OAKWOOD HOSPITAL & MEDICAL CENTER-DEA
Summary by Body System, Sex, Class, Status and Best CS/AJCC Stage Report
Filter(s): Quick Filter: Year:1ST CONTACT YEAR 2018-2018
1/2/2020 8:49 PM
Primary Site Class of Case Total (%) Analy NA F M Sex Stage Distribution - Analytic Cases Only Status Alive Exp Stg 0 Stg I Stg II Stg III Stg IV 88 Unk Blank/Oth 42 2 33 11 35 9 44 (2.3%) ORAL CAVITY & PHARYNX 0 5 3 9 9 7 9 0 Lip 1 0 1 0 1 0 1 (0.1%) 0 0 1 0 0 0 0 0 Tongue 17 1 12 6 13 5 18 (0.9%) 0 4 1 2 1 4 5 0 Salivary Glands 2 0 2 0 2 0 2 (0.1%) 0 0 0 0 1 0 1 0 Floor of Mouth 1 0 0 1 1 0 1 (0.1%) 0 0 0 1 0 0 0 0 Gum & Other Mouth 2 0 2 0 2 0 2 (0.1%) 0 0 0 1 1 0 0 0 Nasopharynx 3 0 1 2 3 0 3 (0.2%) 0 1 0 1 1 0 0 0 Tonsil 9 1 8 2 8 2 10 (0.5%) 0 0 0 3 2 2 2 0 Oropharynx 3 0 3 0 2 1 3 (0.2%) 0 0 0 0 2 1 0 0 Hypopharynx 4 0 4 0 3 1 4 (0.2%) 0 0 1 1 1 0 1 0 258 25 158 125 181 102 283 (14.8%) DIGESTIVE SYSTEM 0 28 18 79 68 42 18 5 Esophagus 20 3 15 8 10 13 23 (1.2%) 0 4 2 7 2 3 1 1 Stomach 25 0 17 8 17 8 25 (1.3%) 0 4 0 9 9 2 1 0 Small Intestine 5 1 3 3 4 2 6 (0.3%) 0 0 5 0 0 0 0 0 Colon Excluding Rectum 83 7 42 48 71 19 90 (4.7%) 0 7 2 24 25 16 7 2 19 17 2 8 11 14 5 Cecum 0 0 0 3 8 5 1 0 7 7 0 1 6 7 0 Appendix 0 1 2 2 1 1 0 0 12 11 1 6 6 9 3 Ascending Colon 0 0 0 4 4 2 1 0 6 6 0 4 2 6 0 Hepatic Flexure 0 2 0 1 2 0 0 1 4 3 1 1 3 3 1 Transverse Colon 0 0 0 2 0 1 0 0 2 2 0 1 1 2 0 Splenic Flexure 0 0 0 0 0 1 1 0 4 4 0 2 2 4 0 Descending Colon 0 1 0 1 1 0 0 1 29 29 0 14 15 21 8 Sigmoid Colon 0 2 0 8 9 6 4 0 7 4 3 5 2 5 2 Large Intestine, NOS 0 1 0 3 0 0 0 0 Rectum & Rectosigmoid 35 6 23 18 28 13 41 (2.1%) 0 7 4 5 11 6 0 2 6 4 2 3 3 6 0 Rectosigmoid Junction 0 1 1 0 2 0 0 0 35 31 4 20 15 22 13 Rectum 0 6 3 5 9 6 0 2 Anus, Anal Canal & Anorectum 10 2 4 8 10 2 12 (0.6%) 0 0 1 1 6 2 0 0 Liver & Intrahepatic Bile Duct 24 2 19 7 15 11 26 (1.4%) 0 2 2 6 5 5 4 0 24 22 2 18 6 14 10 Liver 0 1 2 5 5 5 4 0 2 2 0 1 1 1 1 Intrahepatic Bile Duct 0 1 0 1 0 0 0 0 Gallbladder 3 0 1 2 3 0 3 (0.2%) 0 0 0 1 1 1 0 0 Other Biliary 6 0 4 2 3 3 6 (0.3%) 0 3 0 1 1 1 0 0 Pancreas 43 4 28 19 16 31 47 (2.5%) 0 1 0 24 8 5 5 0 Retroperitoneum 1 0 1 0 1 0 1 (0.1%) 0 0 1 0 0 0 0 0 Peritoneum, Omentum & Mesentery 2 0 0 2 2 0 2 (0.1%) 0 0 0 1 0 1 0 0 Other Digestive Organs 1 0 1 0 1 0 1 (0.1%) 0 0 1 0 0 0 0 0 323 25 163 185 208 140 348 (18.2%) RESPIRATORY SYSTEM 18 3 19 131 77 21 53 1 Nose, Nasal Cavity & Middle Ear 3 0 1 2 3 0 3 (0.2%) 0 0 1 1 0 0 1 0 Larynx 16 1 14 3 15 2 17 (0.9%) 0 1 0 3 5 2 4 1 Page 1
