Conference Coverage

Cancer Incidence in the Veterans Affairs Healthcare System: A Veterans Affairs Central Cancer Registry Analysis

Abstract 19: 2016 AVAHO Meeting


 

Purpose: Our objective is to comprehensively describe cancer incidence as reported in the VA Central Cancer Registry (VACCR).

Background: Approximately 3% of US cancer cases are diagnosed and treated in the VA healthcare system each year. These cancer cases are reported in the VACCR. In 2012, we published the first comprehensive description of cancer incidence as reported in the VACCR for patients diagnosed in 2007. In our current analysis, we provide an updated description of cancer incidence as reported in the VACCR for patients diagnosed in 2010.

Methods: This was a retrospective, cross-sectional study. We obtained data from 2 sources: (1) VACCR for incident cancer cases; (2) VHA Support Service Center (VSSC) for underlying population of VA healthcare system users.

Data Analysis: Analyses focused on diagnoses in 2010. Noninvasive cancers and those missing TNM stage were excluded from analyses. Cancer incidence among VA patients was descriptively
compared to the general US cancer population.

Results: In 2010, 49,857 cases were reported in VACCR. We excluded non-invasive cases (n = 3,687) and those with missing/unknown stage (n = 8,645). There were 37,525 reported invasive, incident cancers, and 97% (n = 36,454) of those were diagnosed among men. Almost 80% (n = 29,364) of newly diagnosed patients were white, 20% (n = 7,293) were black, and less than 2% (n = 450) were another race. The median age at diagnosis was 64 years. The six most frequently diagnosed cancers were prostate (33%, n = 12,431), lung/bronchus (19%, n = 7,159), colon/rectum (9%, n = 3,419), kidney/renal pelvis (4%, n = 1,657), and urinary bladder (4%, n = 1,427) and skin melanomas (4%, n = 1,421). The most common cancers reported in VACCR have remained stable from 2007 to 2010. Approximately 87% (n = 10,845) of prostate, 33% (n = 2,391) of lung/bronchus, and 59% (n = 2,013) of colon/rectum cancers were diagnosed with early stage (stage I or II) disease. Compared to SEER, cases reported in the VACCR tend to be diagnosed at earlier stages. The overall cancer incidence rate among VA users was 414.8 per 100,000 person-years.

Implications: The VA continues to be a large provider of cancer care in the US. VACCR data indicate that incident cancers in VA in 2010 approximately mirrored those observed among US men.

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