Mapping cancer mortality-to-incidence ratios to illustrate racial and sex disparities in a high-risk population

Authors

  • James R. Hébert MSPH, ScD,

    Corresponding author
    1. South Carolina Statewide Cancer Prevention and Control Program, University of South Carolina, Columbia, South Carolina
    2. Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
    3. South Carolina Cancer Alliance, Columbia, South Carolina
    • Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Director, Statewide Cancer Prevention and Control Program, 2221 Devine Street, Columbia, SC 29208
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    • Fax: (803) 734-5259

  • Virginie G. Daguise PhD,

    1. Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
    2. South Carolina Cancer Alliance, Columbia, South Carolina
    3. Division of Cancer, Bureau of Chronic Disease and Community Health, South Carolina Department of Health and Environmental Control, Columbia, South Carolina
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  • Deborah M. Hurley MSPH,

    1. South Carolina Central Cancer Registry, Office of Public Health Statistics and Information Services, South Carolina Department of Health and Environmental Control, Columbia, South Carolina
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  • Rebecca C. Wilkerson MSPH,

    1. Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
    2. Department of Health and Environmental Control, Division of Public Health Informatics, Office of Public Health Statistics and Information Services, South Carolina Department of Health and Environmental Control, Columbia, South Carolina
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  • Catishia M. Mosley MSPH,

    1. South Carolina Central Cancer Registry, Office of Public Health Statistics and Information Services, South Carolina Department of Health and Environmental Control, Columbia, South Carolina
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  • Swann A. Adams PhD,

    1. South Carolina Statewide Cancer Prevention and Control Program, University of South Carolina, Columbia, South Carolina
    2. Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
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  • Robin Puett PhD,

    1. South Carolina Statewide Cancer Prevention and Control Program, University of South Carolina, Columbia, South Carolina
    2. Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
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  • James B. Burch PhD,

    1. South Carolina Statewide Cancer Prevention and Control Program, University of South Carolina, Columbia, South Carolina
    2. Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
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  • Susan E. Steck PhD,

    1. South Carolina Statewide Cancer Prevention and Control Program, University of South Carolina, Columbia, South Carolina
    2. Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
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  • Susan W. Bolick-Aldrich MSPH, CTR

    1. South Carolina Central Cancer Registry, Office of Public Health Statistics and Information Services, South Carolina Department of Health and Environmental Control, Columbia, South Carolina
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Abstract

BACKGROUND:

Comparisons of incidence and mortality rates are the metrics used most commonly to define cancer-related racial disparities. In the US, and particularly in South Carolina, these largely disfavor African Americans (AAs). Computed from readily available data sources, the mortality-to-incidence rate ratio (MIR) provides a population-based indicator of survival.

METHODS:

South Carolina Central Cancer Registry incidence data and Vital Registry death data were used to construct MIRs. ArcGIS 9.2 mapping software was used to map cancer MIRs by sex and race for 8 Health Regions within South Carolina for all cancers combined and for breast, cervical, colorectal, lung, oral, and prostate cancers.

RESULTS:

Racial differences in cancer MIRs were observed for both sexes for all cancers combined and for most individual sites. The largest racial differences were observed for female breast, prostate, and oral cancers, and AAs had MIRs nearly twice those of European Americans (EAs).

CONCLUSIONS:

Comparing and mapping race- and sex-specific cancer MIRs provides a powerful way to observe the scope of the cancer problem. By using these methods, in the current study, AAs had much higher cancer MIRs compared with EAs for most cancer sites in nearly all regions of South Carolina. Future work must be directed at explaining and addressing the underlying differences in cancer outcomes by region and race. MIR mapping allows for pinpointing areas where future research has the greatest likelihood of identifying the causes of large, persistent, cancer-related disparities. Other regions with access to high-quality data may find it useful to compare MIRs and conduct MIR mapping. Cancer 2009. © 2009 American Cancer Society.

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