OAKWOOD HOSPITAL & MEDICAL CENTER-DEA
Summary by Body System, Sex, Class, Status and Best CS/AJCC Stage Report
1/2/2020 8:49 PM
Primary Site Class of Case Total (%) Analy NA F M Sex Stage Distribution - Analytic Cases Only Status Alive Exp Stg 0 Stg I Stg II Stg III Stg IV 88 Unk Blank/Oth Lung & Bronchus 304 24 148 180 190 138 328 (17.1%) 18 2 18 127 72 19 48 0 1 0 0 1 1 0 1 (0.1%) BONES & JOINTS 0 0 0 0 0 1 0 0 Bones & Joints 1 0 0 1 1 0 1 (0.1%) 0 0 0 0 0 1 0 0 7 0 5 2 7 0 7 (0.4%) SOFT TISSUE 0 0 2 0 4 1 0 0 Soft Tissue (including Heart) 7 0 5 2 7 0 7 (0.4%) 0 0 2 0 4 1 0 0 3 2 3 2 2 3 5 (0.3%) SKIN EXCLUDING BASAL & SQUAMOUS 0 1 0 2 0 0 0 0 Melanoma -- Skin 3 2 3 2 2 3 5 (0.3%) 0 1 0 2 0 0 0 0 406 11 2 415 400 17 417 (21.8%) BREAST 0 12 15 18 32 45 214 70 Breast 406 11 2 415 400 17 417 (21.8%) 0 12 15 18 32 45 214 70 123 78 0 201 191 10 201 (10.5%) FEMALE GENITAL SYSTEM 0 13 4 18 22 0 66 0 Cervix Uteri 11 54 0 65 63 2 65 (3.4%) 0 3 0 2 2 0 4 0 Corpus & Uterus, NOS 85 0 0 85 79 6 85 (4.4%) 0 9 1 9 11 0 55 0 84 84 0 0 84 78 6 Corpus Uteri 0 9 1 8 11 0 55 0 1 1 0 0 1 1 0 Uterus, NOS 0 0 0 1 0 0 0 0 Ovary 16 3 0 19 17 2 19 (1.0%) 0 0 2 4 6 0 4 0 Vagina 0 1 0 1 1 0 1 (0.1%) 0 0 0 0 0 0 0 0 Vulva 6 20 0 26 26 0 26 (1.4%) 0 1 1 1 0 0 3 0 Other Female Genital Organs 5 0 0 5 5 0 5 (0.3%) 0 0 0 2 3 0 0 0 133 36 169 0 161 8 169 (8.8%) MALE GENITAL SYSTEM 0 11 0 15 29 63 15 0 Prostate 126 34 160 0 153 7 160 (8.4%) 0 7 0 15 27 62 15 0 Testis 6 0 6 0 6 0 6 (0.3%) 0 3 0 0 2 1 0 0 Penis 1 2 3 0 2 1 3 (0.2%) 0 1 0 0 0 0 0 0 123 20 95 48 121 22 143 (7.5%) URINARY SYSTEM 27 9 1 10 12 11 53 0 Urinary Bladder 58 12 55 15 56 14 70 (3.7%) 26 2 1 4 5 7 13 0 Kidney & Renal Pelvis 61 8 39 30 63 6 69 (3.6%) 0 6 0 5 7 3 40 0 Ureter 4 0 1 3 2 2 4 (0.2%) 1 1 0 1 0 1 0 0 1 1 1 1 1 1 2 (0.1%) EYE & ORBIT 0 0 1 0 0 0 0 0 Eye & Orbit 1 1 1 1 1 1 2 (0.1%) 0 0 1 0 0 0 0 0 30 3 21 12 27 6 33 (1.7%) BRAIN & OTHER NERVOUS SYSTEM 0 0 30 0 0 0 0 0 Brain 17 0 14 3 12 5 17 (0.9%) 0 0 17 0 0 0 0 0 Cranial Nerves Other Nervous System 13 3 7 9 15 1 16 (0.8%) 0 0 13 0 0 0 0 0 54 1 12 43 55 0 55 (2.9%) ENDOCRINE SYSTEM 0 1 2 1 0 5 45 