Cancer Causes & Control

, Volume 22, Issue 8, pp 1173–1181

Temporal trends in geographic disparities in small-area-level colorectal cancer incidence and mortality in the United States

  • Mario Schootman
  • Min Lian
  • Anjali D. Deshpande
  • Amy McQueen
  • Sandi L. Pruitt
  • Donna B. Jeffe
Original paper

DOI: 10.1007/s10552-011-9796-6

Cite this article as:
Schootman, M., Lian, M., Deshpande, A.D. et al. Cancer Causes Control (2011) 22: 1173. doi:10.1007/s10552-011-9796-6
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Abstract

Objective

We examined the extent of changes in absolute and relative geographic disparities in six colorectal cancer (CRC) indicators using data about persons aged 50 and older from 195 counties in the 1988–2006 Surveillance, Epidemiology, and End Results Program database.

Methods

County-level trends in six colorectal cancer indicators (overall CRC incidence, descending colon cancer incidence, proximal colon cancer incidence, late-stage CRC incidence, CRC mortality, and 5-year probability of CRC death) were summarized using the estimated annual percentage change. Observed county rates were smoothed using Bayesian hierarchical spatiotemporal methods to calculate measures of absolute and relative geographic disparity and their changes over time.

Results

During the study period, absolute disparity for all six indicators decreased (CRC incidence: 43.2%; proximal colon cancer: 31.9%; descending colon cancer: 52.8%; late-stage CRC: 50.0%; CRC mortality: 57.8%; 5-year CRC-specific probability of death: 12.2%). Relative disparity remained stable for all six indicators over the entire study period.

Conclusion

Important progress has been made toward achieving the Healthy People 2010 and NCI strategic objectives for reducing geographic disparities, although absolute and relative disparities remain in CRC.

Keywords

Geography Colon and rectal cancer Bayesian models Disparity 

Copyright information

© Springer Science+Business Media B.V. 2011

Authors and Affiliations

  • Mario Schootman
    • 1
    • 2
    • 3
  • Min Lian
    • 1
  • Anjali D. Deshpande
    • 1
    • 2
  • Amy McQueen
    • 1
    • 2
  • Sandi L. Pruitt
    • 1
  • Donna B. Jeffe
    • 1
    • 2
  1. 1.Department of Medicine, Division of Health Behavior ResearchWashington University School of MedicineSaint LouisUSA
  2. 2.Alvin J. Siteman Cancer Center at Barnes-Jewish HospitalSaint LouisUSA
  3. 3.Division of Health Behavior Research, Departments of Medicine and PediatricsWashington University School of MedicineSaint LouisUSA

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