
WSCR Data Online (WSCRDO) V2
WSCRDO Technical Notes: Table of Contents WSCR Online Query Options and Data Results Headings Cancer Site (Query Options and Results) Data Type (Query Options and Results) Stage at Diagnosis (Query Options and Results) Rate (Query Options and Results) Gender (Query Options and Results) Time period or Year (Query Options and Results) Geography (Query Options and Results) Average Annual Population (Results) Average Annual Observations (Results) Direct method of age adjustment General InformationThe data available in the Washington State Cancer Registry (WSCR) online database change as new incidence data are added. WSCR regularly receives information on people newly diagnosed with cancer and new information about previously diagnosed cancer cases. Thus, the current online data may differ from earlier printed reports. WSCR online provides data on cancer of all types combined and the 24 most frequently diagnosed cancers. Information is also provided on "Hodgkin lymphoma" and "Larynx" because previous years of the WSCR Annual Report included them among the 24 most frequently diagnosed cancers. See the Background and Cancer Case Reporting sections in About WSCR for the information on the WSCR data collection system. Query Option DetailsThe following notes provide information for WSCR Online query options and results. Query options vary depending on the user’s initial selections. Selecting common types of cancer with relatively large numbers of cases each results in more query options than selecting rare types of cancer with few cases each year. Even when query options are available, WSCR Online suppresses output when there are less than ten cases for the query options selected. When numbers are small, some parameter values may be aggregated (for example, you may not be able to obtain single years, but only threeyear periods). Similarly, you may not be able to query multiple parameters simultaneously (for example, if you want data by county, you may not be able to select individual age groups). If you can see that there is a parameter available, such as geography, but no options appear for that parameter, try aggregating other parameters. For example, change age to allagescombined, and then check to see if the other parameters are available. For some measures with small numbers, you may be able to stratify only one or two parameters at a time. For some measures where the numbers are very small, few options for subgroup analysis are possible; if you need to conduct subgroup analysis, contact assessment staff in your local health agency, who have access to the restricted data. WSCR Online Query Options and Data Results HeadingsCancer Site (Query Options and Results)New cases of cancer (incidence) are coded to International Classification of Diseases for Oncology Third Edition (ICDO3) codes. The WSCR Online query results produces the definition box for each selected cancer site with the ICDO3 primary site and histology codes. The cancer sites definitions (http://seer.cancer.gov/siterecode/icdo3_dwhoheme/index.html) are consistent with those used by the National Cancer Institute’s SEER program. The underlying cause of death is coded to an International Classification of Diseases, 9th Revision (ICD9) code for years prior to 1999 and 10th Revision (ICD10) for 1999 and after. The WSCR Online query results produces the definition box for the selected cancer sites based on the selection of death year with the ICD9 or ICD10 codes. The cancer sites definitions (http://seer.cancer.gov/codrecode/1969+_d04162012/index.html) are consistent with those used by the National Cancer Institute’s SEER program. For some cancer sites (such as, colorectal, endometrial, leukemia, lung and bronchus, myeloma and thyroid), the SEER coding differs from the National Center for Health Statistics coding. Therefore, before comparing information from different reports, one must be sure that the definitions are consistent. Data Type (Query Options and Results)IncidenceIncidence refers to new cases of cancer diagnosed in a calendar year (annual) or during a 3 or 5year time span divided by 3 or 5 (average annual). Incidence data are from the Washington State Cancer Registry. For information on incidence rates, see age adjusted rate. MortalityMortality refers deaths from cancer in a calendar year (annual) or during a 3or 5year time span divided by 3 or 5 (average annual). The cancer was not necessarily diagnosed in the same year (annual) or time period (average annual). Mortality data reflect the underlying cause of death as recorded on the death certificate. Mortality data are from the Washington State Center for Health Statistics. For information on mortality rates, see age adjusted rate. Stage at Diagnosis (Query Options and Results)Stage at diagnosis refers to how far a cancer has spread from its site of origin at the time of diagnosis. The stages, in order of increasing spread, are in situ, local, regional and distant.
Cancers staged as local, regional, distant, or unstaged are referred to as invasive. For most cancers, diagnosis at an early stage (in situ or local) results in improved survival. WSCR uses the national Surveillance Epidemiology and End Results (SEER) guidelines to code stage at diagnosis. WSCR online allows users to obtain data by stage at diagnosis (in situ, invasive, or in situ and invasive combined) for all cancer sites combined, female breast cancer and melanoma of the skin. For the remaining types of cancer, WSCR online provides data on all diagnoses reported to WSCR irrespective of stage. Stage at diagnosis option is not available for other types of cancers because
For information on stage at diagnosis for specific cancers see WSCR Reports. Rate (Query Options and Results)AgeAdjusted RateAgeadjusted rate allows for comparisons between two or more populations that differ in their age composition. This is particularly important for agerelated diseases like cancer. To develop ageadjusted rates, the agespecific rates of each population being compared are computed. These agespecific rates are weighted by multiplying them by the proportion their corresponding agegroup represented in a “standard population.” The sum of each population’s weighted agespecific rates equals that population’s ageadjusted rate. The agespecific rates used to compute annual ageadjusted rates equal the number of new cases or deaths in given age group and year divided by the population in that age group. The agespecific rates used to compute average annual ageadjusted rates, equal the number of new cases or deaths for the 3 or 5year period divided by the number of personyears over the 3 or 5year period, respectively. WSCR online ageadjusts using 19 age groups as shown below from the United States 2000 standard population. US Standard Population Proportions
The formulas for computing the age adjusted rates can be found in Appendix A. AgeSpecific RateAnnual and average annual agespecific rates are the rates per 100,000 population for combinations of 5year age groups. For annual rates, the agespecific rate is the number of new cases or deaths in given age group and year divided by the population in that age group. For average annual rates, the agespecific rate is the number of new cases or deaths for the 3 or 5year period divided by the number of personyears over the 3 or 5year period, respectively. Age GroupThe age group (combinations of 5 years) of the population used for calculating the agespecific rate. Gender (Query Options and Results)Male, Female, All Time period or Year (Query Options and Results)The time period or year of diagnosis or death used for calculating the rate and count. Options vary depending on the average annual number of cases diagnosed over the last 10 years. The following table shows available options.
