Luo Chongliang, Khan Saira, Jin Liyan, James Aimee S, Colditz Graham A, Drake Bettina F
Washington University in St. Louis, St Louis, Missouri, United States.
Washington University in St. Louis, Saint Louis, MO, United States.
Cancer Epidemiol Biomarkers Prev. 2024 Dec 5. doi: 10.1158/1055-9965.EPI-24-0957.
Identifying changes in geographical disparities of cancer mortality reveals locations where cancer prevention and control efforts should be focused/targeted. We use recent cancer surveillance data to demonstrate the geographical disparity of major cancer mortality rates in the US and its shift compared to previous data.
This cross-sectional study used the 2018-2022 county-level mortality rates of colorectal, lung, breast and prostate cancer from the CDC mortality data. Counties with suppressed death counts were imputed by spatial regression models. Getis-Ord Gi* statistics were used to evaluate spatial clustering of county mortality. Identified hotspot counties were visualized and compared with literature for hotspot pattern change.
A total of 3108 US mainland counties were included. Cancer mortality rates were significantly higher in 244 counties for colorectal, 456 for lung, 147 for breast and 180 for prostate. Hotspot areas were central Appalachia (for colorectal and lung), Lower Mississippi Delta (colorectal, breast and prostate), Midwest (colorectal and lung), north Michigan/Wisconsin (lung and prostate), north Florida (lung), and the West (prostate).
West central Appalachia and Lower Mississippi Delta continue to be hotspots for major cancer types, while previously identified eastern North Carolina/Virginia hotspots shrunk, east Oklahoma and north Florida emerged as the new hotspot for lung cancer, and several hotspots emerged in the West for prostate cancer.
This study updated the analyses for geospatial disparity in major cancers' mortality since 2018-illustrating recent changes in the disparity pattern and pinpointing areas that cancer prevention and control efforts should target.
识别癌症死亡率地理差异的变化，有助于揭示癌症预防和控制工作应重点关注/针对的地区。我们利用最新的癌症监测数据，展示美国主要癌症死亡率的地理差异及其与以往数据相比的变化。
这项横断面研究使用了美国疾病控制与预防中心（CDC）死亡率数据中2018 - 2022年县级结直肠癌、肺癌、乳腺癌和前列腺癌的死亡率。死亡人数被抑制的县通过空间回归模型进行估算。Getis-Ord Gi*统计量用于评估县死亡率的空间聚类情况。将识别出的热点县进行可视化展示，并与文献中热点模式的变化进行比较。
共纳入美国本土3108个县。结直肠癌死亡率在244个县显著更高，肺癌在456个县，乳腺癌在147个县，前列腺癌在180个县。热点地区包括阿巴拉契亚中部（结直肠癌和肺癌）、密西西比河下游三角洲（结直肠癌、乳腺癌和前列腺癌）、中西部（结直肠癌和肺癌）、密歇根北部/威斯康星州（肺癌和前列腺癌）、佛罗里达州北部（肺癌）以及西部（前列腺癌）。
阿巴拉契亚中西部和密西西比河下游三角洲仍是主要癌症类型的热点地区，而之前确定的北卡罗来纳州东部/弗吉尼亚州热点地区缩小，俄克拉荷马州东部和佛罗里达州北部成为肺癌新热点，西部出现了几个前列腺癌热点地区。
本研究更新了2018年以来主要癌症死亡率地理差异的分析，阐明了差异模式的近期变化，并确定了癌症预防和控制工作应针对的地区。