0 Thyroid 52 0 10 42 52 0 52 (2.7%) 0 1 0 1 0 5 45 0 Other Endocrine including Thymus 2 1 2 1 3 0 3 (0.2%) 0 0 2 0 0 0 0 0 74 16 53 37 76 14 90 (4.7%) LYMPHOMA 0 3 8 26 10 13 14 0 Hodgkin Lymphoma 13 3 8 8 15 1 16 (0.8%) 0 1 1 1 3 4 3 0 Non-Hodgkin Lymphoma 61 13 45 29 61 13 74 (3.9%) 0 2 7 25 7 9 11 0 52 43 9 32 20 41 11 NHL - Nodal 0 2 4 21 6 6 4 0 22 18 4 13 9 20 2 NHL - Extranodal 0 0 3 4 1 3 7 0 24 4 10 18 19 9 28 (1.5%) MYELOMA 0 0 24 0 0 0 0 0 Page 2
OAKWOOD
HOSPITAL & MEDICAL CENTER-DEA
1/2/2020 8:49 PM
Summary by Body System, Sex, Class, Status and Best CS/AJCC Stage Report Primary Site Class of Case Total (%) Analy NA F M Sex Stage Distribution - Analytic Cases Only Status Alive Exp Stg 0 Stg I Stg II Stg III Stg IV 88 Unk Blank/Oth Myeloma 24 4 10 18 19 9 28 (1.5%) 0 0 24 0 0 0 0 0 33 15 28 20 29 19 48 (2.5%) LEUKEMIA 0 0 33 0 0 0 0 0 Lymphocytic Leukemia 16 11 15 12 21 6 27 (1.4%) 0 0 16 0 0 0 0 0 3 2 1 3 0 3 0 Acute Lymphocytic Leukemia 0 0 2 0 0 0 0 0 20 10 10 11 9 17 3 Chronic Lymphocytic Leukemia 0 0 10 0 0 0 0 0 4 4 0 1 3 1 3 Other Lymphocytic Leukemia 0 0 4 0 0 0 0 0 Myeloid & Monocytic Leukemia 14 4 12 6 7 11 18 (0.9%) 0 0 14 0 0 0 0 0 10 9 1 7 3 2 8 Acute Myeloid Leukemia 0 0 9 0 0 0 0 0 7 4 3 5 2 4 3 Chronic Myeloid Leukemia 0 0 4 0 0 0 0 0 1 1 0 0 1 1 0 Other Myeloid/Monocytic Leukemia 0 0 1 0 0 0 0 0 Other Leukemia 3 0 1 2 1 2 3 (0.2%) 0 0 3 0 0 0 0 0 3 0 2 1 2 1 3 (0.2%) MESOTHELIOMA 1 0 1 0 0 1 0 0 Mesothelioma 3 0 2 1 2 1 3 (0.2%) 1 0 1 0 0 1 0 0 35 1 22 14 16 20 36 (1.9%) MISCELLANEOUS 0 0 35 0 0 0 0 0 Miscellaneous 35 1 22 14 16 20 36 (1.9%) 0 0 35 0 0 0 0 0 Total 1,673 240 777 1,136 1,913 1,532 381 76 487 210 263 309 196 86 46 Exclusions: Not Male and Not Female 0 Page 3
OAKWOOD HOSPITAL
& MEDICAL
CENTER-DEA
Summary by Body System and Sex Report
Filter(s): Quick Filter: Year:1ST CONTACT YEAR 2018-2018
1/2/2020 8:52 PM
Primary Site % % % Total Male Female 44 2.3% 4.2% 1.0% ORAL CAVITY & PHARYNX 11 33 1 0.1% 0.1% 0.0% Lip 0 1 18 0.9% 1.5% 0.5% Tongue 6 12 2 0.1% 0.3% 0.0% Salivary Glands 0 2 1 0.1% 0.0% 0.1% Floor of Mouth 1 0 2 0.1% 0.3% 0.0% Gum & Other Mouth 0 2 3 0.2% 0.1% 0.2% Nasopharynx 2 1 10 0.5% 1.0% 0.2% Tonsil 2 8 3 0.2% 0.4% 0.0% Oropharynx 0 3 4 0.2% 0.5% 0.0% Hypopharynx 0 4 283 14.8% 20.3% 11.0% DIGESTIVE SYSTEM 125 158 23 1.2% 