2008 Cancer Incidence and Mortality in North Carolina
State Center for Health Statistics
November 2011
Contributing Editors
April Alston, Ph.D.
Jordan Bostic, Ph.D.
STATE OF NORTH CAROLINA
Beverly E. Perdue, Governor
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Lanier M. Cansler, Secretary
DIVISION OF PUBLIC HEALTH
Jeffrey P. Engel, M.D., Director
STATE CENTER FOR HEALTH STATISTICS
Karen L. Knight, M.S., Director
CENTRAL CANCER REGISTRY
Chandrika Rao, Ph.D., Director
www.ncdhhs.gov
The North Carolina Department of Health and Human Services does not
discriminate on the basis of race, color, national origin, sex, religion, age, or
disability in employment or the provision of services. 11/11
Table of Contents
Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1
Background . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1
Purpose . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1
Data Sources and Collection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2
Cancer Incidence. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2
Cancer Mortality . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2
Differences in Collecting Incidence and Mortality. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2
Cancer Classification . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3
Statistical Methods . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4
Age-Specific Rates . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4
Age-Adjusted Rates . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4
Gender-Specific Rates. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5
Race-Specific Rates . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5
Reliability of Rates . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5
Limitations of Data . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6
Summary of 2008 Cancer Data . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6
Age . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6
Gender. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .7
Race and Ethnicity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8
Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9
Available Cancer Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
Maps
Map 1: 2008 North Carolina Cancer Incidence Rates by County . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .12
Map 2: 2008 North Carolina Cancer Mortality Rates by County . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13
Tables
Table 1: 2008 North Carolina Cancer Incidence and Mortality. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .14
Table 2: 2008 North Carolina Top Ten Cancer Incidence and Mortality Sites . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .16
Table 3: 2008 Cancer Incidence and Mortality by County . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .17
Table 4: 2008 Ten Highest and Lowest Cancer Incidence and Mortality Rates by County . . . . . . . . . . . . . . . . . . . .20
Table 5: 2008 Cancer Incidence and Mortality by Age Group . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .21
Table 6: 2008 Top Ten Cancer Incidence and Mortality by Age Group . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .23
Table 7: 2008 Cancer Incidence and Mortality by Gender . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .25
Table 8: 2008 Top Ten Cancer Incidence and Mortality Sites by Gender . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .27
Table 9: 2008 Cancer Incidence and Mortality by Race . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .28
Table 10: 2008 Top Ten Cancer Incidence and Mortality Sites by Race . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .30
Table 11: 2008 Top Ten Cancer Incidence and Mortality by Race and Gender . . . . . . . . . . . . . . . . . . . . . . . . . . . . .31
Table 12: 2004 – 2008 Top Five Cancer Incidence and Mortality Sites by Age Group, Race and Gender. . . . . . . . .33
Table 13: 2008 Cancer Incidence and Mortality by Race and Ethnicity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .37
Table 14: 2008 Top Ten Cancer Incidence and Mortality Sites by Race and Ethnicity. . . . . . . . . . . . . . . . . . . . . . . .39
Table 15: 2008 Cancer Incidence and Mortality Median Age . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .41
Figures
Figure 1a: 1997 – 2008 Colorectal Cancer Incidence Trends by Gender and Race . . . . . . . . . . . . . . . . . . . . . . . . . . .43
Figure 1b: 1997 – 2008 Colorectal Cancer Mortality Trends by Gender and Race . . . . . . . . . . . . . . . . . . . . . . . . . . .43
Figure 2a: 1997 – 2008 Lung and Bronchus Cancer Incidence Trends by Gender and Race . . . . . . . . . . . . . . . . . . .44
Figure 2b: 1997 – 2008 Lung and Bronchus Cancer Mortality Trends by Gender and Race. . . . . . . . . . . . . . . . . . . .44
Figure 3a: 1997 – 2008 Female Breast Cancer Incidence Trends by Race . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .45
Figure 3b: 1997 – 2008 Female Breast Cancer Mortality Trends by Race. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .45
Figure 4a: 1997 – 2008 Prostate Cancer Incidence Trends by Race. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .46
Figure 4b: 1997 – 2008 Prostate Cancer Mortality Trends by Race. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .46
Figure 5: 1997 – 2008 Oral Cavity Cancer Incidence Trends by Gender and Race . . . . . . . . . . . . . . . . . . . . . . . . . . .47
Figure 6: 1997 – 2008 Laryngeal Cancer Incidence Trends by Gender and Race . . . . . . . . . . . . . . . . . . . . . . . . . . . .47
Figure 7: 1997 – 2008 Melanoma Incidence Trends by Gender and Race . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .48
Figure 8: 1997 – 2008 Cervical Cancer Incidence Trends by Race . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .48
Figure 9: 1997 – 2008 Kidney Cancer Incidence Trends by Gender and Race . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .49
Figure 10: 1997 – 2008 Endocrine Cancer Incidence Trends by Gender and Race . . . . . . . . . . . . . . . . . . . . . . . . . . .49
Figure 11: 1997 – 2008 Stomach Cancer Mortality Trends by Gender and Race . . . . . . . . . . . . . . . . . . . . . . . . . . . .50
Figure 12: 1997 – 2008 Liver Cancer Mortality Trends by Gender and Race . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .50
Figure 13: 1997 – 2008 Pancreatic Cancer Mortality Trends by Gender and Race . . . . . . . . . . . . . . . . . . . . . . . . . . .51
Figure 14: 1997 – 2008 Cervical Cancer Mortality Trends by Race . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .51
Figure 15: 2008 Percent of Top Four Cancer Cases by Stage . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .52
Appendices
Appendix A: 2008 Population Estimates by Race and County. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .53
Appendix B: 2008 Population Estimates by Age Group and County . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .56
Appendix C: 2008 Population Estimates by Race, Sex and County. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .59
Bibliography . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .62
2008 Cancer Incidence and Mortality in North Carolina
N.C. Central Cancer Registry • State Center for Health Statistics • N.C. Division of Public Health
1
Introduction
Cancer is a group of diseases in which there is an uncontrolled growth of abnormal cells in a part
of the body. Half of all men and one-third of all women in the United States will develop cancer
during their lifetimes.1 In 2008, cancer was the second leading cause of death in North Carolina,
trailing heart disease by only 14 deaths.2 In order to determine the effect cancer has on the state’s
population, the North Carolina Central Cancer Registry (CCR) collects, compiles and tabulates
data regarding the occurrence of cancer and reports the deaths due to cancer within the state.
This report is a summary of the incidence of and mortality due to cancer with the most complete
and recent data the CCR has available.
Background
The CCR, located in the State Center for Health Statistics (SCHS), was established in 1986. The
CCR operates under the authority granted in North Carolina General Statute 130A-208.3
Legislation declaring cancer reporting to be mandatory in North Carolina became effective in
1947. Authorized funding for establishing a registry, however, was not appropriated until 1986.
Between 1986 and 1989, only 50-60 percent of the cases were reported each year. The first year
for which relatively complete statewide reporting was achieved was 1990. In 1999, new
legislation was passed that requires every healthcare provider that detects, diagnoses or treats
cancer cases to report all cases to the CCR.3
On a national level, the CCR reports data to the North American Association of Central Cancer
Registries (NAACCR)4 and the Centers for Disease Control and Prevention National Program of
Cancer Registries (NPCR).5 Both organizations annually review the data the CCR submits for its
completeness, quality and timeliness. Completeness is the percentage of cases reported. Having
high quality data ensures that there are not duplicate records per case and that certain data
variables are accurate and complete. In order to meet the timeliness requirement, the data must
be submitted within 23 months of the completion of the diagnosis year under review. For the last
three years, the CCR has achieved the NAACCR Gold Standard for Registry Certification. This
certification is the highest NAACCR standard awarded for completeness, quality and timeliness
of data. The CCR continues to meet the requirements for NPCR in order to receive funding and
to have data publicized nationally.
Purpose
As a population-based registry, the CCR collects, analyzes and disseminates information on the
occurrence of cancer in North Carolina. The data collected include patient demographics (e.g.,
race, gender and age) and medical information on each cancer diagnosis (e.g., primary site,
morphology, stage and first course of treatment). This information is used to improve cancer
treatment and identify groups that have higher incidence and mortality from cancer.6 The CCR
preserves the confidentiality of information obtained for medical, educational, research and
statistical purposes. No identifying information regarding patients, hospitals or physicians is
released except under the conditions specified in General Statute and North Carolina
Administrative Code.3
2008 Cancer Incidence and Mortality in North Carolina is the 15th annual report of the CCR.
The contents of this report represent a summary of the information collected on cancer diagnoses
and deaths in 2008. The information includes incidence and mortality counts and rates for all
2008 Cancer Incidence and Mortality in North Carolina
N.C. Central Cancer Registry • State Center for Health Statistics • N.C. Division of Public Health
2
cancers by county, race, gender and age. The primary goal of this report is to provide cancer data
to healthcare planners, researchers and the general public.
Data Sources and Collection
Healthcare providers who detect, diagnose and treat cancer report cases to the CCR. The CCR
receives data on death due to cancer from the Vital Records (VR) Unit, also located in the SCHS.
The data are coded according to standard procedures and guidelines.
Cancer Incidence
Cancer incidence is the number of newly diagnosed cancer cases, not including recurrences,
during a particular time period within a certain population. With each cancer diagnosis or
treatment, the healthcare providers report the case to the CCR within six months. The CCR
releases data approximately two years after the end of the diagnosis year, due to reporting delay,
consolidation of records and cleaning of files.
From each case, the CCR collects patient demographics and medical information on the cancer
diagnosis. Some demographics the CCR receives regarding an individual diagnosed with cancer
include race, ethnicity, gender, age and residence. In addition, the CCR gathers data such as the
first location of the cancer (primary site), the form of cancer (morphology), tumor size and the
spread of the cancer (stage). Data regarding first course of treatment and vital status are also
collected.
The CCR receives the majority of the cancer incidence data from healthcare facilities (hospitals,
cancer centers, dermatology centers, urology centers and surgical oncology centers). Incidence
data also come from pathology reports, interstate data exchange, nursing facilities and death
clearance cases. There are 144 hospitals which routinely diagnose and treat cancer patients. Of
these, 70 have tumor registries where the data are abstracted and submitted to the CCR. There
are around 70 physician offices and clinics in North Carolina that report to the CCR. Death
clearance cases are cancers reported in death certificates that were previously unreported cancer
cases. The CCR received over 67,000 reports from approximately 210 facilities in 2008.
Cancer Mortality
Cancer mortality is the number of deaths due to cancer during a specified time period within a
certain population. Death certificates are filed to a county health director within five days. The
death certificate is then passed on to VR on the fifth day of the following month.3
Once a year, VR provides the CCR with data on the deceased whose primary cause of death is
cancer. This information includes demographics on the deceased including race, ethnicity,
gender, age and residence. In addition to demographics, a primary cause of death and date of
death are also collected.
Differences in Collecting Incidence and Mortality
For many studies, the CCR examines both incidence and mortality. Therefore, it is important to
note differences in obtaining incidence data and mortality data. These differences include, but
are not limited to, timeliness in reporting (both in state and out-of-state cases) and case finding.
2008 Cancer Incidence and Mortality in North Carolina
N.C. Central Cancer Registry • State Center for Health Statistics • N.C. Division of Public Health
3
There is a difference in the timeliness of reporting incidence and mortality data of cases reported
in the state for North Carolina residents. For incidence data, the healthcare facility is supposed to
report the case to the CCR within six months. However, with mortality data, a report of each
death is submitted to the VR within two months.
Some people living near neighboring states go outside North Carolina for health care. Also,
people may get diagnosed with or die of cancer outside of the state. North Carolina has an
exchange agreement for cancer incidence data with 25 states and Washington, D.C., including its
border states of Virginia, Tennessee and South Carolina. In addition, North Carolina has an
exchange agreement with the other 49 states, as well as with Washington, D.C., and United
States territories, for exchanging death certificates. Typically, incidence data is exchanged twice
a year while mortality data, monitored by the National Center for Health Statistics (NCHS), is
exchanged between states within two months of a death. However, even with these exchange
agreements in place, delays or omissions can occur in the interchange of incidence and mortality
records.
Although new cancer cases are required by law to be reported to the CCR, there are many that
are not. Cases diagnosed in small hospitals that do not have a cancer registry may be under
reported. Physicians associated with a large hospital will often report cases via a hospital
registrar, but those not affiliated with a hospital may not have ample staff to report cases to the
CCR. In the last few years, more cases are being diagnosed and treated in physician offices or
surgical oncology centers and may never be referred to an oncologist nor be reported. The CCR
has improved the completeness of reporting by recruiting physician offices and pathology
laboratories as well as sending staff to smaller facilities to collect the required data. Despite the
efforts of the CCR, incidence data are considered to be incomplete. On the other hand, death data
are regarded as complete. Therefore, there may appear to be an excess of deaths compared to the
number of cases for some cancers in rural counties.
Cancer Classification
The CCR receives an abstract of each medical record from a reporting facility. Each abstract
contains specific medical information about the cancer. The cancers are categorized using codes
according to the International Classification of Diseases for Oncology, Third Edition.7 Each
code is comprised of two pieces: topography and morphology. The topography code tells where
the tumor began (primary site). The morphology code tells the type of cell (histology), the way it
behaves within the body (behavior) and supplementary information about the tumor (grade).
Care must be taken when coding lymphomas and leukemia.
The medical record also contains data regarding the cancer stage. The stage at diagnosis
indicates how far the cancer has spread when it is first diagnosed. Knowing the extent of the
cancer is important in treatment and prognosis. The CCR commonly uses National Cancer
Institute’s Surveillance, Epidemiology and End Results Program8 definitions for staging and
groups cancers as in situ, local, regional, distant and unknown.
In the data collected by the CCR, only malignant tumors are included with one exception. Data
on benign brain and central nervous system tumors are also reported to the CCR. Only malignant
tumors are included in this report. In situ cases are generally reportable to the CCR. However,
2008 Cancer Incidence and Mortality in North Carolina
N.C. Central Cancer Registry • State Center for Health Statistics • N.C. Division of Public Health
4
these tumors, with the exception of in situ breast and bladder cases, are not used in cancer
surveillance nor in cancer incidence statistics. Data on basal and squamous cell skin cancers are
not collected by the CCR unless they have spread to tissue beyond the original site. Malignant
melanoma may occur at many different body sites; however, this report focuses on melanoma of
the skin.
Statistical Methods
Populations not only vary in size, but also in their racial, gender and age breakups. Thus, the
counts of cancer incidence and mortality have limitations when comparisons are needed.
Rates are used to show the risk of an event occurring in a population and the CCR presents rates
per 100,000 persons. The CCR calculates rates for both incidence and mortality data. A crude
rate is found by dividing the number of events (e.g., cancer cases or deaths) for a population of
interest in a specified time period by the population of interest at risk during the same time
period. This ratio is then multiplied by 100,000 to express it as a rate per 100,000 persons. A
crude rate can be expressed as
= ×100,000.
population of interest at risk
count of events for a population of interest
crude rate
Crude incidence and mortality rates for 2008 used the population estimates obtained from the
NCHS. Incidence reports published by the CCR prior to 2005 were calculated using the State
Demographer’s population estimates. Hence, rates from reports prior to 2005 are not comparable
to rates in this report.
Age-Specific Rates
An age-specific rate is an example of a crude rate where the population of interest is a specific
age group. For age group i, an age-specific rate can be calculated as
= ×100,000.
population of age group at risk
count of events for age group
age-specific rate
i
i
i
A typical way to divide age groups is in five year increments (0-4, 5-9, …, 80-84, 85+). In this
report, the ages are grouped as 0 to 19 (pediatrics), 20 to 44 (young adults), 45 to 64 (middle-aged
adults) and 65 and older (senior adults).
Age-specific rates are used to examine the burden cancer has on a particular age group and to
determine the need for services for a given population. In addition, they can be used to compare
different population groups of the same age and notice the effect that cancer has on the various
populations. Within a population, age-specific rates can be used to examine how cancer burden
differs between age groups.
Age-Adjusted Rates
The occurrence of an event may vary with age, and the age structure of a population can vary as
well. Therefore, age-specific rates are not always useful for comparisons and as a result must be
adjusted to account for these differences. An age-adjusted rate is a weighted average of the age-specific
rates expressed as a rate per 100,000 persons. Age-adjusted rates should be used only if
the same standard population is used for computing weights. The standard population provides
the proportion of the population in specific age groups and includes information regarding age,
2008 Cancer Incidence and Mortality in North Carolina
N.C. Central Cancer Registry • State Center for Health Statistics • N.C. Division of Public Health
5
but not race, sex or geographic location. The standard population the CCR uses is the 2000
United States Census population.
To calculate age-adjusted rates, multiply each age-specific rate by the proportion of individuals
in that age group in the standard population. For example, for age group i,
.
total standard population
standard population in age group
weighted rate age-specific rate i
i i
= ×
The age-adjusted rate is the sum of all the weighted age-specific rates. For n age groups the age
adjusted rate is
. 1 2 n age-adjusted rate = weighted rate + weighted rate +L+ weighted rate
An age-adjusted rate allows comparison between populations of different age groups, time
periods and/or geographic areas. Age-adjusting ensures that discrepancies in rates of various
populations are not a result of differences in age distributions.
