 | The 131st Annual Meeting (November 15-19, 2003) of APHA |
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| The 131st Annual Meeting (November 15-19, 2003) of APHA |
Eugene J Lengerich, VMD, MS1, Thomas Tucker, PhD2, Ray Powell, MPH3, Pat Colsher, Phd4, Ann J Ward, MS5, and Stephen Wyatt, DMD, MPH2. (1) Health Evaluation Sciences, Pennsylvania State University, 600 Centerview Drive, PO Box 855, Hershey, PA 17033, 717 531 7178, elengerich@psu.edu, (2) Markey Cancer Center, University of Kentucky, 2365 Harrodsburg Road, Lexington, KY 40504, (3) Pennsylvania Cancer Registry, Pennsylvania Department of Health, 555 Walnut Street, 6th Floor, Harrisburg, PA 17101, (4) West Virginia Cancer Registry, West Virginia Department of Health, Room 126, 350 Capitol Street, Charleston, WV 25301, (5) Food Science, Pennsylvania State University, 111 Borland Lab, University Park, PA 16802
Background: Composed of all or a portion of 13 states, Appalachia is a large, heterogeneous, economically disadvantaged region of the eastern United States. While mortality from cancer in Appalachia has previously been reported to be elevated, rates of cancer incidence in Appalachia remain unreported.
Method: Using 1994 through 1998 data from the central registries of Kentucky, Pennsylvania, and West Virginia, age-adjusted incidence rates were calculated for the rural and nonrural regions of Appalachia. These state rates were compared to rates from the Surveillance, Epidemiology, and End Results (SEER) program for the same years by calculating adjusted rate ratios (RR) and 95% confidence intervals.
Result: Both the entire and rural Appalachian regions had an adjusted incidence rate for all cancer sites similar to the SEER rate (RR=1.00 and RR=0.99, respectively). However, incidence of cancer of the lung/bronchus, colon, rectum, and cervix in Appalachia were significantly increased (RR=1.22, 1.13, 1.19, and 1.12, respectively). Incidence of cancers of the lung and cervix were even more elevated (RR=1.34 and 1.29, respectively). Incidence of unstaged disease for all cancer sites in Appalachia (RR=1.06), particularly rural Appalachia (RR=1.28), was elevated.
Conclusion: These findings support the National Cancer Institute’s designation of residents of Appalachia as a special population, experiencing disparities in cancer burden. Elevated rates of cancer mortality in Appalachia are consistent with elevated rates of cancer incidence. High rates of unstaged disease may suggest a lack of access to or utilization of cancer health care by residents of Appalachia
Learning Objectives:
Keywords: Cancer, Health Care Quality
Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.