Department of Epidemiology, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire.
Dartmouth Cancer Center, Lebanon, New Hampshire.
Cancer Res Commun. 2023 Aug 14;3(8):1538-1550. doi: 10.1158/2767-9764.CRC-23-0152. eCollection 2023 Aug.
We tested the hypotheses that adult cancer incidence and mortality in the Northeast region and in Northern New England (NNE) were different than the rest of the United States, and described other related cancer metrics and risk factor prevalence. Using national, publicly available cancer registry data, we compared cancer incidence and mortality in the Northeast region with the United States and NNE with the United States overall and by race/ethnicity, using age-standardized cancer incidence and rate ratios (RR). Compared with the United States, age-adjusted cancer incidence in adults of all races combined was higher in the Northeast (RR, 1.07; 95% confidence interval [CI] 1.07-1.08) and in NNE (RR 1.06; CI 1.05-1.07). However compared with the United States, mortality was lower in the Northeast (RR, 0.98; CI 0.98-0.98) but higher in NNE (RR, 1.05; CI 1.03-1.06). Mortality in NNE was higher than the United States for cancers of the brain (RR, 1.16; CI 1.07-1.26), uterus (RR, 1.32; CI 1.14-1.52), esophagus (RR, 1.36; CI 1.26-1.47), lung (RR, 1.12; CI 1.09-1.15), bladder (RR, 1.23; CI 1.14-1.33), and melanoma (RR, 1.13; CI 1.01-1.27). Significantly higher overall cancer incidence was seen in the Northeast than the United States in all race/ethnicity subgroups except Native American/Alaska Natives (RR, 0.68; CI 0.64-0.72). In conclusion, NNE has higher cancer incidence and mortality than the United States, a pattern that contrasts with the Northeast region, which has lower cancer mortality overall than the United States despite higher incidence.
These findings highlight the need to identify the causes of higher cancer incidence in the Northeast and the excess cancer mortality in NNE.
我们检验了以下假设，即美国东北部和新英格兰北部（NNE）的成人癌症发病率和死亡率与美国其他地区不同，并且描述了其他相关的癌症指标和风险因素流行率。使用国家公开的癌症登记数据，我们比较了美国东北部和美国的癌症发病率和死亡率，以及 NNE 与美国整体的癌症发病率和死亡率，使用年龄标准化癌症发病率和率比（RR）。与美国相比，所有种族成年人的年龄调整癌症发病率在东北部（RR，1.07；95%置信区间[CI] 1.07-1.08）和 NNE（RR 1.06；CI 1.05-1.07）更高。然而，与美国相比，东北部的死亡率较低（RR，0.98；CI 0.98-0.98），但 NNE 较高（RR，1.05；CI 1.03-1.06）。NNE 的癌症死亡率高于美国的脑癌（RR，1.16；CI 1.07-1.26）、子宫癌（RR，1.32；CI 1.14-1.52）、食道癌（RR，1.36；CI 1.26-1.47）、肺癌（RR，1.12；CI 1.09-1.15）、膀胱癌（RR，1.23；CI 1.14-1.33）和黑色素瘤（RR，1.13；CI 1.01-1.27）。除了美国原住民/阿拉斯加原住民（RR，0.68；CI 0.64-0.72）外，所有种族/族裔亚组的东北部的总体癌症发病率均高于美国。总之，与美国东北部相比，NNE 的癌症发病率和死亡率更高，这一模式与东北部地区形成鲜明对比，尽管东北部地区的癌症死亡率总体上低于美国，但癌症死亡率却更高。
这些发现强调了需要确定东北部地区癌症发病率上升的原因以及 NNE 地区癌症死亡率过高的原因。