Gender-Specific Rates
In addition to computing rates by age, rates can be computed by gender. For both incidence and
mortality, gender data are collected by the CCR. Gender-specific rates are used for comparison
between different population groups of the same gender and to examine how cancer tendencies
differ between males and females. Gender-specific rates are also used when calculating rates that
only affect males (e.g., prostate and testes) or females (e.g., ovary and cervix).
Race-Specific Rates
Rates can also be calculated by race. Race-specific rates are used for comparison between
different population groups of the race and to examine how the cancer burden varies between
racial groups.
Both race and Hispanic ethnicity are collected by the CCR. Race information can be classified as
one of the following: white, black, Asian/Pacific Islander, American Indian and other. Although
the CCR has five race fields to account for people who are multi-racial, only the primary race is
used. Often the CCR reports rates for whites and minorities. Minorities are defined to be blacks,
Asian/Pacific Islanders, American Indians and others. To assist in identifying Hispanic ethnicity,
the CCR uses the NAACCR Hispanic Identification Algorithm (NHIA). This algorithm uses
name, birthplace, gender and race to determine Hispanic ethnicity.9 Thus, the CCR can report
rates on white non-Hispanics, black non-Hispanics, other races non-Hispanics and Hispanics.
Reliability of Rates
Precautions should always be taken when comparing rates. Rates are not a measure of actual
risk. They are used to compare cancer burden between time periods, age groups, gender groups
and racial groups. Both the size of the numbers and the characteristics of the population are
important indicators of the real value of the rate. Rates based on a small number of cases or for
sparsely populated geographic areas should be viewed with caution. Small fluctuations can lead
to drastic changes. Therefore, sometimes it is more appropriate to look at the number of cases
instead of the rates. When the number of events is small, multiple-year summary rates will
provide a much better measurement of risk. Expanding the period of time studied enlarges the
absolute numbers and adds more credence to a statement regarding a rate.10
2008 Cancer Incidence and Mortality in North Carolina
N.C. Central Cancer Registry • State Center for Health Statistics • N.C. Division of Public Health
6
Limitations of Data
When comparing rates between two populations, the user should note that age structure is the
only difference between the populations for which rates have been adjusted. Since county
demographics can vary considerably, one needs to be careful not to misinterpret rates. Racial
composition, for example, can have a marked influence on the patterns of cancer incidence and
mortality. Under-reporting, due to out of state cases or poor case-finding in some non-hospital
situations, also needs to be taken into account when making comparisons of cancer data.
Summary of 2008 Cancer Data
The CCR collected approximately 47,588 cases of newly diagnosed cancers and 17,403 deaths
due to cancer in 2008 (Table 1). Female breast, lung and bronchus, prostate, and colon and
rectum cancers were the leading diagnosed cancers among all gender and races combined. The
CCR often refers to these as the top four cancers (Table 2).
Cancer risk is strongly associated with lifestyle and behavior. Dietary patterns, alcohol use, and
sexual and reproductive behaviors, which vary by demographic groups, are risk factors of cancer.
Cancer is diagnosed more often among older North Carolinians than younger ones. In general,
males have a higher burden of cancer compared with females. Overall, non-Hispanic blacks and
non-Hispanic whites had the highest incidence and mortality rates when compared with other
non-Hispanics and Hispanics. Lung and bronchus cancer was the most common cause of death
due to cancer.
Age
More adults are directly affected by cancer than children. Senior adults made up only 12.5
percent of the population in 2008,11 but accounted for over 50 percent of newly diagnosed cancer
cases and over two-thirds of deaths due to cancer. Children were the second largest age group,
but made up less than 1 percent of both newly diagnosed cancers and deaths due to cancer (Chart
1). In 2008, the median age at which cancer was diagnosed was 65, but people ranged in age
from 0 to 106. People who died of cancer ranged in age from 1 to 106 with the median age being
71. The median age of incidence and mortality for each age group as well as the percentage of
cases and deaths the top four cancers comprise are shown below. In both middle-aged and senior
adults, the top four cancers combined accounted for over half of the cancer cases and cancer
deaths (Chart 2).
Children (ages 0 to 19) had a very different pattern of cancer than adults. Leukemia, brain
cancer, endocrine cancer and lymphomas accounted for over 60 percent of cancers diagnosed in
people under age 20. Leukemia, bone and brain cancers made up over two-thirds of pediatric
cancer deaths (Tables 5 and 6).
Young adults (ages 20 to 44) had a different pattern of cancer than children. In this age group,
there was a greater incidence of colon and rectum, lung and bronchus, and female breast cancers
than in the pediatric age group. On the other hand, the frequency of leukemia, bone, liver and
brain cancers was lower. Female breast cancer accounted for over 16 percent of all cancer deaths
and had the highest mortality rate within this age group. The mortality rate for female breast
cancer was three times higher than the next highest cancer rate, lung and bronchus (Tables 5 and
6).
2008 Cancer Incidence and Mortality in North Carolina
N.C. Central Cancer Registry • State Center for Health Statistics • N.C. Division of Public Health
7
Cancer patterns were different in middle-aged adults (ages 45 to 64) compared with young
adults. In this age group, there was a higher frequency of prostate, liver, lung and bronchus,
esophageal, and pancreatic cancers. The incidence of Hodgkin disease, testicular and bone
cancers was lower. In addition, the number of deaths due to testicular and bone cancers was less.
The frequency of prostate cancer deaths was higher for young adults than middle-aged adults
(Tables 5 and 6).
Chart 1: 2008 Percentages of NC Population, Cancer Incidence and Mortality by Age
In senior adults (ages 65 and older), cancer patterns were similar to middle-aged adults. In this
age group, there was a slightly higher frequency of bladder cancer compared with middle-aged
adults. The incidence of testicular cancer continued to be lower. Lung and bronchus cancer
accounted for more deaths than colon and rectum, female breast, and prostate cancers combined
(Tables 5 and 6).
Chart 2: 2008 Median Age and Percentage of Top Four Sites for Cancer Incidence and
Mortality by Age Group
Incidence Mortality
Median Age Top 4 Sites Median Age Top 4 Sites
Children (ages 0-19) 8 1.0% 13 0.0%
Young Adults (ages 20 to 44) 39 35.3% 40 36.6%
Middle-Aged Adults (ages 45 to 64) 57 57.8% 58 52.1%
Senior Adults (ages 65 and older) 74 57.1% 77 52.3%
Gender
In 2008, slightly more than 50 percent of the state population was female. However, slightly
more than half of all cancer cases were diagnosed in males and a little more than half of deaths
due to cancer were in males (Chart 3). The median age of diagnosis for females was slightly less
than males, but the median age of mortality was slightly greater than females. The top four sites
comprised more than half of both cancer incidence and mortality (Chart 4).
The most frequently occurring cancers among males were prostate, lung and bronchus, colon and
rectum, bladder, and melanoma. Lung and bronchus, prostate, colon and rectum, pancreatic, and
leukemia were the leading causes of death due to cancer (Table 8).
2008 Cancer Incidence and Mortality in North Carolina
N.C. Central Cancer Registry • State Center for Health Statistics • N.C. Division of Public Health
8
Among females, the most frequently occurring cancers were breast, lung and bronchus, colon
and rectum, uterine, melanoma, and endocrine. Lung and bronchus, breast, colon and rectum,
pancreatic, and ovarian were the leading causes of death due to cancer (Table 8).
Chart 3: 2008 Percentages of NC Population, Cancer Incidence and Mortality by Gender
Differences between genders could provide clues to factors involved in the development of
cancer. Esophageal, laryngeal, bladder, liver and oral cavity cancers had a higher frequency
among males compared with females. However, females had a higher frequency of endocrine
and gallbladder cancers compared with males. In males, one third of deaths due to cancer came
from lung and bronchus cancer, whereas in females, lung and bronchus cancer constituted a
quarter of cancer deaths (Table 7).
Chart 4: 2008 Median Age and Percentage of Top Four Sites for Cancer Incidence and
Mortality by Gender
Incidence Mortality
Median Age Top 4 Sites Median Age Top 4 Sites
Males 65 53.9% 70 51.6%
Females 64 56.5% 72 51.6%
Race and Ethnicity
In 2008, almost 75 percent of the North Carolina population was white. Blacks comprised more
than one-fifth of the population. More than 75 percent of cancer cases and cancer deaths
occurred in whites and almost 20 percent occurred in blacks (Chart 5). The median age and the
percentage the top four cancer sites comprise among all cancers for both incidence and mortality
are displayed for all racial ethnic groups (Chart 6). Hispanics were diagnosed with cancer at an
earlier age than the other racial groups. Hispanics also had the youngest median age of mortality.
Approximately 60 percent of cancer diagnosed in non-Hispanic blacks were from the top four
sites.
For non-Hispanic whites, besides the top four cancers, melanoma was the next most frequently
diagnosed cancer. Pancreatic cancer was a leading cause of death due to cancer in this group.
The number of lung and bronchus cancer deaths was more than 1.6 times as large as the number
of deaths due to female breast, colon and rectum, and prostate cancers combined (Table 14).
2008 Cancer Incidence and Mortality in North Carolina
N.C. Central Cancer Registry • State Center for Health Statistics • N.C. Division of Public Health
9
Among non-Hispanic blacks, prostate cancer comprised almost 20 percent of all diagnosed
cancers. Kidney cancer was also among the top five frequently diagnosed cancers for this group.
Pancreatic cancer was the next leading cause of death due to cancer after the top four cancers.
The number of lung and bronchus cancer deaths was less than the number of deaths due to
female breast, colon and rectum, and prostate cancers combined (Table 14).
Chart 5: 2008 Percentages of NC Population, Cancer Incidence and Mortality by Race
For non-Hispanic other races, besides the top four cancers, endocrine cancer was another
commonly diagnosed cancer. Liver was the second leading cause of death due to cancer in this
group, followed by female breast, colon and rectum, and prostate cancers (Table 14).
For Hispanics, outside of the top four cancers, non-Hodgkin lymphoma was the next most
frequently diagnosed cancer. Lung and bronchus cancer constituted less than 20 percent of
cancer deaths. For other racial and ethnic groups, lung and bronchus cancers made up over a
quarter of cancer deaths. In Hispanics, the most common causes of death due to cancer were lung
and bronchus, leukemia, female breast, liver, and stomach cancers (Table 14).
Chart 6: 2008 Median Age and Percentage of Top Four Sites for Cancer Incidence and
Mortality by Race and Ethnicity
Incidence Mortality
Median Age Top 4 Sites Median Age Top 4 Sites
Non-Hispanic Whites 66 54.2% 72 51.6%
Non-Hispanic Blacks 62 60.4% 67 52.9%
Non-Hispanic Other Races 60 49.9% 66 44.6%
Hispanics 51 41.9% 59 36.9%
Conclusion
This descriptive report is intended to serve as a reference on cancer incidence and mortality for
healthcare planners, researchers and the general public. This publication should not be regarded
as a definitive description of the cancer incidence in North Carolina. Although there are
important limitations in the use of these data, the observed number of cases and the calculated
rates within a county, a gender group, a racial and ethnic group, or an age group have many uses.
2008 Cancer Incidence and Mortality in North Carolina
N.C. Central Cancer Registry • State Center for Health Statistics • N.C. Division of Public Health
10
These uses include planning and evaluating health services at the county and state level and
identifying cancer disparities between specific groups. The data provided by the CCR can be
used by the Comprehensive Cancer Program in the Division of Public Health and other research
organizations for prevention, detection and treatment of cancer.
The editors would like to thank Ann Farmer, Christian Klaus, Karen Knight, Sandy Overton,
Chandrika Rao and the other members of the CCR staff for their contributions to this report.
2008 Cancer Incidence and Mortality in North Carolina
N.C. Central Cancer Registry • State Center for Health Statistics • N.C. Division of Public Health
11
Available Cancer Information
www.schs.state.nc.us/SCHS/CCR 919-715-4574
www.epi.state.nc.us/SCHS 919-733-4728
http://bcccp.ncdhhs.gov 919-707-5300
http://unclineberger.org/rapid-case-ascertainment 919-966-0032
www.cancer.org 1-800-ACS-2345
www.cancer.gov 1-800-4-CANCER
http://seer.cancer.gov
http://cancercontrolplanet.cancer.gov
http://statecancerprofiles.cancer.gov
www.cdc.gov/cancer/NPCR
www.naaccr.org
www.cdc.gov
http://wonder.cdc.gov/cancer.html
www.ncregistrars.com
www.ncra-usa.org
National Cancer Registrars Association
American Cancer Society
National Cancer Institute
Surveillance Epidemiology and End Results
Cancer Control P.L.A.N.E.T.
Centers for Disease Control and Prevention
CDC Wonder United States Cancer Statistics
NCI State Cancer Profiles
National Program of Cancer Registries
North American Association of Central Cancer Registries
North Carolina Breast and Cervical Cancer Control Progam
North Carolina CCR Rapid Case Ascertainment
Association of North Carolina Cancer Registrars
North Carolina State Center for Health Statistics
North Carolina Central Cancer Registry
Wake Wilson
Beaufort
Onslow
Chatham
Franklin
Lee
Randolph
Guilford
Clay
Swain
Madison
Polk
Lincoln
Burke
Caldwell
Ashe
Wilkes
Iredell
Yadkin
Surry
Rowan
Davie
Union Anson
Stanly
Forsyth
Moore
Hoke
Robeson
Johnston
Duplin
Pender
Craven
Pitt
Nash
Lenoir
Brunswick
Jones
Carteret
Pamlico
Hyde
Hertford
Gates
Bertie
Halifax
Dare
Tyrrell
Harnett
Columbus
Pasquotank
Camden
Cherokee
Graham
Haywood
Buncombe
Watauga
Rockingham Caswell
Perquimans
Currituck
sylvania
Tran- Meck-lenburg
mond
Rich-
New
Hanover
Macon
Jackson
Rutherford
Yancey
Avery
McDowell Catawba
ander
Alex-ghany
Alle-
Northampton
derson
D av idson
Stokes
ville
gomery
Mont-
Hen-mance
Ala-ham
Dur-
Cumber-land
Bladen
Scot-land
Gran-
Warren
Edge-
Martin ington
Wash-
Wayne
Greene
Mitchell
Chowan
Vance
Sampson
Cabarrus
Gaston
Cleveland
Orange
Person
combe
Map 1: 2008 North Carolina Cancer Incidence Rates by County
^ Rates are based on cases reported to North Carolina
Central Cancer Registry and are subject to change as
files are updated.
Rate per 100,000 Population^
347.1 - 423.4
423.5 - 466.6
466.7 - 507.1
507.2 - 552.9
553.0 - 593.5
2008 Cancer Incidence and Mortality in North Carolina
N.C. Central Cancer Registry • State Center for Health Statistics • N.C. Division of Public Health 12
Wake Wilson
Beaufort
Onslow
Chatham
Franklin
Lee
Randolph
Guilford
Clay
Swain
Madison
Polk
Lincoln
Burke
Caldwell
Ashe
Wilkes
Iredell
Yadkin
Surry
Rowan
Davie
Union Anson
Stanly
Forsyth
Moore
Hoke
Robeson
Johnston
Duplin
Pender
Craven
Pitt
Nash
Lenoir
Brunswick
Jones
Carteret
Pamlico
Hyde
Hertford
Gates
Bertie
Halifax
Dare
Tyrrell
Harnett
Columbus
Pasquotank
Camden
Cherokee
Graham
Haywood
Buncombe
Watauga
Rockingham Caswell
Perquimans
Currituck
sylvania
Tran- Meck-lenburg
mond
Rich-
New
Hanover
Macon
Jackson
Rutherford
Yancey
Avery
McDowell Catawba
ander
Alex-ghany
Alle-
Northampton
derson
D av idson
Stokes
ville
gomery
Mont-
Hen-mance
Ala-ham
Dur-
Cumber-land
Bladen
Scot-land
Gran-
Warren
Edge-
Martin ington
Wash-
Wayne
Greene
Mitchell
Chowan
Vance
Sampson
Cabarrus
Gaston
Cleveland
Orange
Person
combe
Map 2: 2008 North Carolina Cancer Mortality Rates by County
*
*
*Rates based on counts less than 16 are unstable
and should be used with caution.