1.9% 0.7% Esophagus 8 15 25 1.3% 2.2% 0.7% Stomach 8 17 6 0.3% 0.4% 0.3% Small Intestine 3 3 90 4.7% 5.4% 4.2% Colon Excluding Rectum 48 42 19 Cecum 11 8 7 Appendix 6 1 12 Ascending Colon 6 6 6 Hepatic Flexure 2 4 4 Transverse Colon 3 1 2 Splenic Flexure 1 1 4 Descending Colon 2 2 29 Sigmoid Colon 15 14 7 Large Intestine, NOS 2 5 41 2.1% 3.0% 1.6% Rectum & Rectosigmoid 18 23 6 Rectosigmoid Junction 3 3 35 Rectum 15 20 12 0.6% 0.5% 0.7% Anus, Anal Canal & Anorectum 8 4 26 1.4% 2.4% 0.6% Liver & Intrahepatic Bile Duct 7 19 24 Liver 6 18 2 Intrahepatic Bile Duct 1 1 3 0.2% 0.1% 0.2% Gallbladder 2 1 6 0.3% 0.5% 0.2% Other Biliary 2 4 47 2.5% 3.6% 1.7% Pancreas 19 28 1 0.1% 0.1% 0.0% Retroperitoneum 0 1 2 0.1% 0.0% 0.2% Peritoneum, Omentum & Mesentery 2 0 1 0.1% 0.1% 0.0% Other Digestive Organs 0 1 348 18.2% 21.0% 16.3% RESPIRATORY SYSTEM 185 163 3 0.2% 0.1% 0.2% Nose, Nasal Cavity & Middle Ear 2 1 17 0.9% 1.8% 0.3% Larynx 3 14 328 17.1% 19.0% 15.8% Lung & Bronchus 180 148 1 0.1% 0.0% 0.1% BONES & JOINTS 1 0 1 0.1% 0.0% 0.1% Bones & Joints 1 0 7 0.4% 0.6% 0.2% SOFT TISSUE 2 5 7 0.4% 0.6% 0.2% Soft Tissue (including Heart) 2 5 5 0.3% 0.4% 0.2% SKIN EXCLUDING BASAL & SQUAMOUS 2 3 5 0.3% 0.4% 0.2% Melanoma -- Skin 2 3 417 21.8% 0.3% 36.5% BREAST 415 2 417 21.8% 0.3% 36.5% Breast 415 2 201 10.5% 0.0% 17.7% FEMALE GENITAL SYSTEM 201 0 65 3.4% 0.0% 5.7% Cervix Uteri 65 0 85 4.4% 0.0% 7.5% Corpus & Uterus, NOS 85 0 84 Corpus Uteri 84 0 1 Uterus, NOS 1 0 Page 1
OAKWOOD HOSPITAL & MEDICAL CENTER-DEA
Summary by Body System and Sex Report
1/2/2020 8:52 PM
Primary Site % % % Total Male Female 19 1.0% 0.0% 1.7% Ovary 19 0 1 0.1% 0.0% 0.1% Vagina 1 0 26 1.4% 0.0% 2.3% Vulva 26 0 5 0.3% 0.0% 0.4% Other Female Genital Organs 5 0 169 8.8% 21.8% 0.0% MALE GENITAL SYSTEM 0 169 160 8.4% 20.6% 0.0% Prostate 0 160 6 0.3% 0.8% 0.0% Testis 0 6 3 0.2% 0.4% 0.0% Penis 0 3 143 7.5% 12.2% 4.2% URINARY SYSTEM 48 95 70 3.7% 7.1% 1.3% Urinary Bladder 15 55 69 3.6% 5.0% 2.6% Kidney & Renal Pelvis 30 39 4 0.2% 0.1% 0.3% Ureter 3 1 2 0.1% 0.1% 0.1% EYE & ORBIT 1 1 2 0.1% 0.1% 0.1% Eye & Orbit 1 1 33 1.7% 2.7% 1.1% BRAIN & OTHER NERVOUS SYSTEM 12 21 17 0.9% 1.8% 0.3% Brain 3 14 16 0.8% 0.9% 0.8% Cranial Nerves Other Nervous System 9 7 55 2.9% 1.5% 3.8% ENDOCRINE SYSTEM 43 12 52 2.7% 1.3% 3.7% Thyroid 42 10 3 