Geography (Query Options and Results)Geography includes Washington State, each of the 39 Washington Counties, and 6 multicounty regions shown below.
Output (Query Option)Show ChartWhen this box is checked, the horizontal bar chart is shown with rates. Data LabelsWhen this box is checked, the chart includes rates above the corresponding bars. Error BarsWhen this box is checked, the chart includes bars showing the extent of variation attributable to chance. See “Confidence Intervals” below. Zero MinimumWhen this box is checked, the chart xaxis begins at zero. This box is automatically selected as default. Output (Results)Annual Observations (Results)Number of cancer cases or deaths of the specified cancer type for the population group and year selected. Annual Population (Results)Number of people estimated to live in the specified geographic area for the population group and year selected. Average Annual Population (Results)Number of people estimated to live in the specified geographic area for the population group and years selected divided by 3 or 5 for the 3 or 5year ranges, respectively. Average Annual Observations (Results)Number of cancer cases or deaths of the specified cancer type for the population group and years selected divided by 3 or 5 for the 3 or 5year ranges, respectively. Rate/100,000 (Results)Either the ageadjusted rate or the agespecific rate chosen by the user. 95% CI (Results)95% confidence interval (CI) around the rate. While the incidence and death statistics in this report are not subject to sampling error, they may be affected by random variation. The confidence interval is used to describe the range of that variation. When the confidence interval for the area of interest does not overlap with the confidence interval for the comparison area, the two areas are statistically significantly different, i.e., the difference between the two rates is more than that expected by random variation or chance. However, if we are making many comparisons, we may still find statistically significant differences just by chance. In fact, with a 95% confidence interval, we expect that 5% of the comparisons will be statistically significant by chance. Thus, with 39 counties and 26 cancer sites, we might see as many as 50 instances where the rate for a county is statistically significantly different from the state rate just by chance. Confidence intervals for the ageadjusted rates are calculated with a method based on the gamma distribution (Fay and Feuer, 1997). This method produces valid confidence intervals even when the number of cases is very small. When the number of cases is large the confidence intervals produced with the gamma method are equivalent to those produced with the more traditional methods, as described by Chiang (1961) and Brillinger (1986). The formulas for computing the confidence intervals can be found in Appendix A. Data Results NotesNR: "Not reported"Statistic is not reported or calculated when the number of observations is less than or equal to nine (9) for rates and stage at diagnosis. Appendix ADirect method of age adjustmentMultiply the agespecific rates in the target populatiMultiply the agespecific rates in the target population by the age distribution of the standard population.
Where m is the number of age groups, d_{i} is the number of events in age group i, P_{i} is the population in age group i and s_{i} is the proportion of the standard population in age group i. This is a weighted sum of Poisson random variables, with the weights being ( s_{i} / P_{i} ). Confidence IntervalsConfidence intervals for the ageadjusted rates were calculated with a method based on the gamma distribution (Fay and Feuer, 1997). This method produces valid confidence intervals even when the number of cases is very small. When the number of cases is large the confidence intervals produced with the gamma method are equivalent to those produced with the more traditional methods, as described by Chiang (1961) and Brillinger (1986). The formulas for computing the confidence intervals are given below. Although the derivation of this method is based on the gamma distribution, the relationship between the gamma and Chisquared distributions allows the formulas to be expressed in terms of quantiles of the Chisquared distribution, which can be more convenient for computation.
where y is the ageadjusted rate, v is the variance as calculated as shown below, w_{M} is the maximum of the weights s_{i}P_{i} , 1α is the confidence level desired (e.g., for 95% confidence intervals, = 0.05), and ( x^{2} )_{x}^{1} is the inverse of the x^{2}distribution with x degrees of freedom.
ReferencesBrillinger, D. R. The natural variability of vital rates and associated statistics [with discussion]. Biometrics 42:693734, 1986. Chiang, C. L. Standard error of the ageadjusted death rate. Vital Statistics, Special Reports 47:271285, USDHEW, 1961. Fay, M.P. and Feuer, E.J. Confidence intervals for directly rates: a method based on the gamma distribution. Stat Med16:791801, 1997. 

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