Rate per 100,000 Population
102.4 - 155.9
156.0 - 180.4
180.5 - 211.0
211.1 - 266.7
266.8 - 356.6
2008 Cancer Incidence and Mortality in North Carolina
N.C. Central Cancer Registry • State Center for Health Statistics • N.C. Division of Public Health 13
2008 Cancer Incidence and Mortality in North Carolina
N.C. Central Cancer Registry • State Center for Health Statistics • N.C. Division of Public Health
14
Table 1: 2008 North Carolina Cancer Incidence and Mortality
Cases Rate Deaths Rate
All Cancers 47,588 488.2 17,403 181.7
Oral Cavity and Pharynx 1,231 12.3 248 2.5
Lip 54 0.6 4 0.0
Tongue 320 3.2 54 0.6
Salivary Glands 126 1.3 16 0.2
Floor of Mouth 83 0.8 2 0.0
Nasopharynx 53 0.5 19 0.2
Oropharynx 67 0.7 25 0.2
Hypopharynx 73 0.7 15 0.2
Other Mouth and Pharynx 455 4.6 113 1.1
Digestive System 7,595 78.0 3,874 40.2
Esophagus 499 5.0 357 3.6
Stomach 544 5.6 310 3.3
Small Intestine 221 2.2 40 0.4
Colon and Rectum 4,154 42.9 1,480 15.4
Anus and Anal Canal 162 1.6 23 0.2
Liver and Intrahepatic Bile Duct 591 5.9 522 5.3
Gallbladder 93 1.0 63 0.7
Pancreas 1,072 11.0 998 10.4
Other Digestive Organs 259 2.7 81 0.8
Respiratory System 7,780 79.8 5,517 57.3
Larynx 450 4.5 138 1.4
Lung and Bronchus 7,164 73.6 5,352 55.6
Other Respiratory Organs 166 1.7 27 0.3
Bones and Joints 80 0.9 43 0.5
Soft Tissue including Heart 311 3.3 109 1.2
Malignant Melanoma of the Skin 2,090 21.8 291 3.1
Breast 8,129 83.4 1,257 13.0
Invasive Breast 6,543 67.3
In Situ Breast 1,586 16.1
Female Genital System 2,422 45.8 784 14.2
Cervix Uteri, Invasive 343 7.0 111 2.1
Uterus (Corpus, NOS) 1,224 22.6 207 3.7
Ovary 628 11.9 411 7.5
Other Female Genital Organs 227 4.3 55 1.0
Cancers of the urinary bladder and female breast include in situ cases.
Rates are calculated using the bridged-race population estimates obtained from the National Center for Health Statistics available online at
www.cdc.gov/nchs/nvss/bridged_race/data_documentation.htm#vintage2009.
Brain and other central nervous system cancer excludes benign cases.
Incidence Mortality
Rates are per 100,000 persons and are age-adjusted to the 2000 U.S. Census.
Rates based on counts less than 16 are unstable and should be used with caution.
2008 Cancer Incidence and Mortality in North Carolina
N.C. Central Cancer Registry • State Center for Health Statistics • N.C. Division of Public Health
15
Table 1 (continued): 2008 North Carolina Cancer Incidence and Mortality
Cases Rate Deaths Rate
Male Genital System 7,155 158.5 915 25.9
Prostate 6,896 152.6 895 25.5
Testis 215 4.8 11 0.3
Penis 38 0.9 8 0.2
Other Male Genital Organs 6 0.2 1 0.0
Urinary System 3,636 37.8 800 8.5
Urinary Bladder 1,971 20.7 373 4.0
Kidney and Renal Pelvis 1,593 16.3 399 4.2
Ureter 53 0.6 11 0.1
Other Urinary Organs 19 0.2 17 0.2
Eye and Orbit 87 0.9 6 0.1
Brain and Other CNS 569 5.9 403 4.2
Endocrine System 1,187 12.6 72 0.8
Thyriod Gland 1,130 11.9 47 0.5
Other Endocrine and Thymus 57 0.6 25 0.3
Lymphomas 2,046 21.5 583 6.2
Hodgkin Disease 245 2.7 34 0.4
Non-Hodgkin Lymphoma 1,801 18.9 549 5.8
Multiple Myeloma 649 6.7 374 3.9
Leukemia 1,047 11.0 614 6.6
Acute Lymphocytic Leukemia 121 1.3 33 0.4
Chronic Lymphocytic Leukemia 347 3.6 130 1.4
Acute Myeloid Leukemia 324 3.4 248 2.6
Chronic Myeloid Leukemia 134 1.4 29 0.3
Other Leukemia 121 1.3 174 1.9
Other Cancers - Uncategorized 1,574 16.6 1,513 15.9
Incidence Mortality
Brain and other central nervous system cancer excludes benign cases.
Rates are per 100,000 persons and are age-adjusted to the 2000 U.S. Census.
Cancers of the urinary bladder and female breast include in situ cases.
Rates are calculated using the bridged-race population estimates obtained from the National Center for Health Statistics available online at
www.cdc.gov/nchs/nvss/bridged_race/data_documentation.htm#vintage2009.
Rates based on counts less than 16 are unstable and should be used with caution.
2008 Cancer Incidence and Mortality in North Carolina
N.C. Central Cancer Registry • State Center for Health Statistics • N.C. Division of Public Health
16
Table 2: 2008 North Carolina Top Ten Cancer Incidence and Mortality Sites
Cases Rate Deaths Rate
Female Breast 8,043 152.4 Lung and Bronchus 5,352 55.6
Lung and Bronchus 7,164 73.6 Colon and Rectum 1,483 15.4
Prostate 6,896 152.6 Female Breast 1,250 12.9
Colon and Rectum 4,154 42.9 Pancreas 998 10.4
Melanoma (Skin) 2,090 21.8 Prostate 895 9.7
Urinary Bladder 1,971 20.7 Leukemia 614 6.6
Non-Hodgkin Lymphoma 1,801 18.9 Non-Hodgkin Lymphoma 549 5.8
Kidney 1,593 16.3 Liver 522 5.3
Uterus (Corpus, NOS) 1,224 22.6 Ovary 411 4.3
Endocrine 1,187 12.6 Brain and Other CNS 403 4.2
Cancers of the urinary bladder and female breast include in situ cases.
Brain and other central nervous system cancer excludes benign cases.
Incidence Mortality
Rates are calculated using the bridged-race population estimates obtained from the National Center for Health Statistics available online at
www.cdc.gov/nchs/nvss/bridged_race/data_documentation.htm#vintage2009.
Rates are per 100,000 persons and are age-adjusted to the 2000 U.S. Census.
2008 Cancer Incidence and Mortality in North Carolina
N.C. Central Cancer Registry • State Center for Health Statistics • N.C. Division of Public Health
17
Table 3: 2008 Cancer Incidence and Mortality by County
Cases Rate Deaths Rate
North Carolina 47,588 488.2 17,403 181.7
Alamance 845 513.1 310 183.5
Alexander 210 491.7 72 179.3
Alleghany 73 436.3 29 168.0
Anson 122 418.3 55 186.6
Ashe 173 472.5 56 145.4
Avery 117 506.3 45 197.2
Beaufort 361 566.4 114 175.1
Bertie 124 502.8 63 246.2
Bladen 157 422.8 90 241.1
Brunswick 603 386.1 258 168.5
Buncombe 1,429 502.9 505 171.6
Burke 526 494.2 224 204.1
Cabarrus 930 586.4 267 173.7
Caldwell 428 441.9 199 207.2
Camden 51 529.3 15 164.0
Carteret 487 545.2 172 186.5
Caswell 142 484.9 60 210.9
Catawba 858 481.7 329 186.8
Chatham 290 381.1 116 151.2
Cherokee 189 450.2 78 177.7
Chowan 113 552.9 52 244.5
Clay 72 427.4 24 138.1
Cleveland 550 466.6 207 176.1
Columbus 264 395.0 123 190.3
Craven 581 500.1 236 202.8
Cumberland 1,271 480.1 489 196.7
Currituck 105 412.5 43 174.0
Dare 196 455.2 64 155.9
Davidson 891 494.4 316 178.9
Davie 221 450.0 80 158.3
Duplin 235 411.1 105 187.9
Durham 1,106 483.8 407 185.6
Edgecombe 291 526.7 138 266.7
Forsyth 1,911 500.8 666 177.1
Mortality
Rates are calculated using the bridged-race population estimates obtained from the National Center for Health Statistics available online at
www.cdc.gov/nchs/nvss/bridged_race/data_documentation.htm#vintage2009.
Rates are per 100,000 persons and are age-adjusted to the 2000 U.S. Census.
Cancers of the urinary bladder and female breast include in situ cases.
Brain and other central nervous system cancer excludes benign cases.
Incidence
Rates based on counts less than 16 are unstable and should be used with caution.
2008 Cancer Incidence and Mortality in North Carolina
N.C. Central Cancer Registry • State Center for Health Statistics • N.C. Division of Public Health
18
Table 3 (continued): 2008 Cancer Incidence and Mortality by County
Cases Rate Deaths Rate
Franklin 286 476.1 125 214.1
Gaston 1,115 494.5 429 191.0
Gates 68 499.1 29 220.3
Graham 49 409.8 25 223.4
Granville 333 560.4 142 252.9
Greene 105 496.7 31 153.4
Guilford 2,651 543.4 822 168.9
Halifax 354 520.7 128 187.0
Harnett 413 420.3 181 198.7
Haywood 429 517.5 163 183.8
Henderson 820 522.2 285 171.6
Hertford 109 381.7 67 233.7
Hoke 119 347.1 51 175.2
Hyde 35 534.9 11 166.7
Iredell 817 493.7 304 188.7
Jackson 201 477.0 66 153.3
Johnston 658 445.6 244 178.7
Jones 60 439.6 29 204.9
Lee 350 517.8 102 147.1
Lenoir 427 588.8 152 207.2
Lincoln 392 476.6 157 200.0
McDowell 251 461.9 104 188.6
Macon 216 395.0 99 167.5
Madison 133 507.1 67 236.4
Martin 161 521.1 69 216.9
Mecklenburg 3,548 474.7 1,146 167.7
Mitchell 87 401.0 49 198.8
Montgomery 141 438.3 40 124.7
Moore 622 500.1 234 167.2
Nash 514 454.9 185 164.6
New Hanover 967 459.6 382 182.1
Northampton 146 490.8 53 170.5
Onslow 563 529.5 216 215.2
Orange 585 502.2 177 159.6
Pamlico 88 418.1 36 171.5
Incidence Mortality
Rates are per 100,000 persons and are age-adjusted to the 2000 U.S. Census.
Cancers of the urinary bladder and female breast include in situ cases.
Rates are calculated using the bridged-race population estimates obtained from the National Center for Health Statistics available online at
www.cdc.gov/nchs/nvss/bridged_race/data_documentation.htm#vintage2009.
Brain and other central nervous system cancer excludes benign cases.
Rates based on counts less than 16 are unstable and should be used with caution.
2008 Cancer Incidence and Mortality in North Carolina
N.C. Central Cancer Registry • State Center for Health Statistics • N.C. Division of Public Health
19
Table 3 (continued): 2008 Cancer Incidence and Mortality by County
Cases Rate Deaths Rate
Pasquotank 222 497.7 80 173.2
Pender 269 430.5 120 196.0
Perquimans 83 423.4 45 231.1
Person 211 472.4 78 178.7
Pitt 691 502.0 249 185.2
Polk 156 482.0 72 193.0
Randolph 822 518.5 297 188.0
Richmond 250 479.8 114 213.4
Robeson 578 465.2 249 208.5
Rockingham 618 539.8 231 197.4
Rowan 802 496.2 306 184.3
Rutherford 448 532.9 192 231.1
Sampson 282 408.5 130 190.6
Scotland 217 540.1 94 243.0
Stanly 356 498.8 129 178.8
Stokes 231 405.0 90 154.1
Surry 483 535.6 186 197.2
Swain 89 511.2 33 183.0
Transylvania 261 545.2 83 147.9
Tyrrell 17 350.6 18 356.6
Union 646 388.1 251 172.0
Vance 246 510.9 93 191.4
Wake 3,514 494.2 1,015 159.9
Warren 120 437.1 41 145.6
Washington 82 474.4 18 102.4
Watauga 212 488.9 74 165.6
Wayne 629 521.7 218 184.7
Wilkes 425 499.3 154 180.4
Wilson 439 495.5 194 224.8
Yadkin 228 492.3 88 189.2
Yancey 152 593.5 54 196.7
Cancers of the urinary bladder and female breast include in situ cases.
Rates are calculated using the bridged-race population estimates obtained from the National Center for Health Statistics available online at
www.cdc.gov/nchs/nvss/bridged_race/data_documentation.htm#vintage2009.
Brain and other central nervous system cancer excludes benign cases.
Rates are per 100,000 persons and are age-adjusted to the 2000 U.S. Census.
Incidence Mortality
Rates based on counts less than 16 are unstable and should be used with caution.
2008 Cancer Incidence and Mortality in North Carolina
N.C. Central Cancer Registry • State Center for Health Statistics • N.C. Division of Public Health
20
Table 4: 2008 Ten Highest and Lowest Cancer Incidence and Mortality Rates by County
Cases Rate Deaths Rate
Hoke 119 347.1 Washington 18 102.4
Tyrrell 17 350.6 Montgomery 40 124.7
Chatham 290 381.1 Clay 24 138.1
Hertford 109 381.7 Ashe 56 145.4
Brunswick 603 386.1 Warren 41 145.6
Union 646 388.1 Lee 102 147.1
Columbus 264 395.0 Transylvania 83 147.9
Macon 216 395.0 Chatham 116 151.2
Mitchell 87 401.0 Jackson 66 153.3
Stokes 231 405.0 Greene 31 153.4
Cases Rate Deaths Rate
Scotland 217 540.1 Rutherford 192 231.1
Guilford 2,651 543.4 Hertford 67 233.7
Carteret 487 545.2 Madison 67 236.4
Transylvania 261 545.2 Bladen 90 241.1
Chowan 113 552.9 Scotland 94 243.0
Granville 333 560.4 Chowan 52 244.5
Beaufort 361 566.4 Bertie 63 246.2
Cabarrus 930 586.4 Granville 142 252.9
Lenoir 427 588.8 Edgecombe 138 266.7
Yancey 152 593.5 Tyrrell 18 356.6
Rates are per 100,000 persons and are age-adjusted to the 2000 U.S. Census.
Cancers of the urinary bladder and female breast include in situ cases.
Rates are calculated using the bridged-race population estimates obtained from the National Center for Health Statistics available online at
www.cdc.gov/nchs/nvss/bridged_race/data_documentation.htm#vintage2009.
Incidence - Lowest Ten
Incidence - Highest Ten Mortality - Highest Ten
Mortality - Lowest Ten
Brain and other central nervous system cancer excludes benign cases.
2008 Cancer Incidence and Mortality in North Carolina
N.C. Central Cancer Registry • State Center for Health Statistics • N.C. Division of Public Health
21
Table 5: 2008 Cancer Incidence and Mortality by Age Group
Cases Rate Cases Rate Deaths Rate Deaths Rate
All Cancers 392 15.5 3,819 119.1 59 2.3 549 17.1
Oral Cavity 10 0.4 87 2.7 0 0.0 12 0.4
Esophagus * * 12 0.4 0 0.0 6 0.2
Stomach * * 36 1.1 0 0.0 15 0.5
Colon and Rectum * * 221 6.9 0 0.0 51 1.6
Liver 9 0.4 13 0.4 2 0.1 14 0.4
Gallbladder * * * * 0 0.0 1 0.0
Pancreas * * 24 0.7 0 0.0 20 0.6
Larynx * * 16 0.5 0 0.0 2 0.1
Lung and Bronchus * * 130 4.1 0 0.0 58 1.8
Bone 23 0.9 21 0.7 10 0.4 12 0.4
Soft Tissue 24 1.0 78 2.4 4 0.2 8 0.2
Melanoma (Skin) 12 0.5 408 12.7 0 0.0 24 0.7
Female Breast * * 950 59.7 0 0.0 91 5.7
Cervix Uteri * * 130 8.2 0 0.0 19 1.2
Corpus Uteri * * 102 6.4 0 0.0 0 0.0
Ovary 8 0.7 73 4.6 0 0.0 17 1.1
Prostate * * 46 2.8 0 0.0 1 0.1
Testes 8 0.6 150 9.3 0 0.0 7 0.4
Urinary Bladder * * 38 1.2 0 0.0 2 0.1
Kidney 15 0.6 136 4.2 2 0.1 14 0.4
Endocrine 31 1.2 393 12.3 4 0.2 9 0.3
Multiple Myeloma * * 19 0.6 0 0.0 2 0.1
Leukemia 95 3.8 118 3.7 20 0.8 38 1.2
Brain and Other CNS 66 2.6 101 3.1 10 0.4 47 1.5
Hodgkin Disease 23 0.9 106 3.3 0 0.0 6 0.2
Non-Hodgkin Lymphoma 29 1.1 203 6.3 3 0.1 21 0.7
Other Cancers 31 1.2 204 6.4 4 0.2 52 1.6
0-19 20-44
Incidence Mortality
0-19 20-44
Rates are per 100,000 persons.
Cancers of the urinary bladder and female breast include in situ cases.
Brain and other central nervous system cancer excludes benign cases.
Rates are calculated using the bridged-race population estimates obtained from the National Center for Health Statistics available online at
www.cdc.gov/nchs/nvss/bridged_race/data_documentation.htm#vintage2009.
* Incidence counts less than five are suppressed.
Rates based on counts less than 16 are unstable and should be used with caution.
