Cancer mortality-to-incidence ratios in Georgia
Describing racial cancer disparities and potential geographic determinants
Article first published online: 31 JAN 2012
Copyright © 2012 American Cancer Society
Volume 118, Issue 16, pages 4032–4045, 15 August 2012
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
- Issue published online: 3 AUG 2012
- Article first published online: 31 JAN 2012
- Manuscript Accepted: 7 NOV 2011
- Manuscript Revised: 14 OCT 2011
- Manuscript Received: 24 AUG 2011
- health status disparities;
- minority health;
- geographic factors
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.
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.
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.
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