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, 8 (7), e67913

Regional Variations in Esophageal Cancer Rates by Census Region in the United States, 1999-2008

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Regional Variations in Esophageal Cancer Rates by Census Region in the United States, 1999-2008

Jennifer Drahos et al. PLoS One.

Abstract

Background: Assessment of cancer incidence trends within the U.S. have mostly relied upon Surveillance, Epidemiology, and End Results (SEER) data, with implicit inference that such is representative of the general population. However, many cancer policy decisions are based at a more granular level. To help inform such, analyses of regional cancer incidence data are needed. Leveraging the unique resource of National Program of Cancer Registries (NPCR)-SEER, we assessed whether regional rates and trends of esophageal cancer significantly deviated from national estimates.

Methods: From NPCR-SEER, we extracted cancer case counts and populations for whites aged 45-84 years by calendar year, histology, sex, and census region for the period 1999-2008. We calculated age-standardized incidence rates (ASRs), annual percent changes (APCs), and male-to-female incidence rate ratios (IRRs).

Results: This analysis included 65,823 esophageal adenocarcinomas and 27,094 esophageal squamous cell carcinomas diagnosed during 778 million person-years. We observed significant geographic variability in incidence rates and trends, especially for esophageal adenocarcinomas in males: ASRs were highest in the Northeast (17.7 per 100,000) and Midwest (18.1). Both were significantly higher than the national estimate (16.0). In addition, the Northeast APC was 62% higher than the national estimate (3.19% vs. 1.97%). Lastly, IRRs remained fairly constant across calendar time, despite changes in incidence rates.

Conclusion: Significant regional variations in esophageal cancer incidence trends exist in the U.S. Stable IRRs may indicate the predominant factors affecting incidence rates are similar in men and women.

Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. United States census regions.
The states included in the Northeast, Midwest, South, and West census regions are highlighted. Coverage varied slightly by census region with nearly complete population coverage of the Northeast (100%), West (100%), and Midwest (98.8%), and slightly less population coverage in the South (76.0%).
Figure 2
Figure 2. Age-adjusted incidence rates stratified by histology, sex, and region in whites, aged 45–84, 1999–2008.
Panel A and B illustrate the age-adjusted incidence rate per 100,000 person-years by census region of the histologic subtype EA in men and women, respectively. Panel C shows the male-to-female incidence rate ratio (IRRs) of EA by calendar year. Panel D and E depicts the age-adjusted incidence rate of ESCC in men and women, respectively. Panel F shows the male-to-female incidence rate ratio (IRRs) of ESCC by calendar year. Rates graphed are per 100,000 person-years.

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References

    1. American Cancer Society (2012) Cancer Facts and Figures. Atlanta: American Cancer Society.
    1. Surveillance, Epidemiology, and End Results (SEER) Program. SEER*Stat Database: Incidence – SEER 18 Regs Research National Cancer Institute, DCCPS, Surveillance Research Program, Surveillance Systems Branch, released April 2012, based on the November 2011 submission. Avaiable: http://www.seer.cancer.gov.
    1. Bollschweiler E, Wolfgarten E, Gutschow C, Holscher AH (2001) Demographic variations in the rising incidence of esophageal adenocarcinoma in white males. Cancer 92: 549–555. - PubMed
    1. Cook MB, Chow WH, Devesa SS (2009) Oesophageal cancer incidence in the United States by race, sex, and histologic type, 1977–2005. Br J Cancer 101: 855–859. - PMC - PubMed
    1. Surveillance Epidemiology and End Results (SEER) Program. SEER*Stat Database: Incidence–SEER 9 Regs Research Data, Nov 2009 Sub (1973–2007). Linked To County Attributes–Total US, 1969–2007 Counties, National Cancer Institute, DCCPS, Surveillance Research Program, Cancer Statistics Branch, released April 2010, based on the November 2009 submission. Available: http://www.seer.cancer.

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