2008 Cancer Incidence and Mortality in North Carolina
N.C. Central Cancer Registry • State Center for Health Statistics • N.C. Division of Public Health
22
Table 5 (continued): 2008 Cancer Incidence and Mortality by Age Group
Cases Rate Cases Rate Deaths Rate Deaths Rate
All Cancers 19,010 805.6 24,367 2,104.2 5,078 215.2 11,717 1,011.8
Oral Cavity 659 27.9 475 41.0 106 4.5 130 11.2
Esophagus 212 9.0 275 23.7 140 5.9 211 18.2
Stomach 189 8.0 319 27.5 78 3.3 217 18.7
Colon and Rectum 1,560 66.1 2,371 204.7 455 19.3 977 84.4
Liver 324 13.7 245 21.2 232 9.8 274 23.7
Gallbladder 28 1.2 61 5.3 17 0.7 45 3.9
Pancreas 366 15.5 681 58.8 262 11.1 716 61.8
Larynx 230 9.7 204 17.6 54 2.3 82 7.1
Lung and Bronchus 2,492 105.6 4,541 392.1 1,626 68.9 3,668 316.7
Bone 18 0.8 18 1.6 5 0.2 16 1.4
Soft Tissue 107 4.5 102 8.8 34 1.4 63 5.4
Melanoma (Skin) 828 35.1 842 72.7 91 3.9 176 15.2
Female Breast 3,788 309.4 3,304 488.9 461 37.7 698 103.3
Cervix Uteri 147 12.0 64 9.5 58 4.7 34 5.0
Uterus (Corpus, NOS) 598 48.8 524 77.5 65 5.3 142 21.0
Ovary 224 18.3 323 47.8 115 9.4 279 41.3
Prostate 3,147 277.2 3,703 767.9 105 9.2 789 163.6
Testes 50 4.4 7 1.5 2 0.2 2 0.4
Urinary Bladder 521 22.1 1,411 121.8 68 2.9 303 26.2
Kidney 693 29.4 749 64.7 124 5.3 259 22.4
Endocrine 486 20.6 277 23.9 16 0.7 43 3.7
Multiple Myeloma 232 9.8 398 34.4 102 4.3 270 23.3
Leukemia 278 11.8 556 48.0 117 5.0 439 37.9
Brain and Other CNS 204 8.6 198 17.1 147 6.2 199 17.2
Hodgkin Disease 70 3.0 46 4.0 12 0.5 16 1.4
Non-Hodgkin Lymphoma 608 25.8 961 83.0 113 4.8 412 35.6
Other Cancers 951 40.3 1,712 147.8 473 20.0 1,257 108.5
Rates are per 100,000 persons.
Cancers of the urinary bladder and female breast include in situ cases.
Brain and other central nervous system excludes benign cases.
Rates are calculated using the bridged-race population estimates obtained from the National Center for Health Statistics available online at
www.cdc.gov/nchs/nvss/bridged_race/data_documentation.htm#vintage2009.
* Incidence counts less than five are suppressed.
Rates based on counts less than 16 are unstable and should be used with caution.
45-64 65 and above 45-64 65 and above
Incidence Mortality
2008 Cancer Incidence and Mortality in North Carolina
N.C. Central Cancer Registry • State Center for Health Statistics • N.C. Division of Public Health
23
Table 6: 2008 Top Ten Cancer Incidence and Mortality by Age Group
Cases Rate Deaths Rate
Leukemia 95 3.8 Leukemia 20 0.8
Brain and Other CNS 66 2.6 Bone 10 0.4
Endocrine 31 1.2 Brain and Other CNS 10 0.4
Non-Hodgkin Lymphoma 29 1.1 Soft Tissue 4 0.2
Soft Tissue 24 1.0 Endocrine 4 0.2
Bone 23 0.9 Non-Hodgkin Lymphoma 3 0.1
Hodgkin Disease 23 0.9 Liver 2 0.1
Kidney 15 0.6 Kidney 2 0.1
Melanoma (Skin) 12 0.5
Oral Cavity 10 0.4
Cases Rate Deaths Rate
Female Breast 950 59.7 Female Breast 91 5.7
Melanoma (Skin) 408 12.7 Lung and Bronchus 58 1.8
Endocrine 393 12.3 Colon and Rectum 51 1.6
Colon and Rectum 221 6.9 Brain and Other CNS 47 1.5
Non-Hodgkin Lymphoma 203 6.3 Leukemia 38 1.2
Testes 150 9.3 Melanoma (Skin) 24 0.7
Kidney 136 4.2 Non-Hodgkin Lymphoma 21 0.7
Lung and Bronchus 130 4.1 Pancreas 20 0.6
Cervix Uteri 130 8.2 Cervix Uteri 19 1.2
Leukemia 118 3.7 Ovary 17 1.1
Incidence Mortality
Ages 0 to 19
Incidence Mortality
Ages 20 to 44
Rates based on counts less than 16 are unstable and should be used with caution.
Rates are per 100,000 persons.
Cancers of the urinary bladder and female breast include in situ cases.
Brain and other central nervous system cancer excludes benign cases.
Rates are calculated using the bridged-race population estimates obtained from the National Center for Health Statistics available online at
www.cdc.gov/nchs/nvss/bridged_race/data_documentation.htm#vintage2009.
2008 Cancer Incidence and Mortality in North Carolina
N.C. Central Cancer Registry • State Center for Health Statistics • N.C. Division of Public Health
24
Table 6 (continued): 2008 Top Ten Cancer Incidence and Mortality by Age Group
Cases Rate Deaths Rate
Female Breast 3,788 309.4 Lung and Bronchus 1,626 68.9
Prostate 3,147 277.2 Female Breast 461 37.7
Lung and Bronchus 2,492 105.6 Colon and Rectum 455 19.3
Colon and Rectum 1,560 66.1 Pancreas 262 11.1
Melanoma (Skin) 828 35.1 Liver 232 9.8
Kidney 693 29.4 Brain and Other CNS 147 6.2
Oral Cavity 659 27.9 Esophagus 140 5.9
Non-Hodgkin Lymphoma 608 25.8 Kidney 124 5.3
Uterus (Corpus, NOS) 598 48.8 Leukemia 117 5.0
Urinary Bladder 521 22.1 Ovary 115 9.4
Cases Rate Deaths Rate
Lung and Bronchus 4,541 392.1 Lung and Bronchus 3,668 316.7
Prostate 3,703 767.9 Colon and Rectum 977 84.4
Female Breast 3,304 488.9 Prostate 789 163.6
Colon and Rectum 2,371 204.7 Pancreas 716 61.8
Bladder 1,411 121.8 Female Breast 698 103.3
Non-Hodgkin Lymphoma 961 83.0 Leukemia 439 37.9
Melanoma (Skin) 842 72.7 Non-Hodgkin Lymphoma 412 35.6
Kidney 749 64.7 Bladder 303 26.2
Pancreas 681 58.8 Ovary 279 41.3
Leukemia 556 48.0 Liver 274 23.7
Ages 45 to 64
Ages 65 and above
Incidence Mortality
Incidence Mortality
Rates are per 100,000 persons.
Cancers of the urinary bladder and female breast include in situ cases.
Brain and other central nervous system cancer excludes benign cases.
Rates are calculated using the bridged-race population estimates obtained from the National Center for Health Statistics available online at
www.cdc.gov/nchs/nvss/bridged_race/data_documentation.htm#vintage2009.
Rates based on counts less than 16 are unstable and should be used with caution.
2008 Cancer Incidence and Mortality in North Carolina
N.C. Central Cancer Registry • State Center for Health Statistics • N.C. Division of Public Health
25
Table 7: 2008 Cancer Incidence and Mortality by Gender
Cases Rate Cases Rate Deaths Rate Deaths Rate
All Cancers 24,388 564.2 23,194 436.8 9,217 230.0 8,186 149.2
Oral Cavity and Pharynx 847 18.4 384 7.2 172 3.9 76 1.4
Lip 35 0.8 19 0.4 2 0.1 2 0.0
Tongue 225 4.8 95 1.8 31 0.7 23 0.4
Salivary Glands 70 1.7 56 1.1 13 0.3 3 0.1
Floor of Mouth 49 1.0 34 0.6 1 0.0 1 0.0
Nasopharynx 40 0.9 13 0.2 15 0.4 4 0.1
Oropharynx 52 1.1 15 0.3 17 0.4 8 0.1
Hypopharynx 58 1.3 15 0.3 14 0.3 1 0.0
Other Mouth and Pharynx 318 6.8 137 2.6 79 1.8 34 0.6
Digestive System 4,137 96.3 3,454 63.4 2,085 50.2 1,789 32.2
Esophagus 402 9.3 97 1.8 288 6.8 69 1.3
Stomach 330 7.8 213 3.9 172 4.3 138 2.5
Small Intestine 121 2.7 99 1.9 24 0.6 16 0.3
Colon and Rectum 2,181 51.3 1,972 36.3 735 18.1 745 13.4
Anus and Anal Canal 54 1.2 108 2.0 14 0.4 9 0.2
Liver and Intrahepatic Bile Duct 412 9.0 179 3.3 349 7.9 173 3.2
Gallbladder 30 0.7 63 1.1 22 0.6 41 0.7
Pancreas 501 11.7 570 10.2 446 10.8 552 9.8
Other Digestive Organs 106 2.6 153 2.8 35 0.8 46 0.8
Respiratory System 4,550 107.3 3,229 59.5 3,249 79.3 2,268 41.6
Larynx 355 8.0 95 1.7 110 2.7 28 0.5
Lung and Bronchus 4,068 96.3 3,095 57.0 3,125 76.3 2,227 40.9
Other Respiratory Organs 127 3.0 39 0.7 14 0.4 13 0.2
Bones and Joints 40 0.9 40 0.9 23 0.5 20 0.4
Soft Tissue including Heart 187 4.3 124 2.5 60 1.5 49 0.9
Malignant Melanoma of the Skin 1,222 28.8 868 17.1 191 4.8 100 1.9
Breast 86 2.0 8,043 152.4 7 0.2 1,250 23.0
Invasive Breast 68 1.6 6,475 122.7
In Situ Breast 18 0.4 1,568 29.7
Female Genital System . . 2,422 45.8 . . 784 14.2
Cervix Uteri, Invasive . . 343 7.0 . . 111 2.1
Uterus (Corpus, NOS) . . 1,224 22.6 . . 207 3.7
Ovary . . 628 11.9 . . 411 7.5
Other Female Genital Organs . . 227 4.3 . . 55 1.0
Incidence Mortality
Males Females Males Females
Rates are per 100,000 persons and are age-adjusted to the 2000 U.S. Census.
Cancers of the urinary bladder and female breast include in situ cases.
Brain and other central nervous system cancers exclude benign cases.
Rates are calculated using the bridged-race population estimates obtained from the National Center for Health Statistics available online at
www.cdc.gov/nchs/nvss/bridged_race/data_documentation.htm#vintage2009.
Rates based on counts less than 16 are unstable and should be used with caution.
2008 Cancer Incidence and Mortality in North Carolina
N.C. Central Cancer Registry • State Center for Health Statistics • N.C. Division of Public Health
26
Table 7 (continued): 2008 Cancer Incidence and Mortality by Gender
Cases Rate Cases Rate Deaths Rate Deaths Rate
Male Genital System 7,155 158.5 . . 915 25.9 . .
Prostate 6,896 152.6 . . 895 25.5 . .
Testis 215 4.8 . . 11 0.3 . .
Penis 38 0.9 . . 8 0.2 . .
Other Male Genital Organs 6 0.2 . . 1 0.0 . .
Urinary System 2,562 62.1 1,074 19.8 536 14.1 264 4.7
Urinary Bladder 1,477 37.2 494 9.0 249 6.9 124 2.2
Kidney and Renal Pelvis 1,037 23.6 556 10.4 272 6.8 127 2.3
Ureter 37 0.9 16 0.3 9 0.2 2 0.0
Other Urinary Organs 11 0.3 8 0.2 6 0.1 11 0.2
Eye and Orbit 53 1.2 34 0.6 5 0.1 1 0.0
Brain and Other CNS 318 7.1 251 5.0 244 5.7 159 3.0
Endocrine System 326 7.3 861 17.6 38 0.9 34 0.6
Thyriod Gland 291 6.5 839 17.2 19 0.5 28 0.5
Other Endocrine and Thymus 35 0.8 22 0.4 19 0.4 6 0.1
Lymphomas 1,126 26.5 920 17.5 287 7.2 296 5.4
Hodgkin Disease 137 3.1 108 2.2 16 0.4 18 0.3
Non-Hodgkin Lymphoma 989 23.4 812 15.3 271 6.8 278 5.1
Multiple Myeloma 352 8.4 297 5.4 201 5.0 173 3.1
Leukemia 604 14.7 443 8.4 364 9.4 250 4.6
Acute Lymphocytic Leukemia 71 1.5 50 1.1 23 0.5 10 0.2
Chronic Lymphocytic Leukemia 215 5.3 132 2.4 79 2.2 51 0.9
Acute Myeloid Leukemia 175 4.3 149 2.8 139 3.5 109 2.0
Chronic Myeloid Leukemia 79 1.9 55 1.1 18 0.5 11 0.2
Other Leukemia 64 1.6 57 1.1 105 2.7 69 1.3
Other Cancers - Uncategorized 823 20.6 750 13.7 840 21.3 673 12.1
Incidence Mortality
Males Females Males Females
Rates are per 100,000 persons and are age-adjusted to the 2000 U.S. Census.
Cancers of the urinary bladder and female breast include in situ cases.
Brain and other central nervous system cancers exclude benign cases.
Rates are calculated using the bridged-race population estimates obtained from the National Center for Health Statistics available online at
www.cdc.gov/nchs/nvss/bridged_race/data_documentation.htm#vintage2009.
Rates based on counts less than 16 are unstable and should be used with caution.
2008 Cancer Incidence and Mortality in North Carolina
N.C. Central Cancer Registry • State Center for Health Statistics • N.C. Division of Public Health
27
Table 8: 2008 Top Ten Cancer Incidence and Mortality Sites by Gender
Cases Rate Deaths Rate
Prostate 6,896 152.6 Lung and Bronchus 3,125 76.3
Lung and Bronchus 4,068 96.3 Prostate 895 25.5
Colon and Rectum 2,181 51.3 Colon and Rectum 735 18.1
Urinary Bladder 1,477 37.2 Pancreas 446 10.8
Melanoma (Skin) 1,222 28.8 Leukemia 364 9.4
Kidney 1,037 23.6 Liver 349 7.9
Non-Hodgkin Lymphoma 989 23.4 Esophagus 288 6.8
Oral Cavity 847 18.4 Kidney 272 6.8
Leukemia 604 14.7 Non-Hodgkin Lymphoma 271 6.8
Pancreas 501 11.7 Urinary Bladder 249 6.9
Cases Rate Deaths Rate
Female Breast 8,043 152.4 Lung and Bronchus 2,227 40.9
Lung and Bronchus 3,095 57.0 Female Breast 1,250 23.0
Colon and Rectum 1,972 36.3 Colon and Rectum 746 13.4
Uterus (Corpus, NOS) 1,224 22.6 Pancreas 552 9.8
Melanoma (Skin) 868 17.1 Ovary 411 7.5
Endocrine 861 17.6 Non-Hodgkin Lymphoma 278 5.1
Non-Hodgkin Lymphoma 812 15.3 Leukemia 250 4.6
Ovary 628 11.9 Uterus (Corpus, NOS) 207 3.7
Pancreas 570 10.2 Liver 173 3.2
Kidney 556 10.4 Multiple Myeloma 173 3.1
Rates are per 100,000 persons and are age-adjusted to the 2000 U.S. Census.
Cancers of the urinary bladder and female breast include in situ cases.
Rates are calculated using the bridged-race population estimates obtained from the National Center for Health Statistics available online at
www.cdc.gov/nchs/nvss/bridged_race/data_documentation.htm#vintage2009.
Males
Brain and other central nervous system cancers exclude benign cases.
