American College of Surgeons Cancer Programs Annual Report from 2021 Participant User File

Abstract

The National Cancer Database (NCDB) collects data from approximately 1500 Commission on Cancer (CoC) facilities and represent 73.7% of newly diagnosed cancer cases nationwide.The American College of Surgeons Cancer Program developed it first annual report from the NCDB 2021 participant user file reporting new observations and recent trends of cancer diagnoses, patient demographics, and treatments as well as an in depth report on treatment and outcomes in breast, pancreas and colon cancer.Of the 1,328,131 cancers diagnosed in 2021 at 1,281 reporting CoC hospitals, one-fifth continue to be female breast cancer cases. In 2021, the NCDB's five most common adult cancers were: Breast, Prostate, Lung, Colon, and Melanoma and varied by patient sex. Use of neoadjuvant systemic therapy increased in recent years in pancreas, breast and urinary bladder, although a slight decrease in pancreas and breast was observed in 2021.Breast cancer has high survival rates, especially in lower stage disease and ER+/HER2- disease. There is increase in neoadjuvant systemic therapy use especially in HER2+ disease and ER- disease.Colon cancer presents most commonly as stage III or II with a primary in the cecum or ascending colon in 38.9%. The majority are MSI stable, KRAS normal and CEA positive. Survival is most dependent on stage but also associated with MSI stability, abnormal KRAS and positive CEA.Pancreatic cancer presents with stage IV disease in nearly half, although an increase in stage I disease is seen. The most common location is pancreatic head. Survival is relatively low and most dependent on stage.