0.2% 0.3% 0.1% Other Endocrine including Thymus 1 2 90 4.7% 6.8% 3.3% LYMPHOMA 37 53 16 0.8% 1.0% 0.7% Hodgkin Lymphoma 8 8 74 3.9% 5.8% 2.6% Non-Hodgkin Lymphoma 29 45 52 NHL - Nodal 20 32 22 NHL - Extranodal 9 13 28 1.5% 1.3% 1.6% MYELOMA 18 10 28 1.5% 1.3% 1.6% Myeloma 18 10 48 2.5% 3.6% 1.8% LEUKEMIA 20 28 27 1.4% 1.9% 1.1% Lymphocytic Leukemia 12 15 3 Acute Lymphocytic Leukemia 0 3 20 Chronic Lymphocytic Leukemia 9 11 4 Other Lymphocytic Leukemia 3 1 18 0.9% 1.5% 0.5% Myeloid & Monocytic Leukemia 6 12 10 Acute Myeloid Leukemia 3 7 7 Chronic Myeloid Leukemia 2 5 1 Other Myeloid/Monocytic Leukemia 1 0 3 0.2% 0.1% 0.2% Other Leukemia 2 1 3 0.2% 0.3% 0.1% MESOTHELIOMA 1 2 3 0.2% 0.3% 0.1% Mesothelioma 1 2 36 1.9% 2.8% 1.2% MISCELLANEOUS 14 22 36 1.9% 2.8% 1.2% Miscellaneous 14 22 Total 1,913 777 1,136 Not Male and Not Female Exclusions: 0 Page 2
OAKWOOD HOSPITAL & MEDICAL CENTER-DEA
Summary by Body System and Sex Report
Males
Females
Oral Cavity & Pharynx - 33 (4%)
Lung & Bronchus - 148 (19%)
Pancreas - 28 (4%)
Kidney & Renal Pelvis - 39 (5%)
Urinary Bladder - 55 (7%)
Colon & Rectum - 65 (8%)
Prostate - 160 (21%)
Non-Hodgkin Lymphoma - 45 (6%)
Melanoma of the Skin - 3 (0%)
Leukemia - 28 (4%)
All Other Sites - 173 (22%)
Thyroid - 42 (4%)
Lung & Bronchus - 180 (16%)
Breast - 415 (37%)
Kidney & Renal Pelvis - 30 (3%)
Ovary - 19 (2%)
Uterine Corpus - 85 (7%)
Colon & Rectum - 66 (6%)
Non-Hodgkin Lymphoma - 29 (3%)
Melanoma of the Skin - 2 (0%)
Leukemia - 20 (2%)
All Other Sites - 248 (22%)
1/2/2020 8:52 PM
Page 3
Images reprinted by the permission of the American Cancer Society, Inc. from www.cancer.org. All rights reserved.
Lung Cancer Screening Quality Study
Cancer Treatment Center
Marissa Nocar, Oncology Lung Nurse
Navigator
August 20, 2019
Consent Agenda
Program:
– Started in 2016
–
Follows CMS guidelines for eligibility
• Age 55-77
• Asymptomatic
• Cigarette smoking history of 30 pack years
• Current cigarette smoker or quit within the last 15 years
• Cigar, pipe, smokeless tobacco and hookah tobacco exposures are not eligible at this time
2
Problem:
• Some patients miss their initial lung cancer screening exam and do not reschedule
• Patients that have a negative exam are recommended by the American College of Radiology to have a 12 month follow up exam
