The New United States Cancer Atlas
In the early 1970s, a group at the National Cancer Institute prepared an atlas of cancer death rates in the United States at the county level (Mason et al. 1975). Previous surveys had revealed some geographic patterns by region and state (Gordon et al. 1961; Burbank 1971), but the variation seemed rather predictable and limited. Most attention at that time was being given to the striking international differences in cancer occurrence and the changing risk of migrant populations that suggested the importance of environmental determinants. Although the geographic variation in cancer occurrences within the United States was much smaller than the global differences, we thought that by mapping cancer mortality using small areas such as counties, it might be possible to identify unusual patterns or high-risk areas that would escape notice when larger geographic units were used. Also, although alert clinicians had identified unusual clusters of rare tumors that led to an identification of responsible exposures, for example asbestos and mesothelioma, we felt that the detection of clustering of the common tumors required a more systematic approach. The United States county mortality system seemed to provide such a mechanism. Every death in the United States has been reportable by law to the National Center for Health Statistics since 1933 and computerized records exist for death certificates and population censuses since 1950.
KeywordsMigration Europe Lymphoma Leukemia Beach
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