Original Article

Cancer mortality-to-incidence ratios in Georgia

Describing racial cancer disparities and potential geographic determinants

  1. Sara E. Wagner PhD1,*,
  2. Deborah M. Hurley MSPH2,
  3. James R. Hébert ScD3,4,
  4. Chrissy McNamara MSPH5,
  5. A. Rana Bayakly MPH5,
  6. John E. Vena PhD1

Article first published online: 31 JAN 2012

DOI: 10.1002/cncr.26728

Issue

Cancer

Cancer

Volume 118, Issue 16, pages 4032–4045, 15 August 2012

Additional Information

How to Cite

Wagner, S. E., Hurley, D. M., Hébert, J. R., McNamara, C., Bayakly, A. R. and Vena, J. E. (2012), Cancer mortality-to-incidence ratios in Georgia. Cancer, 118: 4032–4045. doi: 10.1002/cncr.26728

Author Information

  1. 1

    College of Public Health, Department of Epidemiology and Biostatistics, University of Georgia, Athens, Georgia

  2. 2

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

  3. 3

    Arnold School of Public Health, Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, South Carolina

  4. 4

    South Carolina Statewide Cancer Prevention and Control Program, Columbia, South Carolina

  5. 5

    Georgia Comprehensive Cancer Registry, Georgia Department of Public Health, Atlanta, Georgia

*Assistant Research Scientist, Department of Epidemiology and Biostatistics, College of Public Health, University of Georgia, Paul D. Coverdell Center, 500 DW Brooks Drive, Athens, GA 30602-7396

Publication History

  1. Issue published online: 3 AUG 2012
  2. Article first published online: 31 JAN 2012
  3. Manuscript Accepted: 7 NOV 2011
  4. Manuscript Revised: 14 OCT 2011
  5. Manuscript Received: 24 AUG 2011

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Keywords:

  • neoplasms;
  • health status disparities;
  • minority health;
  • Georgia;
  • geographic factors

Abstract

BACKGROUND:

The objective of this study was to evaluate racial cancer disparities in Georgia by calculating and comparing mortality-to-incidence ratios (MIRs) by health district and in relation to geographic factors.

METHODS:

Data sources included cancer incidence (Georgia Comprehensive Cancer Registry), cancer mortality (Georgia Vital Records), and health factor (County Health Rankings) data. Age-adjusted incidence and mortality rates were calculated by cancer site (all sites combined, lung, colorectal, prostate, breast, oral, and cervical) for 2003-2007. MIRs and 95% confidence intervals were calculated overall and by district for each cancer site, race, and sex. MIRs were mapped by district and compared with geographic health factors.

RESULTS:

In total, 186,419 incident cases and 71,533 deaths were identified. Blacks had higher MIRs than whites for every cancer site evaluated, and especially large differentials were observed for prostate, cervical, and oral cancer in men. Large geographic disparities were detected, with larger MIRs, chiefly among blacks, in Georgia compared with national data. The highest MIRs were detected in west and east central Georgia, and the lowest MIRs were detected in and around Atlanta. Districts with better health behavior, clinical care, and social/economic factors had lower MIRs, especially among whites.

CONCLUSIONS:

More fatal cancers, particularly prostate, cervical, and oral cancer in men were detected among blacks, especially in central Georgia, where health behavior and social/economic factors were worse. MIRs are an efficient indicator of survival and provide insight into racial cancer disparities. Additional examination of geographic determinants of cancer fatality in Georgia as indicated by MIRs is warranted. Cancer 2012. © 2012 American Cancer Society

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