Incidence Mortality
Incidence Mortality
Females
2008 Cancer Incidence and Mortality in North Carolina
N.C. Central Cancer Registry • State Center for Health Statistics • N.C. Division of Public Health
28
Table 9: 2008 Cancer Incidence and Mortality by Race
Cases Rate Cases Rate Deaths Rate Deaths Rate
All Cancers 37,631 484.7 9,590 480.9 13,702 176.7 3,698 199.8
Oral Cavity and Pharynx 980 12.5 246 11.5 170 2.2 78 3.8
Lip 50 0.7 * * 3 0.0 1 0.1
Tongue 273 3.4 47 2.2 38 0.5 16 0.8
Salivary Glands 106 1.4 20 0.9 15 0.2 1 0.1
Floor of Mouth 67 0.8 15 0.7 2 0.0 0 0.0
Nasopharynx 32 0.4 21 1.0 15 0.2 4 0.2
Oropharynx 40 0.5 27 1.3 14 0.2 11 0.5
Hypopharynx 47 0.6 26 1.2 8 0.1 7 0.3
Other Mouth and Pharynx 365 4.7 88 4.2 75 0.9 38 1.9
Digestive System 5,699 73.0 1,848 95.1 2,873 36.9 1,000 53.1
Esophagus 400 5.0 99 5.2 276 3.5 81 4.1
Stomach 371 4.8 169 8.8 189 2.5 121 6.7
Small Intestine 149 1.9 70 3.4 32 0.4 8 0.4
Colon and Rectum 3,148 40.5 977 50.6 1,082 13.9 398 21.5
Anus and Anal Canal 128 1.6 33 1.6 18 0.2 5 0.2
Liver and Intrahepatic Bile Duct 427 5.4 160 7.3 385 5.0 137 6.6
Gallbladder 66 0.8 26 1.4 46 0.6 17 1.0
Pancreas 800 10.2 266 14.2 780 10.0 217 11.8
Other Digestive Organs 210 2.7 48 2.4 65 0.8 16 0.9
Respiratory System 6,359 80.9 1,390 71.4 4,542 58.2 975 52.2
Larynx 326 4.0 124 6.2 96 1.2 42 2.3
Lung and Bronchus 5,894 75.1 1,240 64.0 4,427 56.8 925 49.6
Other Respiratory Organs 139 1.8 26 1.2 19 0.3 8 0.4
Bones and Joints 61 0.9 19 0.9 42 0.6 1 0.0
Soft Tissue including Heart 248 3.4 63 3.0 85 1.1 24 1.3
Malignant Melanoma of the Skin 2,051 27.3 22 1.2 282 3.7 9 0.5
Breast 6,323 82.0 1,719 83.6 943 12.1 314 16.3
Invasive Breast 5,093 66.1 1,382 67.2
In Situ Breast 1,230 15.9 337 16.5
Female Genital System 1,896 46.0 516 45.1 593 13.5 191 17.2
Cervix Uteri, Invasive 221 6.1 119 9.9 72 1.8 39 3.3
Uterus (Corpus, NOS) 964 22.8 254 22.5 133 2.9 74 6.7
Ovary 525 12.7 102 9.0 346 7.8 65 5.9
Other Female Genital Organs 186 4.5 41 3.7 42 1.0 13 1.2
Rates are per 100,000 persons and are age-adjusted to the 2000 U.S. Census.
Cancers of the urinary bladder and female breast include in situ cases.
Brain and other central nervous system cancers exclude benign cases.
Rates are calculated using the bridged-race population estimates obtained from the National Center for Health Statistics available online at
www.cdc.gov/nchs/nvss/bridged_race/data_documentation.htm#vintage2009.
* Incidence counts less than five are suppressed.
Rates based on counts less than 16 are unstable and should be used with caution.
Incidence Mortality
Whites Minorities Whites Minorities
2008 Cancer Incidence and Mortality in North Carolina
N.C. Central Cancer Registry • State Center for Health Statistics • N.C. Division of Public Health
29
Table 9 (continued): 2008 Cancer Incidence and Mortality by Race
Cases Rate Cases Rate Deaths Rate Deaths Rate
Male Genital System 5,227 142.4 1,822 218.4 607 20.6 308 55.3
Prostate 5,000 135.6 1,790 215.1 594 20.2 301 54.2
Testis 195 5.7 20 1.9 9 0.3 2 0.2
Penis 28 0.9 10 1.2 3 0.1 5 0.8
Other Male Genital Organs * * * * 1 0.0 0 0.0
Urinary System 3,053 39.4 563 28.8 677 8.8 122 6.6
Urinary Bladder 1,755 22.7 204 11.4 326 4.3 47 2.6
Kidney and Renal Pelvis 1,241 16.0 344 16.5 329 4.2 70 3.7
Ureter 44 0.6 9 0.6 7 0.1 4 0.2
Other Urinary Organs 13 0.2 6 0.3 15 0.2 1 0.1
Eye and Orbit 79 1.0 8 0.3 6 0.1 0 0.0
Brain and Other CNS 477 6.4 92 4.1 354 4.7 49 2.3
Endocrine System 956 13.2 224 10.5 56 0.8 16 0.8
Thyriod Gland 913 12.6 210 9.8 39 0.5 8 0.5
Other Endocrine and Thymus 43 0.6 14 0.7 17 0.2 8 0.3
Lymphomas 1,679 22.2 357 17.4 507 6.6 76 4.0
Hodgkin Disease 187 2.7 57 2.5 26 0.3 8 0.4
Non-Hodgkin Lymphoma 1,492 19.5 300 14.9 481 6.3 68 3.7
Multiple Myeloma 417 5.4 230 12.3 255 3.3 119 6.5
Leukemia 873 11.6 167 8.0 514 6.8 99 5.4
Acute Lymphocytic Leukemia 95 1.4 26 1.0 28 0.4 5 0.2
Chronic Lymphocytic Leukemia 293 3.8 48 2.5 108 1.4 22 1.4
Acute Myeloid Leukemia 270 3.6 54 2.7 212 2.8 35 1.8
Chronic Myeloid Leukemia 111 1.5 23 1.1 18 0.2 11 0.5
Other Leukemia 104 1.4 16 0.8 148 1.9 26 1.4
Other Cancers - Uncategorized 1,253 16.3 304 16.2 1,196 15.4 317 17.5
Rates are per 100,000 persons and are age-adjusted to the 2000 U.S. Census.
Cancers of the urinary bladder and female breast include in situ cases.
Brain and other central nervous system cancers exclude benign cases.
Rates are calculated using the bridged-race population estimates obtained from the National Center for Health Statistics available online at
www.cdc.gov/nchs/nvss/bridged_race/data_documentation.htm#vintage2009.
* Incidence counts less than five are suppressed.
Rates based on counts less than 16 are unstable and should be used with caution.
Incidence Mortality
Whites Minorities Whites Minorities
2008 Cancer Incidence and Mortality in North Carolina
N.C. Central Cancer Registry • State Center for Health Statistics • N.C. Division of Public Health
30
Table 10: 2008 Top Ten Cancer Incidence and Mortality Sites by Race
Cases Rate Deaths Rate
Female Breast 6,264 152.2 Lung and Bronchus 4,427 56.8
Lung and Bronchus 5,894 75.1 Colon and Rectum 1,085 13.9
Prostate 5,000 135.6 Female Breast 938 12.1
Colon and Rectum 3,148 40.5 Pancreas 780 10.0
Melanoma (Skin) 2,051 27.3 Prostate 594 7.8
Urinary Bladder 1,755 22.7 Leukemia 514 6.8
Non-Hodgkin Lymphoma 1,492 19.5 Non-Hodgkin Lymphoma 481 6.3
Kidney 1,241 16.0 Liver 385 5.0
Oral Cavity 980 12.5 Brain and Other CNS 354 4.7
Uterus (Corpus, NOS) 964 22.8 Ovary 346 4.4
Cases Rate Deaths Rate
Prostate 1,790 215.1 Lung and Bronchus 925 49.6
Female Breast 1,692 144.0 Colon and Rectum 398 21.5
Lung and Bronchus 1,240 64.0 Prostate 301 18.6
Colon and Rectum 977 50.6 Female Breast 312 16.2
Kidney 344 16.5 Pancreas 218 11.9
Non-Hodgkin Lymphoma 300 14.9 Stomach 121 6.7
Pancreas 266 14.2 Liver 137 6.6
Uterus (Corpus, NOS) 254 22.5 Multiple Myeloma 119 6.5
Oral Cavity 246 11.5 Leukemia 100 5.4
Multiple Myeloma 230 12.3 Esophagus 81 4.1
Rates are per 100,000 persons and are age-adjusted to the 2000 U.S. Census.
Cancers of the urinary bladder and female breast include in situ cases.
Rates are calculated using the bridged-race population estimates obtained from the National Center for Health Statistics available online at
www.cdc.gov/nchs/nvss/bridged_race/data_documentation.htm#vintage2009.
Incidence
Brain and other central nervous system cancers exclude benign cases.
Incidence
Mortality
Mortality
Whites
Minorities
2008 Cancer Incidence and Mortality in North Carolina
N.C. Central Cancer Registry • State Center for Health Statistics • N.C. Division of Public Health
31
Table 11: 2008 Top Ten Cancer Incidence and Mortality by Race and Gender
Cases Rate Deaths Rate
Prostate 5,000 135.6 Lung and Bronchus 2,512 74.7
Lung and Bronchus 3,285 95.2 Prostate 594 20.2
Colon and Rectum 1,685 48.8 Colon and Rectum 539 16.3
Bladder 1,336 40.6 Pancreas 357 10.5
Melanoma (Skin) 1,202 34.8 Leukemia 306 9.5
Non-Hodgkin Lymphoma 837 24.5 Liver 258 7.4
Kidney 821 23.2 Non-Hodgkin Lymphoma 245 7.5
Oral Cavity 655 17.8 Urinary Bladder 228 7.6
Leukemia 513 15.5 Esophagus 226 6.6
Pancreas 392 11.2 Kidney 222 6.8
Cases Rate Deaths Rate
Female Breast 6,264 152.2 Lung and Bronchus 1,915 43.9
Lung and Bronchus 2,609 60.3 Female Breast 938 21.7
Colon and Rectum 1,463 33.9 Colon and Rectum 546 12.2
Uterus (Corpus, NOS) 964 22.8 Pancreas 423 9.3
Melanoma (Skin) 849 22.1 Ovary 346 7.8
Endocrine 678 18.5 Non-Hodgkin Lymphoma 236 5.3
Non-Hodgkin Lymphoma 655 15.4 Leukemia 208 4.8
Ovary 525 12.7 Brain and Other CNS 140 3.4
Kidney 420 10.0 Uterus (Corpus, NOS) 133 2.9
Urinary Bladder 419 9.5 Liver 127 2.9
White Males
Incidence Mortality
White Females
Incidence Mortality
Rates are per 100,000 persons and are age-adjusted to the 2000 U.S. Census.
Cancers of the urinary bladder and female breast include in situ cases.
Brain and other central nervous system cancer excludes benign cases.
Rates are calculated using the bridged-race population estimates obtained from the National Center for Health Statistics available online at
www.cdc.gov/nchs/nvss/bridged_race/data_documentation.htm#vintage2009.
2008 Cancer Incidence and Mortality in North Carolina
N.C. Central Cancer Registry • State Center for Health Statistics • N.C. Division of Public Health
32
Table 11 (continued): 2008 Top Ten Cancer Incidence and Mortality by Race and Gender
Cases Rate Deaths Rate
Prostate 1,790 215.1 Lung and Bronchus 613 82.1
Lung and Bronchus 762 95.7 Prostate 301 54.2
Colon and Rectum 478 59.0 Colon and Rectum 198 26.3
Kidney 209 23.2 Liver 91 9.9
Oral Cavity 190 20.6 Pancreas 89 11.6
Non-Hodgkin Lymphoma 150 17.4 Esophagus 62 7.3
Urinary Bladder 129 18.5 Stomach 62 8.0
Liver 111 11.2 Multiple Myeloma 62 8.7
Multiple Myeloma 110 15.0 Oral Cavity 58 6.5
Pancreas 107 13.8 Leukemia 58 8.2
Cases Rate Deaths Rate
Female Breast 1,692 144.0 Lung and Bronchus 312 28.6
Colon and Rectum 498 44.2 Female Breast 312 27.2
Lung and Bronchus 477 42.6 Colon and Rectum 200 18.0
Uterus (Corpus, NOS) 254 22.5 Pancreas 129 11.8
Endocrine 177 14.8 Uterus (Corpus, NOS) 74 6.7
Pancreas 158 14.2 Ovary 65 5.9
Non-Hodgkin Lymphoma 150 13.1 Stomach 59 5.6
Kidney 135 11.4 Multiple Myeloma 57 5.3
Multiple Myeloma 120 10.7 Liver 46 4.1
Cervix Uteri 119 9.9 Leukemia 42 3.8
Minority Males
Incidence Mortality
Minority Females
Brain and other central nervous system cancer excludes benign cases.
Rates are calculated using the bridged-race population estimates obtained from the National Center for Health Statistics available online at
www.cdc.gov/nchs/nvss/bridged_race/data_documentation.htm#vintage2009.
Incidence Mortality
Rates are per 100,000 persons and are age-adjusted to the 2000 U.S. Census.
Cancers of the urinary bladder and female breast include in situ cases.
2008 Cancer Incidence and Mortality in North Carolina
N.C. Central Cancer Registry • State Center for Health Statistics • N.C. Division of Public Health
33
Table 12: 2004 – 2008 Top Five Cancer Incidence and Mortality Sites
by Age Group, Race and Gender
Cases Rate Deaths Rate
Leukemia 198 4.5 Leukemia 27 0.6
Brain and Other CNS 155 3.5 Brain and Other CNS 23 0.5
Non-Hodgkin Lymphoma 66 1.5 Bone 15 0.3
Bone 51 1.2 Soft Tissue 8 0.2
Testes 49 1.1 Endocrine 6 0.1
Cases Rate Deaths Rate
Testes 712 12.1 Lung and Bronchus 153 2.6
Melanoma (Skin) 692 11.7 Brain and Other CNS 109 1.8
Colon and Rectum 438 7.4 Colon and Rectum 98 1.7
Non-Hodgkin Lymphoma 363 6.2 Leukemia 84 1.4
Kidney 293 5.0 Melanoma (Skin) 65 1.1
Cases Rate Deaths Rate
Prostate 9,810 232.5 Lung and Bronchus 3,630 86.0
Lung and Bronchus 5,200 123.2 Colon and Rectum 869 20.6
Colon and Rectum 3,366 79.8 Pancreas 553 13.1
Melanoma (Skin) 1,938 45.9 Liver 473 11.2
Urinary Bladder 1,702 40.3 Esophagus 454 10.8
Cases Rate Deaths Rate
Prostate 14,013 741.1 Lung and Bronchus 8,720 461.1
Lung and Bronchus 10,701 565.9 Prostate 2,588 136.9
Colon and Rectum 4,936 261.0 Colon and Rectum 1,933 102.2
Urinary Bladder 4,444 235.0 Pancreas 1,271 67.2
Melanoma (Skin) 2,397 126.8 Leukemia 1,099 58.1
Rates based on counts less than 16 are unstable and should be used with caution.
Incidence Mortality
Ages 0 to 19
White Males
Ages 20 to 44
Ages 45 to 64
Ages 65 and above
Rates are per 100,000 persons.
Cancers of the urinary bladder and female breast include in situ cases.
Brain and other central nervous system cancer excludes benign cases.
Rates are calculated using the bridged-race population estimates obtained from the National Center for Health Statistics available online at
www.cdc.gov/nchs/nvss/bridged_race/data_documentation.htm#vintage2009.
2008 Cancer Incidence and Mortality in North Carolina
N.C. Central Cancer Registry • State Center for Health Statistics • N.C. Division of Public Health
34
Table 12 (continued): 2004 – 2008 Top Five Cancer Incidence and Mortality Sites
by Age Group, Race and Gender
Cases Rate Deaths Rate
Leukemia 164 4.0 Brain and Other CNS 26 0.6
Brain and Other CNS 142 3.4 Leukemia 21 0.5
Endocrine 85 2.1 Bone 13 0.3
Hodgkin Disease 47 1.1 Endocrine 5 0.1
Soft Tissue 42 1.0 Soft Tissue 4 0.1
Cases Rate Deaths Rate
Female Breast 3,304 59.0 Female Breast 262 4.7
Endocrine 1,166 20.8 Lung and Bronchus 140 2.5
Melanoma (Skin) 1,096 19.6 Colon and Rectum 92 1.6
Cervix Uteri 544 9.7 Cervix Uteri 66 1.2
Colon and Rectum 393 7.0 Melanoma (Skin) 55 1.0
Cases Rate Deaths Rate
Female Breast 13,812 313.6 Lung and Bronchus 2,499 56.7
Lung and Bronchus 3,978 90.3 Female Breast 1,617 36.7
Colon and Rectum 2,351 53.4 Colon and Rectum 581 13.2
Uterus (Corpus, NOS) 2,211 50.2 Ovary 478 10.9
Melanoma (Skin) 1,445 32.8 Pancreas 392 8.9
Cases Rate Deaths Rate
Female Breast 12,833 490.7 Lung and Bronchus 6,466 247.2
Lung and Bronchus 8,265 316.0 Female Breast 2,710 103.6
Colon and Rectum 4,997 191.1 Colon and Rectum 2,085 79.7
Non-Hodgkin Lymphoma 1,996 76.3 Pancreas 1,464 56.0
Uterus (Corpus, NOS) 1,842 70.4 Ovary 1,222 46.7
White Females
Ages 0 to 19
Ages 20 to 44
Ages 45 to 64
Rates are calculated using the bridged-race population estimates obtained from the National Center for Health Statistics available online at
www.cdc.gov/nchs/nvss/bridged_race/data_documentation.htm#vintage2009.
Rates based on counts less than 16 are unstable and should be used with caution.
Ages 65 and above
Rates are per 100,000 persons.
Cancers of the urinary bladder and female breast include in situ cases.
Brain and other central nervous system cancer excludes benign cases.
