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2017 ; 66
(14
): 1-13
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English Wikipedia
Invasive Cancer Incidence, 2004-2013, and Deaths, 2006-2015, in Nonmetropolitan
and Metropolitan Counties - United States
#MMPMID28683054
Henley SJ
; Anderson RN
; Thomas CC
; Massetti GM
; Peaker B
; Richardson LC
MMWR Surveill Summ
2017[Jul]; 66
(14
): 1-13
PMID28683054
show ga
PROBLEM/CONDITION: Previous reports have shown that persons living in
nonmetropolitan (rural or urban) areas in the United States have higher death
rates from all cancers combined than persons living in metropolitan areas.
Disparities might vary by cancer type and between occurrence and death from the
disease. This report provides a comprehensive assessment of cancer incidence and
deaths by cancer type in nonmetropolitan and metropolitan counties. REPORTING
PERIOD: 2004-2015. DESCRIPTION OF SYSTEM: Cancer incidence data from CDC's
National Program of Cancer Registries and the National Cancer Institute's
Surveillance, Epidemiology, and End Results program were used to calculate
average annual age-adjusted incidence rates for 2009-2013 and trends in annual
age-adjusted incidence rates for 2004-2013. Cancer mortality data from the
National Vital Statistics System were used to calculate average annual
age-adjusted death rates for 2011-2015 and trends in annual age-adjusted death
rates for 2006-2015. For 5-year average annual rates, counties were classified
into four categories (nonmetropolitan rural, nonmetropolitan urban, metropolitan
with population <1 million, and metropolitan with population ?1 million). For the
trend analysis, which used annual rates, these categories were combined into two
categories (nonmetropolitan and metropolitan). Rates by county classification
were examined by sex, age, race/ethnicity, U.S. census region, and cancer site.
Trends in rates were examined by county classification and cancer site. RESULTS:
During the most recent 5-year period for which data were available,
nonmetropolitan rural areas had lower average annual age-adjusted cancer
incidence rates for all anatomic cancer sites combined but higher death rates
than metropolitan areas. During 2006-2015, the annual age-adjusted death rates
for all cancer sites combined decreased at a slower pace in nonmetropolitan areas
(-1.0% per year) than in metropolitan areas (-1.6% per year), increasing the
differences in these rates. In contrast, annual age-adjusted incidence rates for
all cancer sites combined decreased approximately 1% per year during 2004-2013
both in nonmetropolitan and metropolitan counties. INTERPRETATION: This report
provides the first comprehensive description of cancer incidence and mortality in
nonmetropolitan and metropolitan counties in the United States. Nonmetropolitan
rural counties had higher incidence of and deaths from several cancers related to
tobacco use and cancers that can be prevented by screening. Differences between
nonmetropolitan and metropolitan counties in cancer incidence might reflect
differences in risk factors such as cigarette smoking, obesity, and physical
inactivity, whereas differences in cancer death rates might reflect disparities
in access to health care and timely diagnosis and treatment. PUBLIC HEALTH
ACTION: Many cancer cases and deaths could be prevented, and public health
programs can use evidence-based strategies from the U.S. Preventive Services Task
Force and Advisory Committee for Immunization Practices (ACIP) to support cancer
prevention and control. The U.S. Preventive Services Task Force recommends
population-based screening for colorectal, female breast, and cervical cancers
among adults at average risk for these cancers and for lung cancer among adults
at high risk; screening adults for tobacco use and excessive alcohol use,
offering counseling and interventions as needed; and using low-dose aspirin to
prevent colorectal cancer among adults considered to be at high risk for
cardiovascular disease based on specific criteria. ACIP recommends vaccination
against cancer-related infectious diseases including human papillomavirus and
hepatitis B virus. The Guide to Community Preventive Services describes program
and policy interventions proven to increase cancer screening and vaccination
rates and to prevent tobacco use, excessive alcohol use, obesity, and physical
inactivity.
|*Health Status Disparities
[MESH]
|*Population Surveillance
[MESH]
|Adult
[MESH]
|Aged
[MESH]
|Centers for Disease Control and Prevention, U.S.
[MESH]