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> Available Reports > Technical Notes
Technical NotesReportable Cancers and Site DefinitionsNot all cancers diagnosed in Maine are reported to the MCR. Cancers that are reported include all malignant cancers that are in situ or invasive with the exception of basal and squamous cell carcinoma of the skin. The MCR also collects data concerning benign tumors of the brain. Site definitions for annual reports are consistent with those used by the National Institute of Health's Surveillance, Epidemiology and End Results (SEER) Program for calculating rates. Therefore, annual reports exclude all in situ cancers, with the exception of in situ bladder cancer. For a complete listing of site and histology codes used for calculating rates. See ICD-O Codes. Age-adjusted RatesWhy age adjust?Different communities have different age structures. The age structure of a community determines what kind of health problems will be more common. A community made up of more families with young children will have more bicycle accidents than a community with more individuals who are older. Likewise, a community with more individuals who are older will have more chronic disease, including cancer. Age adjustment allows rates of disease to be compared between different communities with different age structures. How is age-adjustment done?Age adjustment is done using a statistical procedure called the direct method. The steps for age-adjustment are:
Here's an example of Age-adjusted rates using all cancers reported in Maine that were diagnosed in 2003:
In the above example, the rate before age adjustment (the crude rate) is 565.9 per 100,000 people and the age adjusted rate is 490.7 per 100,000 people. A Few Words about County RatesThe number of new cancers in a county varies from year to year. Cancer rates therefore also vary from year to year. With a smaller number of cases, there is more variation from year to year. Here is an example of random variation in the number of cases: One county might have 4 cases of brain cancer one year, 9 cases the next year, no cases the next year, 8 the next and 3 the next year. Over the five years there is an average of 5 cases a year. In general, when there are less than 30 cases a year it can be difficult to distinguish between such normal variation in the number of cases and meaningful changes in the cancer rates. The small population of Maine counties mean caution must be used when presenting rates of cancer in some counties. To avoid presenting unstable numbers (with lots of variation), this report presents county-level data for the four most common cancer sites - lung, breast (female only), prostate and colon-rectum, as well as all cancers combined. U.S. SEER RatesWhat is SEER?The National Cancer Institute funds the Surveillance, Epidemiology and End Results (SEER) cancer registries. SEER collects information on cancers from a statistical sample of the United States population composed of 17 population-based registries. These registries represent approximately 26 percent of the US population. The sample is designed to be fairly representative of the U.S. population. Because the non-white population of Maine is less than 2%, the SEER rates for Whites only are used for all comparisons in annual reports. Why is caution needed in interpreting comparisons using an all-white population?Rates of cancer vary by race. These differences are due to cultural differences in personal habits, dietary practices, and environmental exposures that may change the risk of cancer in a population. In addition, many ethnic and racial minorities are at a disadvantage relative to access and availability of health care, preventative services and health education in part due to language differences as well as low income and education. Thus minorities may experience increased cancer incidence and mortality. In the U.S., people of white race have a higher risk of female breast cancer, melanoma and bladder cancer than persons of other races. Whites have a lower risk compared to other races for prostate, colorectal and cervical cancer. Because the non-white population of Maine is relatively small, in the future we will need to combine a number of years of data to be able to reliably report rates in these groups. Changes in Case-Finding Starting in 1995Beginning in 1995, physicians, non-hospital facilities, and pathology labs were added to the list of reporting sources for the registry. In that year, the Maine Cancer Registry also began performing Death Clearance, in which death certificates are reviewed to identify missing cases. ICD-O-3 Codes for Oral Cavity & Pharynx
Note: Oral Cavity & Pharynx codes exclude histologies 9590-9989. ICD-O-3 Codes for Digestive System
Note: Digestive System codes exclude histologies 9590-9989. ICD-O-3 Codes for Respiratory System
Note: Respiratory System codes exclude histologies 9590-9989. ICD-O-3 Codes for Bones & Joints
Note: Bones & Joints codes exclude histologies 9590-9989. ICD-O-3 Codes for Soft Tissue
Note: Soft Tissue codes exclude histologies 9590-9989. ICD-O-3 Codes for Melanoma of Skin
Note: Melanoma codes include histologies 8720-8790 only. ICD-O-3 Codes for Breast
Note: Breast codes exclude histologies 9590-9989. ICD-O-3 Codes for Eye
Note: Eye codes exclude histologies 9590-9989. ICD-O-3 Codes for Female Genital System
Note: Female Genital System codes exclude histologies 9590-9989. ICD-O-3 Codes for Male Genital System
Note: Male Genital System codes exclude histologies 9590-9989. ICD-O-3 Codes for Urinary System
Note: Urinary System codes exclude histologies 9590-9989. ICD-O-3 Codes for Brain & Other Nervous System
Note: Brain & Other Nervous System codes exclude histologies 9590-9989. ICD-O-3 Codes for Endocrine System
Note: Endocrine System codes exclude histologies 9590-9989. ICD-O-3 Codes for Lymphomas
ICD-O-3 Codes for Multiple Myeloma
ICD-O-3 Codes for Leukemias
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| The Department of Health and Human Services, Maine CDC © 2007 Maine Cancer Registry. All rights reserved. |