Incidence Mortality
2008 Cancer Incidence and Mortality in North Carolina
N.C. Central Cancer Registry • State Center for Health Statistics • N.C. Division of Public Health
35
Table 12 (continued): 2004 – 2008 Top Five Cancer Incidence and Mortality Sites
by Age Group, Race and Gender
Cases Rate Deaths Rate
Leukemia 63 3.4 Leukemia 17 0.9
Brain and Other CNS 49 2.7 Brain and Other CNS 9 0.5
Non-Hodgkin Lymphoma 31 1.7 Soft Tissue 5 0.3
Hodgkin Disease 21 1.1 Endocrine 3 0.2
Soft Tissue 18 1.0 Non-Hodgkin Lymphoma 3 0.2
Cases Rate Deaths Rate
Colon and Rectum 172 8.6 Lung and Bronchus 60 3.0
Non-Hodgkin Lymphoma 152 7.6 Colon and Rectum 47 2.3
Prostate 107 5.3 Leukemia 29 1.4
Kidney 106 5.3 Non-Hodgkin Lymphoma 22 1.1
Testes 105 5.2 Oral Cavity 21 1.0
Cases Rate Deaths Rate
Prostate 4,379 385.5 Lung and Bronchus 1,309 115.2
Lung and Bronchus 1,811 159.4 Colon and Rectum 358 31.5
Colon and Rectum 1,103 97.1 Liver 239 21.0
Oral Cavity 582 51.2 Pancreas 225 19.8
Kidney 565 49.7 Prostate 213 18.8
Cases Rate Deaths Rate
Prostate 4,251 1186.7 Lung and Bronchus 1,662 463.9
Lung and Bronchus 1,906 532.1 Prostate 1,242 346.7
Colon and Rectum 1,032 288.1 Colon and Rectum 504 140.7
Urinary Bladder 392 109.4 Pancreas 281 78.4
Kidney 309 86.3 Stomach 191 53.3
Incidence Mortality
Ages 45 to 64
Ages 0 to 19
Ages 20 to 44
Minority Males
Rates are calculated using the bridged-race population estimates obtained from the National Center for Health Statistics available online at
www.cdc.gov/nchs/nvss/bridged_race/data_documentation.htm#vintage2009.
Ages 65 and above
Rates are per 100,000 persons.
Cancers of the urinary bladder and female breast include in situ cases.
Brain and other central nervous system cancer excludes benign cases.
Rates based on counts less than 16 are unstable and should be used with caution.
2008 Cancer Incidence and Mortality in North Carolina
N.C. Central Cancer Registry • State Center for Health Statistics • N.C. Division of Public Health
36
Table 12 (continued): 2004 – 2008 Top Five Cancer Incidence and Mortality Sites
by Age Group, Race and Gender
Cases Rate Deaths Rate
Leukemia 47 2.6 Leukemia 15 0.8
Brain and Other CNS 38 2.1 Brain and Other CNS 10 0.6
Endocrine 22 1.2 Soft Tissue 3 0.2
Kidney 20 1.1 Liver 2 0.1
Bone 17 1.0 Bone 2 0.1
Cases Rate Deaths Rate
Female Breast 1,298 59.0 Female Breast 214 9.7
Endocrine 296 13.5 Colon and Rectum 58 2.6
Colon and Rectum 194 8.8 Lung and Bronchus 46 2.1
Cervix Uteri 185 8.4 Cervix Uteri 45 2.0
Non-Hodgkin Lymphoma 153 7.0 Leukemia 27 1.2
Cases Rate Deaths Rate
Female Breast 4,073 299.4 Female Breast 745 54.8
Colon and Rectum 1,002 73.7 Lung and Bronchus 644 47.3
Lung and Bronchus 976 71.7 Colon and Rectum 293 21.5
Uterus (Corpus, NOS) 498 36.6 Pancreas 169 12.4
Endocrine 305 22.4 Ovary 120 8.8
Cases Rate Deaths Rate
Female Breast 2,622 444.0 Lung and Bronchus 984 166.6
Colon and Rectum 1,289 218.3 Female Breast 699 118.4
Lung and Bronchus 1,217 206.1 Colon and Rectum 618 104.6
Uterus (Corpus, NOS) 534 90.4 Pancreas 467 79.1
Pancreas 470 79.6 Uterus (Corpus, NOS) 254 43.0
Minority Females
Incidence Mortality
Ages 0 to 19
Ages 20 to 44
Brain and other central nervous system cancer excludes benign cases.
Rates are calculated using the bridged-race population estimates obtained from the National Center for Health Statistics available online at
www.cdc.gov/nchs/nvss/bridged_race/data_documentation.htm#vintage2009.
Ages 45 to 64
Ages 65 and above
Rates are per 100,000 persons.
Cancers of the urinary bladder and female breast include in situ cases.
Rates based on counts less than 16 are unstable and should be used with caution.
2008 Cancer Incidence and Mortality in North Carolina
N.C. Central Cancer Registry • State Center for Health Statistics • N.C. Division of Public Health
37
Table 13: 2008 Cancer Incidence and Mortality by Race and Ethnicity
Cases Rate Deaths Rate
Female Breast 6,126 153.4 Lung and Bronchus 4,394 57.5
Lung and Bronchus 5,850 76.2 Colon and Rectum 1,077 14.2
Prostate 4,932 137.1 Female Breast 924 21.9
Colon and Rectum 3,092 40.9 Pancreas 773 10.1
Melanoma (Skin) 2,032 28.3 Prostate 587 20.3
Urinary Bladder 1,747 23.0 Leukemia 500 6.7
Non-Hodgkin Lymphoma 1,451 19.6 Non-Hodgkin Lymphoma 473 6.3
Kidney 1,205 16.1 Liver 371 4.9
Oral Cavity 962 12.7 Brain and Other CNS 344 4.7
Uterus (Corpus, NOS) 945 22.9 Ovary 341 7.8
Cases Rate Deaths Rate
Prostate 1,687 231.7 Lung and Bronchus 867 52.4
Female Breast 1,549 150.5 Colon and Rectum 382 23.3
Lung and Bronchus 1,155 67.6 Female Breast 294 29.0
Colon and Rectum 905 53.2 Prostate 286 58.6
Kidney 320 17.6 Pancreas 209 12.8
Non-Hodgkin Lymphoma 265 15.1 Liver 117 6.4
Pancreas 255 15.4 Multiple Myeloma 115 7.1
Uterus (Corpus, NOS) 236 23.8 Stomach 109 6.8
Oral Cavity 220 11.9 Leukemia 90 5.6
Multiple Myeloma 216 13.1 Esophagus 80 4.6
Rates based on counts less than 16 are unstable and should be used with caution.
Non-Hispanic Whites
Incidence Mortality
Non-Hispanic Blacks
Incidence Mortality
Rates are per 100,000 persons and are age-adjusted to the 2000 U.S. Census.
Cancers of the urinary bladder and female breast include in situ cases.
Brain and other central nervous system cancer excludes benign cases.
Rates are calculated using the bridged-race population estimates obtained from the National Center for Health Statistics available online at
www.cdc.gov/nchs/nvss/bridged_race/data_documentation.htm#vintage2009.
Hispanic ethnicity is independent of race. Hispanic ethnicity is determined by self-report and the National Hispanic Identification
Algorithm available online at www.naaccr.org/LinkClick.aspx?fileticket=iTvgbzLrx8I%3d&tabid=118&mid=458.
Approximately 17 percent of patients of American Indian race are reported as a different race. Therefore, cancer incidence for American
Indians is assumed to be underestimated (Yankaskas BC, Knight K, Fleg A, Rao, C. Misclassification of American Indian Race in State
Cancer Data among Non-federally Recognized Indians in North Carolina. Journal of Registry Management. 2009;36(1):7-11.).
2008 Cancer Incidence and Mortality in North Carolina
N.C. Central Cancer Registry • State Center for Health Statistics • N.C. Division of Public Health
38
Table 13 (continued): 2008 Cancer Incidence and Mortality by Race and Ethnicity
Cases Rate Deaths Rate
Female Breast 114 85.1 Lung and Bronchus 58 29.2
Prostate 94 102.9 Liver 20 7.9
Lung and Bronchus 78 35.8 Female Breast 17 13.2
Colon and Rectum 63 30.2 Colon and Rectum 15 7.9
Endocrine 42 15.1 Prostate 13 19.7
Non-Hodgkin Lymphoma 33 14.9 Stomach 11 6.6
Liver 27 11.3 Pancreas 9 5.6
Oral Cavity 21 7.7 Brain and Other CNS 9 3.8
Urinary Bladder 21 10.8 Leukemia 8 3.3
Kidney 19 7.6 Ovary 7 5.6
Oral Cavity 7 3.5
Cases Rate Deaths Rate
Female Breast 169 125.3 Lung and Bronchus 33 18.2
Prostate 81 93.9 Leukemia 16 5.6
Colon and Rectum 67 30.4 Female Breast 15 11.0
Lung and Bronchus 51 27.6 Liver 14 7.0
Leukemia 49 9.9 Stomach 10 4.7
Non-Hodgkin Lymphoma 43 18.0 Brain and Other CNS 10 3.0
Endocrine 42 8.6 Colon and Rectum 9 3.4
Kidney 41 17.3 Prostate 9 12.7
Cervix Uteri 27 14.1 Non-Hodgkin Lymphoma 9 3.2
Stomach 25 9.2 Pancreas 7 3.2
Rates based on counts less than 16 are unstable and should be used with caution.
Hispanic ethnicity is independent of race. Hispanic ethnicity is determined by self-report and the National Hispanic Identification
Algorithm available online at www.naaccr.org/LinkClick.aspx?fileticket=iTvgbzLrx8I%3d&tabid=118&mid=458.
Approximately 17 percent of patients of American Indian race are reported as a different race. Therefore, cancer incidence for American
Indians is assumed to be underestimated (Yankaskas BC, Knight K, Fleg A, Rao, C. Misclassification of American Indian Race in State
Cancer Data among Non-federally Recognized Indians in North Carolina. Journal of Registry Management. 2009;36(1):7-11.).
Mortality
Hispanics
Brain and other central nervous system cancer excludes benign cases.
Rates are calculated using the bridged-race population estimates obtained from the National Center for Health Statistics available online at
www.cdc.gov/nchs/nvss/bridged_race/data_documentation.htm#vintage2009.
Incidence Mortality
Rates are per 100,000 persons and are age-adjusted to the 2000 U.S. Census.
Cancers of the urinary bladder and female breast include in situ cases.
Non-Hispanic Other Races
Incidence
2008 Cancer Incidence and Mortality in North Carolina
N.C. Central Cancer Registry • State Center for Health Statistics • N.C. Division of Public Health
39
Table 14: 2008 Top Ten Cancer Incidence and Mortality Sites by Race and Ethnicity
Cases Rate Deaths Rate
Female Breast 6,126 153.4 Lung and Bronchus 4,394 57.5
Lung and Bronchus 5,850 76.2 Colon and Rectum 1,077 14.2
Prostate 4,932 137.1 Female Breast 924 21.9
Colon and Rectum 3,092 40.9 Pancreas 773 10.1
Melanoma (Skin) 2,032 28.3 Prostate 587 20.3
Urinary Bladder 1,747 23.0 Leukemia 500 6.7
Non-Hodgkin Lymphoma 1,451 19.6 Non-Hodgkin Lymphoma 473 6.3
Kidney 1,205 16.1 Liver 371 4.9
Oral Cavity 962 12.7 Brain and Other CNS 344 4.7
Uterus (Corpus, NOS) 945 22.9 Ovary 341 7.8
Cases Rate Deaths Rate
Prostate 1,687 231.7 Lung and Bronchus 867 52.4
Female Breast 1,549 150.5 Colon and Rectum 382 23.3
Lung and Bronchus 1,155 67.6 Female Breast 294 29.0
Colon and Rectum 905 53.2 Prostate 286 58.6
Kidney 320 17.6 Pancreas 209 12.8
Non-Hodgkin Lymphoma 265 15.1 Liver 117 6.4
Pancreas 255 15.4 Multiple Myeloma 115 7.1
Uterus (Corpus, NOS) 236 23.8 Stomach 109 6.8
Oral Cavity 220 11.9 Leukemia 90 5.6
Multiple Myeloma 216 13.1 Esophagus 80 4.6
Cancers of the urinary bladder and female breast include in situ cases.
Brain and other central nervous system cancer excludes benign cases.
Rates are calculated using the bridged-race population estimates obtained from the National Center for Health Statistics available online at
www.cdc.gov/nchs/nvss/bridged_race/data_documentation.htm#vintage2009.
Hispanic ethnicity is independent of race. Hispanic ethnicity is determined by self-report and the National Hispanic Identification
Algorithm available online at www.naaccr.org/LinkClick.aspx?fileticket=iTvgbzLrx8I%3d&tabid=118&mid=458.
Approximately 17 percent of patients of American Indian race are reported as a different race. Therefore, cancer incidence for American
Indians is assumed to be underestimated (Yankaskas BC, Knight K, Fleg A, Rao, C. Misclassification of American Indian Race in State
Cancer Data among Non-federally Recognized Indians in North Carolina. Journal of Registry Management . 2009;36(1):7-11.).
Non-Hispanic Blacks
Incidence Mortality
Rates are per 100,000 persons and are age-adjusted to the 2000 U.S. Census.
Non-Hispanic Whites
Incidence Mortality
Rates based on counts less than 16 are unstable and should be used with caution.
2008 Cancer Incidence and Mortality in North Carolina
N.C. Central Cancer Registry • State Center for Health Statistics • N.C. Division of Public Health
40
Table 14 (continued): 2008 Top Ten Cancer Incidence and Mortality Sites by Race and Ethnicity
Cases Rate Deaths Rate
Female Breast 114 85.1 Lung and Bronchus 58 29.2
Prostate 94 102.9 Liver 20 7.9
Lung and Bronchus 78 35.8 Female Breast 17 13.2
Colon and Rectum 63 30.2 Colon and Rectum 15 7.9
Endocrine 42 15.1 Prostate 13 19.7
Non-Hodgkin Lymphoma 33 14.9 Stomach 11 6.6
Liver 27 11.3 Pancreas 9 5.6
Oral Cavity 21 7.7 Brain and Other CNS 9 3.8
Urinary Bladder 21 10.8 Leukemia 8 3.3
Kidney 19 7.6 Ovary 7 5.6
Oral Cavity 7 3.5
Cases Rate Deaths Rate
Female Breast 169 125.3 Lung and Bronchus 33 18.2
Prostate 81 93.9 Leukemia 16 5.6
Colon and Rectum 67 30.4 Female Breast 15 11.0
Lung and Bronchus 51 27.6 Liver 14 7.0
Leukemia 49 9.9 Stomach 10 4.7
Non-Hodgkin Lymphoma 43 18.0 Brain and Other CNS 10 3.0
Endocrine 42 8.6 Colon and Rectum 9 3.4
Kidney 41 17.3 Prostate 9 12.7
Cervix Uteri 27 14.1 Non-Hodgkin Lymphoma 9 3.2
Stomach 25 9.2 Pancreas 7 3.2
Rates are per 100,000 persons and are age-adjusted to the 2000 U.S. Census.
Cancers of the urinary bladder and female breast include in situ cases.
Non-Hispanic Other Races
Incidence
Rates based on counts less than 16 are unstable and should be used with caution.
Hispanic ethnicity is independent of race. Hispanic ethnicity is determined by self-report and the National Hispanic Identification
Algorithm available online at www.naaccr.org/LinkClick.aspx?fileticket=iTvgbzLrx8I%3d&tabid=118&mid=458.
Approximately 17 percent of patients of American Indian race are reported as a different race. Therefore, cancer incidence for American
Indians is assumed to be underestimated (Yankaskas BC, Knight K, Fleg A, Rao, C. Misclassification of American Indian Race in State
Cancer Data among Non-federally Recognized Indians in North Carolina. Journal of Registry Management . 2009;36(1):7-11.).
Mortality
Hispanics
Brain and other central nervous system cancer excludes benign cases.
Rates are calculated using the bridged-race population estimates obtained from the National Center for Health Statistics available online at
www.cdc.gov/nchs/nvss/bridged_race/data_documentation.htm#vintage2009.
Incidence Mortality
2008 Cancer Incidence and Mortality in North Carolina
N.C. Central Cancer Registry • State Center for Health Statistics • N.C. Division of Public Health
41
Table 15: 2008 Cancer Incidence and Mortality Median Age
All Others
All Cancers 65 65 64 66 62 60 51
Oral Cavity 61 60 64 61.5 59 55 57
Esophagus 67 66 71 66.5 67 72 69
Stomach 68 66 70 69 65 58 49
Colon and Rectum 67 66 69 69 63 62 61
Liver 61 60 68 64 59 59 57
Gallbladder 70 70 70 72 68 * *
Pancreas 69 67 73 70 66 67 57
Larynx 63.5 64 61 64 62 * 53
Lung and Bronchus 69 68 69 69 65 64 62
Bone 42 41 42.5 44 49.5 * 18
Soft Tissue 53 55 52 56 48 * 37
Melanoma (Skin) 60 64 54 60 63 58 45
Female Breast 61 . 61 62 57 56.5 49
Cervix Uteri 49 . 49 50 51 67 42
Uterus (Corpus, NOS) 62 . 62 62 65 52 54
Ovary 65 . 65 66 63 56 58
Prostate 65 65 . 66 64 65.5 66
Testes 35 35 . 37 37 . 26
Urinary Bladder 72 72 74 73 69 69 71.5
Kidney 63 62 64 65 58 55 56
Endocrine 51 56.5 49 52 50 49 37.5
Multiple Myeloma 69 68 70 70 68 64.5 61.5
Leukemia 66 65 66 68 57 56 29
Brain and Other CNS 58 57 59 59 55 43 41.5
Hodgkin Disease 43 44 42 45 37 * 35
Non-Hodgkin Lymphoma 66 65 68 67 57 57 55
Other Cancers 68 67 69 70 62 66 49.5
*Median ages based on incidence counts less than five are suppressed.