• A high percentage of patients are not having their follow up screening exam after a prior negative exam
3
National Guidelines:
https://www.acr.org/Clinical-Resources/Reporting-and-Data-Systems/Lung-Rads
4
Numeric Results:
• For May-July, 15% of patients scheduled for a lung screening exam cancelled or were a no show
–
51 out of 330 participants • Examination of 357 previous lung cancer screening participants revealed that 59% did not receive the recommended 12 month follow up exam following a negative result (Lung RADS 0 or 1) –
213 participants did not receive the 12 month follow up
• 60% missed their first 12 month follow up post negative screening exam
• 40% missed their second or third 12 month follow up post negative exams
5
Action Plan:
Problem: Some patients do not keep their scheduled lung screening appointment or complete their annual follow up exam
Root Cause
• Lack of understanding regarding the risks and benefits of lung cancer screening
• Letter to be sent to patients who no-show for their scheduled lung screening appointment from the Lung Nurse Navigator asking them to contact her to reschedule their exam.
• Insurance benefit-not all payers cover lung cancer screening low dose CT’s
• Nurse Navigator to direct patients to provider if prior authorization is required and share the out of pocket cost if it is not a covered benefit.
7-30-2019 7-15-2019
• Follow up screening recommendations unknown
• Letter to be sent to both the patient and referring physician if patient does not schedule a 1 year follow up exam following initial negative screening test.
• Letter to the referring physician will include a copy of the American College of Radiology’s Lung RADS version 1.1 which contains all of the follow up screening guidelines
6
Plan
Plan Implemented
/ Solution
7-30-2019 7-30-2019
Summary Page:
• Lung cancer is the leading cause of cancer deaths in the U.S. for both men and women
• Identifying lung cancer early increases treatment options and survival rates
• Ensuring patients keep their screening appointments and continue with annual follow up exams will increase the possibility of early detection
• More education and awareness is needed regarding the importance of annual exams following a negative screening test, similar to women having annual mammograms after negative tests
7
