerprofiles.cancer.gov/
NCI – SEER (Surveillance Epidemiology and End Results)
http://seer.cancer.gov/
North American Association of Central Cancer Registries (NAACCR)
http://www.naaccr.org/
North Carolina Central Cancer Registry
http://www.schs.state.nc.us/SCHS/CCR/