Incidence
Non-Hispanic
Cancers of the urinary bladder and female breast include in situ cases.
Brain and other central nervous system cancer excludes benign cases.
Males Females Whites Blacks Hispanics
2008 Cancer Incidence and Mortality in North Carolina
N.C. Central Cancer Registry • State Center for Health Statistics • N.C. Division of Public Health
42
Table 15 (continued): 2008 Cancer Incidence and Mortality Median Age
All Males Females Whites Blacks Others Hispanics
All Cancers 71 70 72 72 67 66 59
Oral Cavity 65 64 69 68 61 46 .
Esophagus 67 66 71 69 64 48 69
Stomach 71 70 75 74 68 73 61.5
Colon and Rectum 71 69 74 73 66 62 50
Liver 66 63 71 70 60 61.5 61.5
Gallbladder 73 74 73 74 71 73 70
Pancreas 72 69 74 73 68 74 58
Larynx 69.5 69.5 68.5 70.5 69 67 .
Lung and Bronchus 70 70 71 71 67 67 66
Bone 42 37 65 47 57 . 31
Soft Tissue 70 68 70 70 67 64 37
Melanoma (Skin) 69 70 68.5 69 63 67.5 .
Female Breast 67 . 67 68 63 59 51
Cervix Uteri 60 . 60 57.5 60 60 53.5
Uterus (Corpus, NOS) 69 . 69 70 69 65 57
Ovary 71 . 71 72 67 62 65.5
Prostate 79 79 . 80 77 71 69
Testes 42 42 . 44 39 . 33
Urinary Bladder 77 77 78 78 69.5 78 79
Kidney 70 69 76 71 65 70.5 81
Endocrine 71.5 59 76 75 50 87 .
Multiple Myeloma 72 71 74 75 68 69 75
Leukemia 73 71 75.5 74 69 59 36
Brain and Other CNS 64 63 66 65.5 52 46 43
Hodgkin Disease 64 57.5 68 66 53 . .
Non-Hodgkin Lymphoma 73 71 76 74 66 74.5 58
Other Cancers 73 71 75 74 68 75 59
Mortality
*Median ages based on incidence counts less than five are suppressed.
Non-Hispanic
Cancers of the urinary bladder and female breast include in situ cases.
Brain and other central nervous system cancer excludes benign cases.
2008 Cancer Incidence and Mortality in North Carolina
N.C. Central Cancer Registry • State Center for Health Statistics • N.C. Division of Public Health
43
Figure 1a: 1997 – 2008 Colorectal Cancer Incidence Trends by Gender and Race
0
10
20
30
40
50
60
70
80
1997-
1999
1998-
2000
1999-
2001
2000-
2002
2001-
2003
2002-
2004
2003-
2005
2004-
2006
2005-
2007
2006-
2008
Years
Rate per 100,000 Persons
White Males White Females Minority Males Minority Females
Figure 1b: 1997 – 2008 Colorectal Cancer Mortality Trends by Gender and Race
0
10
20
30
40
50
60
70
80
1997-
1999
1998-
2000
1999-
2001
2000-
2002
2001-
2003
2002-
2004
2003-
2005
2004-
2006
2005-
2007
2006-
2008
Years
Rate per 100,000 Persons
White Males White Females Minority Males Minority Females
2008 Cancer Incidence and Mortality in North Carolina
N.C. Central Cancer Registry • State Center for Health Statistics • N.C. Division of Public Health
44
Figure 2a: 1997 – 2008 Lung and Bronchus Cancer Incidence Trends by Gender and Race
0
20
40
60
80
100
120
1997-
1999
1998-
2000
1999-
2001
2000-
2002
2001-
2003
2002-
2004
2003-
2005
2004-
2006
2005-
2007
2006-
2008
Years
Rate per 100,000 Persons
White Males White Females Minority Males Minority Females
Figure 2b: 1997 – 2008 Lung and Bronchus Cancer Mortality Trends by Gender and Race
0
20
40
60
80
100
120
1997-
1999
1998-
2000
1999-
2001
2000-
2002
2001-
2003
2002-
2004
2003-
2005
2004-
2006
2005-
2007
2006-
2008
Years
Rate per 100,000 Persons White Males White Females Minority Males Minority Females
2008 Cancer Incidence and Mortality in North Carolina
N.C. Central Cancer Registry • State Center for Health Statistics • N.C. Division of Public Health
45
Figure 3a: 1997 – 2008 Female Breast Cancer Incidence Trends by Race
0
20
40
60
80
100
120
140
160
180
1997-
1999
1998-
2000
1999-
2001
2000-
2002
2001-
2003
2002-
2004
2003-
2005
2004-
2006
2005-
2007
2006-
2008
Years
Rate per 100,000 Persons
White Females Minority Females
Figure 3b: 1997 – 2008 Female Breast Cancer Mortality Trends by Race
0
5
10
15
20
25
30
35
40
1997-
1999
1998-
2000
1999-
2001
2000-
2002
2001-
2003
2002-
2004
2003-
2005
2004-
2006
2005-
2007
2006-
2008
Years
Rate per 100,000 Persons White Females Minority Females
2008 Cancer Incidence and Mortality in North Carolina
N.C. Central Cancer Registry • State Center for Health Statistics • N.C. Division of Public Health
46
Figure 4a: 1997 – 2008 Prostate Cancer Incidence Trends by Race
0
50
100
150
200
250
300
1997-
1999
1998-
2000
1999-
2001
2000-
2002
2001-
2003
2002-
2004
2003-
2005
2004-
2006
2005-
2007
2006-
2008
Years
Rate per 100,000 Persons
White Males Minority Males
Figure 4b: 1997 – 2008 Prostate Cancer Mortality Trends by Race
0
10
20
30
40
50
60
70
80
90
1997-
1999
1998-
2000
1999-
2001
2000-
2002
2001-
2003
2002-
2004
2003-
2005
2004-
2006
2005-
2007
2006-
2008
Years
Rate per 100,000 Persons White Males Minority Males
2008 Cancer Incidence and Mortality in North Carolina
N.C. Central Cancer Registry • State Center for Health Statistics • N.C. Division of Public Health
47
Figure 5: 1997 – 2008 Oral Cavity Cancer Incidence Trends by Gender and Race
0
5
10
15
20
25
1997-
1999
1998-
2000
1999-
2001
2000-
2002
2001-
2003
2002-
2004
2003-
2005
2004-
2006
2005-
2007
2006-
2008
Years
Rate per 100,000 Persons
White Males White Females Minority Males Minority Females
Figure 6: 1997 – 2008 Laryngeal Cancer Incidence Trends by Gender and Race
0
2
4
6
8
10
12
14
16
1997-
1999
1998-
2000
1999-
2001
2000-
2002
2001-
2003
2002-
2004
2003-
2005
2004-
2006
2005-
2007
2006-
2008
Years
Rate per 100,000 Persons White Males White Females Minority Males Minority Females
2008 Cancer Incidence and Mortality in North Carolina
N.C. Central Cancer Registry • State Center for Health Statistics • N.C. Division of Public Health
48
Figure 7: 1997 – 2008 Melanoma Incidence Trends by Gender and Race
0
5
10
15
20
25
30
35
1997-
1999
1998-
2000
1999-
2001
2000-
2002
2001-
2003
2002-
2004
2003-
2005
2004-
2006
2005-
2007
2006-
2008
Years
Rate per 100,000 Persons
White Males White Females Minority Males Minority Females
Figure 8: 1997 – 2008 Cervical Cancer Incidence Trends by Race
0
2
4
6
8
10
12
14
1997-
1999
1998-
2000
1999-
2001
2000-
2002
2001-
2003
2002-
2004
2003-
2005
2004-
2006
2005-
2007
2006-
2008
Years
Rate per 100,000 Persons White Females Minority Females
2008 Cancer Incidence and Mortality in North Carolina
N.C. Central Cancer Registry • State Center for Health Statistics • N.C. Division of Public Health
49
Figure 9: 1997 – 2008 Kidney Cancer Incidence Trends by Gender and Race
0
5
10
15
20
25
30
1997-
1999
1998-
2000
1999-
2001
2000-
2002
2001-
2003
2002-
2004
2003-
2005
2004-
2006
2005-
2007
2006-
2008
Years
Rate per 100,000 Persons
White Males White Females Minority Males Minority Females
Figure 10: 1997 – 2008 Endocrine Cancer Incidence Trends by Gender and Race
0
2
4
6
8
10
12
14
16
18
20
1997-
1999
1998-
2000
1999-
2001
2000-
2002
2001-
2003
2002-
2004
2003-
2005
2004-
2006
2005-
2007
2006-
2008
Years
Rate per 100,000 Persons White Males White Females Minority Males Minority Females
2008 Cancer Incidence and Mortality in North Carolina
N.C. Central Cancer Registry • State Center for Health Statistics • N.C. Division of Public Health
50
Figure 11: 1997 – 2008 Stomach Cancer Mortality Trends by Gender and Race
0
2
4
6
8
10
12
14
16
1997-
1999
1998-
2000
1999-
2001
2000-
2002
2001-
2003
2002-
2004
2003-
2005
2004-
2006
2005-
2007
2006-
2008
Years
Rate per 100,000 Persons
White Males White Females Minority Males Minority Females
Figure 12: 1997 – 2008 Liver Cancer Mortality Trends by Gender and Race
0
1
2
3
4
5
6
7
8
9
10
1997-
1999
1998-
2000
1999-
2001
2000-
2002
2001-
2003
2002-
2004
2003-
2005
2004-
2006
2005-
2007
2006-
2008
Years
Rate per 100,000 Persons White Males White Females Minority Males Minority Females
2008 Cancer Incidence and Mortality in North Carolina
N.C. Central Cancer Registry • State Center for Health Statistics • N.C. Division of Public Health
51
Figure 13: 1997 – 2008 Pancreatic Cancer Mortality Trends by Gender and Race
0
2
4
6
8
10
12
14
16
18
20
1997-
1999
1998-
2000
1999-
2001
2000-
2002
2001-
2003
2002-
2004
2003-
2005
2004-
2006
2005-
2007
2006-
2008
Years
Rate per 100,000 Persons
White Males White Females Minority Males Minority Females
Figure 14: 1997 – 2008 Cervical Cancer Mortality Trends by Race
0
1
2
3
4
5
6
7
1997-
1999
1998-
2000
1999-
2001
2000-
2002
2001-
2003
2002-
2004
2003-
2005
2004-
2006
2005-
2007
2006-
2008
Years
Rate per 100,000 Persons White Females Minority Females
2008 Cancer Incidence and Mortality in North Carolina
N.C. Central Cancer Registry • State Center for Health Statistics • N.C. Division of Public Health
52
Figure 15: 2008 Percent of Top Four Cancer Cases by Stage
2008 Cancer Incidence and Mortality in North Carolina
N.C. Central Cancer Registry • State Center for Health Statistics • N.C. Division of Public Health
53
Appendix A: 2008 Population Estimates by Race and County
Whites Blacks
American
Indian
Asian/
Pacific
Islander Total
North Carolina 6,889,047 2,034,474 120,478 203,135 9,247,134
Alamance 116,821 28,281 744 2,064 147,910
Alexander 33,697 2,351 96 442 36,586
Alleghany 10,750 200 29 46 11,025
Anson 12,576 12,237 143 233 25,189
Ashe 25,288 259 84 60 25,691
Avery 16,824 957 74 60 17,915
Beaufort 33,403 12,676 105 159 46,343
Bertie 6,995 12,335 107 29 19,466
Bladen 19,858 11,700 780 73 32,411
Brunswick 90,355 12,497 697 573 104,122
Buncombe 208,387 17,120 1,046 2,820 229,373
Burke 79,264 6,065 404 3,549 89,282
Cabarrus 139,017 25,719 747 3,076 168,559
Caldwell 74,717 4,438 209 498 79,862
Camden 7,921 1,603 32 76 9,632
Carteret 57,895 4,850 322 480 63,547
Caswell 15,091 7,986 53 59 23,189
Catawba 138,192 13,695 470 5,150 157,507
Chatham 53,175 8,575 255 1,368 63,373
Cherokee 25,500 565 416 80 26,561
Chowan 9,270 5,336 38 44 14,688
Clay 10,107 143 37 14 10,301
Cleveland 77,111 20,916 182 825 99,034
Columbus 35,470 16,785 1,847 191 54,293
Craven 71,701 23,760 491 1,449 97,401
Cumberland 176,629 119,672 5,490 8,895 310,686
Currituck 22,058 1,821 93 188 24,160
Dare 32,572 1,195 96 189 34,052
Davidson 140,224 15,190 684 1,893 157,991
Davie 37,839 2,951 101 191 41,082
Duplin 38,591 14,039 216 179 53,025
Durham 150,062 99,507 1,160 12,319 263,048
Edgecombe 22,040 30,024 156 179 52,399
Forsyth 253,929 93,545 1,456 6,210 355,140
Population estimates are from the bridged-race population estimates obtained from the National Center for Health Statistics available
online at www.cdc.gov/nchs/nvss/bridged_race/data_documentation.htm#vintage2009.
2008 Cancer Incidence and Mortality in North Carolina
N.C. Central Cancer Registry • State Center for Health Statistics • N.C. Division of Public Health
54
Appendix A (continued): 2008 Population Estimates by Race and County
Whites Blacks
American
Indian
Asian/
Pacific
Islander Total
Franklin 42,526 15,924 239 340 59,029
Gaston 171,563 31,759 750 2,761 206,833
Gates 7,449 4,164 46 87 11,746
Graham 7,264 56 617 43 7,980
Granville 36,932 19,302 506 347 57,087
Greene 12,110 8,399 106 39 20,654
Guilford 301,646 152,364 2,875 17,223 474,108
Halifax 22,828 29,911 1,954 401 55,094
Harnett 83,990 25,494 1,108 1,433 112,025
Haywood 55,442 924 330 179 56,875
Henderson 97,563 3,628 362 830 102,383
Hertford 8,421 14,528 285 123 23,357
Hoke 23,622 15,144 4,222 660 43,648
Hyde 3,261 1,950 23 26 5,260
Iredell 132,443 19,805 492 2,873 155,613
Jackson 31,413 965 4,078 333 36,789
Johnston 135,085 26,071 821 1,334 163,311
Jones 6,537 3,348 48 27 9,960
Lee 46,291 11,934 360 550 59,135
Lenoir 32,906 23,305 152 311 56,674
Lincoln 69,221 4,940 210 371 74,742
McDowell 41,370 1,858 150 534 43,912
Macon 32,130 661 108 203 33,102
Madison 19,927 310 59 74 20,370
Martin 12,881 10,406 97 103 23,487
Mecklenburg 580,966 266,491 5,354 39,645 892,456
Mitchell 15,427 127 94 43 15,691
Montgomery 21,398 5,514 177 618 27,707
Moore 72,131 12,569 696 635 86,031
Nash 57,766 35,017 523 819 94,125
New Hanover 158,247 30,996 888 2,567 192,698
Northampton 8,380 11,948 77 54 20,459
Onslow 131,751 31,653 1,509 4,320 169,233
Orange 100,629 17,946 628 7,782 126,985
Pamlico 9,442 2,842 74 72 12,430
Population estimates are from the bridged-race population estimates obtained from the National Center for Health Statistics available
online at www.cdc.gov/nchs/nvss/bridged_race/data_documentation.htm#vintage2009.
2008 Cancer Incidence and Mortality in North Carolina
N.C. Central Cancer Registry • State Center for Health Statistics • N.C. Division of Public Health
55
Appendix A (continued): 2008 Population Estimates by Race and County
Whites Blacks
American
Indian
Asian/
Pacific
Islander Total
Pasquotank 24,575 16,148 153 566 41,442
Pender 40,723 10,013 283 215 51,234
Perquimans 9,382 3,339 21 30 12,772
Person 26,529 10,630 240 102 37,501
Pitt 99,684 53,582 559 2,110 155,935
Polk 18,074 1,064 44 50 19,232
Randolph 130,103 8,615 798 1,447 140,963
Richmond 30,272 14,372 974 410 46,028
Robeson 46,519 31,222 49,801 1,154 128,696
Rockingham 73,459 17,834 334 487 92,114
Rowan 115,593 22,187 515 1,444 139,739
Rutherford 55,776 7,205 143 312 63,436
Sampson 43,517 18,210 1,235 475 63,437
Scotland 18,321 14,142 3,779 238 36,480
Stanly 51,181 7,111 152 1,241 59,685
Stokes 43,522 2,351 131 136 46,140
Surry 68,673 3,082 198 435 72,388
Swain 9,400 236 3,696 45 13,377
Transylvania 28,215 1,682 92 166 30,155
Tyrrell 2,350 1,680 9 65 4,104
Union 164,885 24,216 1,013 3,286 193,400
Vance 21,142 21,356 118 374 42,990
Wake 637,378 181,691 5,098 43,901 868,068
Warren 7,799 10,669 1,011 51 19,530
Washington 6,237 6,612 7 103 12,959
Watauga 43,876 1,002 150 393 45,421
Wayne 74,068 37,696 506 1,149 113,419
Wilkes 63,194 2,901 107 523 66,725
Wilson 46,043 30,746 243 660 77,692
Yadkin 36,097 1,423 70 111 37,701
Yancey 18,173 211 120 35 18,539
Population estimates are from the bridged-race population estimates obtained from the National Center for Health Statistics available
online at www.cdc.gov/nchs/nvss/bridged_race/data_documentation.htm#vintage2009.
2008 Cancer Incidence and Mortality in North Carolina
N.C. Central Cancer Registry • State Center for Health Statistics • N.C. Division of Public Health
56
Appendix B: 2008 Population Estimates by Age Group and County
0-19 20-44 45-64 65+ Total
North Carolina 2,522,524 3,206,862 2,359,724 1,158,024 9,247,134
Alamance 40,732 49,029 37,351 20,798 147,910
Alexander 9,100 12,105 10,332 5,049 36,586
Alleghany 2,416 3,106 3,291 2,212 11,025
Anson 6,325 8,453 6,770 3,641 25,189
Ashe 5,525 7,412 7,774 4,980 25,691
Avery 3,831 6,535 4,451 3,098 17,915
Beaufort 11,418 12,401 14,208 8,316 46,343
Bertie 5,082 5,592 5,648 3,144 19,466
Bladen 8,650 9,563 9,470 4,728 32,411
Brunswick 21,551 28,603 33,368 20,600 104,122
Buncombe 53,236 76,355 63,727 36,055 229,373
Burke 22,938 27,865 24,821 13,658 89,282
Cabarrus 50,568 59,045 41,013 17,933 168,559
Caldwell 20,052 25,193 22,456 12,161 79,862
Camden 2,825 3,161 2,503 1,143 9,632
Carteret 13,564 17,894 20,321 11,768 63,547
Caswell 5,473 7,030 7,127 3,559 23,189
Catawba 41,896 51,337 42,627 21,647 157,507
Chatham 15,193 21,062 17,927 9,191 63,373
Cherokee 5,788 6,825 8,187 5,761 26,561
Chowan 3,733 3,888 4,313 2,754 14,688
Clay 2,082 2,514 3,357 2,348 10,301
Cleveland 27,111 30,455 26,716 14,752 99,034
Columbus 14,825 16,511 14,739 8,218 54,293
Craven 25,167 31,735 25,245 15,254 97,401
Cumberland 95,060 118,811 67,701 29,114 310,686
Currituck 6,450 7,578 7,275 2,857 24,160
Dare 7,752 10,131 11,175 4,994 34,052
Davidson 41,834 50,842 43,888 21,427 157,991
Davie 10,727 12,273 11,855 6,227 41,082
Duplin 15,136 17,548 13,393 6,948 53,025
Durham 70,115 109,050 59,208 24,675 263,048
Edgecombe 15,439 15,920 15,030 6,010 52,399
Forsyth 98,128 119,464 91,817 45,731 355,140
Population estimates are from the bridged-race population estimates obtained from the National Center for Health Statistics available
online at www.cdc.gov/nchs/nvss/bridged_race/data_documentation.htm#vintage2009.
2008 Cancer Incidence and Mortality in North Carolina
N.C. Central Cancer Registry • State Center for Health Statistics • N.C. Division of Public Health
57
Appendix B (continued): 2008 Population Estimates by Age Group and County
0-19 20-44 45-64 65+ Total
Franklin 16,067 20,079 16,355 6,528 59,029
Gaston 55,754 69,423 54,838 26,818 206,833
Gates 3,251 3,541 3,337 1,617 11,746
Graham 1,933 2,261 2,205 1,581 7,980
Granville 14,606 20,892 15,167 6,422 57,087
Greene 5,160 7,741 5,323 2,430 20,654
Guilford 129,768 167,973 118,494 57,873 474,108
Halifax 14,751 16,163 15,393 8,787 55,094
Harnett 33,737 41,819 25,762 10,707 112,025
Haywood 12,591 15,959 16,672 11,653 56,875
Henderson 23,448 27,834 28,425 22,676 102,383
Hertford 6,145 7,162 6,465 3,585 23,357
Hoke 13,788 17,451 9,135 3,274 43,648
Hyde 1,089 1,799 1,538 834 5,260
Iredell 43,912 51,153 40,897 19,651 155,613
Jackson 9,188 12,656 9,556 5,389 36,789
Johnston 48,935 58,729 40,336 15,311 163,311
Jones 2,358 2,805 3,045 1,752 9,960
Lee 16,713 18,409 15,374 8,639 59,135
Lenoir 15,611 15,818 16,024 9,221 56,674
Lincoln 20,045 24,541 20,931 9,225 74,742
McDowell 10,712 14,169 12,089 6,942 43,912
Macon 7,292 8,180 9,721 7,909 33,102
Madison 4,882 6,258 5,774 3,456 20,370
Martin 6,068 6,398 7,021 4,000 23,487
Mecklenburg 255,951 357,226 203,411 75,868 892,456
Mitchell 3,562 4,512 4,560 3,057 15,691
Montgomery 7,587 8,649 7,530 3,941 27,707
Moore 20,789 23,476 23,119 18,647 86,031
Nash 25,730 28,409 26,064 13,922 94,125
New Hanover 46,446 71,173 49,219 25,860 192,698
Northampton 4,902 5,285 6,281 3,991 20,459
Onslow 51,052 78,422 27,688 12,071 169,233
Orange 35,062 47,731 31,306 12,886 126,985
Pamlico 2,463 3,218 4,062 2,687 12,430
Population estimates are from the bridged-race population estimates obtained from the National Center for Health Statistics available
online at www.cdc.gov/nchs/nvss/bridged_race/data_documentation.htm#vintage2009.
2008 Cancer Incidence and Mortality in North Carolina
N.C. Central Cancer Registry • State Center for Health Statistics • N.C. Division of Public Health
58
Appendix B (continued): 2008 Population Estimates by Age Group and County
0-19 20-44 45-64 65+ Total
Pasquotank 11,390 14,363 10,218 5,471 41,442
Pender 12,585 16,193 14,813 7,643 51,234
Perquimans 2,863 3,407 3,894 2,608 12,772
Person 9,761 11,349 11,164 5,227 37,501
Pitt 45,027 60,741 34,588 15,579 155,935
Polk 3,953 4,620 5,971 4,688 19,232
Randolph 38,123 45,827 37,973 19,040 140,963
Richmond 13,084 14,549 11,854 6,541 46,028
Robeson 39,973 43,810 31,050 13,863 128,696
Rockingham 23,110 27,955 26,516 14,533 92,114
Rowan 36,953 45,164 37,248 20,374 139,739
Rutherford 16,081 18,798 17,724 10,833 63,436
Sampson 18,350 20,775 15,972 8,340 63,437
Scotland 10,507 11,546 9,828 4,599 36,480
Stanly 15,632 18,950 15,953 9,150 59,685
Stokes 11,396 13,820 13,808 7,116 46,140
Surry 18,935 21,846 19,553 12,054 72,388
Swain 3,459 3,845 3,781 2,292 13,377
Transylvania 6,626 7,483 8,652 7,394 30,155
Tyrrell 876 1,521 1,069 638 4,104
Union 63,357 66,762 46,392 16,889 193,400
Vance 12,696 12,890 11,508 5,896 42,990
Wake 253,890 340,482 203,495 70,201 868,068
Warren 4,548 5,689 5,624 3,669 19,530
Washington 3,606 3,343 3,809 2,201 12,959
Watauga 10,653 18,855 10,298 5,615 45,421
Wayne 32,177 37,761 29,024 14,457 113,419
Wilkes 16,368 20,450 18,982 10,925 66,725
Wilson 21,571 24,478 20,888 10,755 77,692
Yadkin 9,769 11,645 10,431 5,856 37,701
Yancey 4,135 5,345 5,443 3,616 18,539
Population estimates are from the bridged-race population estimates obtained from the National Center for Health Statistics available
online at www.cdc.gov/nchs/nvss/bridged_race/data_documentation.htm#vintage2009.
2008 Cancer Incidence and Mortality in North Carolina
N.C. Central Cancer Registry • State Center for Health Statistics • N.C. Division of Public Health
59
Appendix C: 2008 Population Estimates by Race, Sex and County
White
Males
White
Females
Minority
Males
Minority
Females
Total
North Carolina
Alamance 56,846 59,975 14,388 16,701 147,910
Alexander 16,929 16,768 1,674 1,215 36,586
Alleghany 5,351 5,399 163 112 11,025
Anson 6,396 6,180 6,542 6,071 25,189
Ashe 12,453 12,835 212 191 25,691
Avery 8,727 8,097 964 127 17,915
Beaufort 16,170 17,233 5,850 7,090 46,343
Bertie 3,397 3,598 6,026 6,445 19,466
Bladen 9,763 10,095 5,790 6,763 32,411
Brunswick 44,141 46,214 6,477 7,290 104,122
Buncombe 100,048 108,339 9,973 11,013 229,373
Burke 39,134 40,130 5,581 4,437 89,282
Cabarrus 68,835 70,182 14,009 15,533 168,559
Caldwell 36,777 37,940 2,551 2,594 79,862
Camden 3,923 3,998 799 912 9,632
Carteret 28,221 29,674 2,772 2,880 63,547
Caswell 7,643 7,448 4,092 4,006 23,189
Catawba 68,252 69,940 9,333 9,982 157,507
Chatham 26,334 26,841 4,786 5,412 63,373
Cherokee 12,259 13,241 522 539 26,561
Chowan 4,468 4,802 2,429 2,989 14,688
Clay 4,904 5,203 92 102 10,301
Cleveland 37,279 39,832 10,192 11,731 99,034
Columbus 17,193 18,277 8,749 10,074 54,293
Craven 35,496 36,205 12,106 13,594 97,401
Cumberland 88,031 88,598 62,591 71,466 310,686
Currituck 10,914 11,144 995 1,107 24,160
Dare 16,297 16,275 723 757 34,052
Davidson 69,168 71,056 8,311 9,456 157,991
Davie 18,635 19,204 1,574 1,669 41,082
Duplin 19,719 18,872 6,628 7,806 53,025
Durham 75,290 74,772 52,417 60,569 263,048
Edgecombe 10,816 11,224 13,740 16,619 52,399
Forsyth 123,896 130,033 46,590 54,621 355,140
Population estimates are from the bridged-race population estimates obtained from the National Center for Health Statistics available
online at www.cdc.gov/nchs/nvss/bridged_race/data_documentation.htm#vintage2009.
2008 Cancer Incidence and Mortality in North Carolina
N.C. Central Cancer Registry • State Center for Health Statistics • N.C. Division of Public Health
60
Appendix C (continued): 2008 Population Estimates by Race, Sex and County
White
Males
White
Females
Minority
Males
Minority
Females
Total
Franklin 21,243 21,283 7,807 8,696 59,029
Gaston 83,715 87,848 16,386 18,884 206,833
Gates 3,737 3,712 2,033 2,264 11,746
Graham 3,527 3,737 359 357 7,980
Granville 19,409 17,523 11,305 8,850 57,087
Greene 6,436 5,674 4,768 3,776 20,654
Guilford 146,983 154,663 80,666 91,796 474,108
Halifax 10,884 11,944 15,323 16,943 55,094
Harnett 41,460 42,530 13,324 14,711 112,025
Haywood 26,629 28,813 684 749 56,875
Henderson 47,254 50,309 2,308 2,512 102,383
Hertford 4,102 4,319 7,215 7,721 23,357
Hoke 11,848 11,774 9,571 10,455 43,648
Hyde 1,717 1,544 1,206 793 5,260
Iredell 65,523 66,920 10,835 12,335 155,613
Jackson 15,296 16,117 2,671 2,705 36,789
Johnston 67,804 67,281 13,528 14,698 163,311
Jones 3,228 3,309 1,584 1,839 9,960
Lee 23,055 23,236 5,956 6,888 59,135
Lenoir 15,999 16,907 10,825 12,943 56,674
Lincoln 34,394 34,827 2,672 2,849 74,742
McDowell 20,447 20,923 1,404 1,138 43,912
Macon 15,253 16,877 518 454 33,102
Madison 9,786 10,141 249 194 20,370
Martin 6,145 6,736 4,729 5,877 23,487
Mecklenburg 291,389 289,577 145,921 165,569 892,456
Mitchell 7,608 7,819 150 114 15,691
Montgomery 10,738 10,660 3,246 3,063 27,707
Moore 34,814 37,317 6,391 7,509 86,031
Nash 28,118 29,648 17,041 19,318 94,125
New Hanover 77,232 81,015 15,827 18,624 192,698
Northampton 4,113 4,267 5,615 6,464 20,459
Onslow 74,715 57,036 19,601 17,881 169,233
Orange 48,159 52,470 12,170 14,186 126,985
Pamlico 4,685 4,757 1,579 1,409 12,430
Population estimates are from the bridged-race population estimates obtained from the National Center for Health Statistics available
online at www.cdc.gov/nchs/nvss/bridged_race/data_documentation.htm#vintage2009.
2008 Cancer Incidence and Mortality in North Carolina
N.C. Central Cancer Registry • State Center for Health Statistics • N.C. Division of Public Health
61
Appendix C (continued): 2008 Population Estimates by Race, Sex and County
White
Males
White
Females
Minority
Males
Minority
Females
Total
Pasquotank 12,057 12,518 8,090 8,777 41,442
Pender 20,429 20,294 5,148 5,363 51,234
Perquimans 4,520 4,862 1,541 1,849 12,772
Person 13,027 13,502 5,061 5,911 37,501
Pitt 48,488 51,196 25,524 30,727 155,935
Polk 8,578 9,496 533 625 19,232
Randolph 64,276 65,827 5,235 5,625 140,963
Richmond 15,065 15,207 7,681 8,075 46,028
Robeson 23,513 23,006 39,291 42,886 128,696
Rockingham 35,830 37,629 8,691 9,964 92,114
Rowan 57,041 58,552 11,788 12,358 139,739
Rutherford 26,753 29,023 3,683 3,977 63,436
Sampson 21,839 21,678 9,581 10,339 63,437
Scotland 8,862 9,459 8,759 9,400 36,480
Stanly 25,238 25,943 4,274 4,230 59,685
Stokes 21,229 22,293 1,244 1,374 46,140
Surry 33,493 35,180 1,809 1,906 72,388
Swain 4,543 4,857 1,955 2,022 13,377
Transylvania 13,551 14,664 893 1,047 30,155
Tyrrell 1,235 1,115 1,084 670 4,104
Union 82,458 82,427 13,804 14,711 193,400
Vance 10,222 10,920 10,013 11,835 42,990
Wake 320,276 317,102 109,494 121,196 868,068
Warren 3,882 3,917 5,736 5,995 19,530
Washington 3,057 3,180 3,144 3,578 12,959
Watauga 21,879 21,997 785 760 45,421
Wayne 36,800 37,268 18,433 20,918 113,419
Wilkes 31,248 31,946 1,752 1,779 66,725
Wilson 22,742 23,301 14,505 17,144 77,692
Yadkin 17,768 18,329 786 818 37,701
Yancey 9,028 9,145 188 178 18,539
Population estimates are from the bridged-race population estimates obtained from the National Center for Health Statistics available
online at www.cdc.gov/nchs/nvss/bridged_race/data_documentation.htm#vintage2009.
2008 Cancer Incidence and Mortality in North Carolina
N.C. Central Cancer Registry • State Center for Health Statistics • N.C. Division of Public Health
62
Bibliography
1. American Cancer Society: What is cancer? Available at
www.cancer.org/Cancer/CancerBasics/what-is-cancer. Accessed April 8, 2011.
2. Akin D, Avery M, Daye R, Enright D, Farmer AH. North Carolina Vital Statistics 2008,
Volume 2: Leading Causes of Death, January 2010. Available at
www.schs.state.nc.us/SCHS/deaths/lcd/2008/pdf/Vol2_2008_PRT.pdf. Accessed April 8,
2011.
3. North Carolina General Assembly - General Statutes - Chapter 130A: Public Health.
Available at www.ncleg.net/gascripts/Statutes/StatutesTOC.pl?Chapter=0130A. Accessed
April 8, 2011.
4. North American Association of Central Cancer Registries. Available at www.naaccr.org.
Accessed April 8, 2011.
5. Centers for Disease Control and Prevention – Cancer - National Program of Cancer
Registries. Available at www.cdc.gov/cancer/npcr. Accessed April 27, 2011.
6. North Carolina Administrative Code - Health and Human Services - Information Services -
Laboratory Sections - Cancer Registries. Available at
http://reports.oah.state.nc.us/ncac/title%2010a%20-
%20health%20and%20human%20services/chapter%2047%20-
%20information%20services/subchapter%20b/subchapter%20b%20rules.html. Accessed
April 27, 2011.
7. Fritz A, Percy C, Jack A, Shanmugaratnam K, Sobin L, Parkin DM, Whelan S (eds).
International Classification of Diseases for Oncology, 3rd ed. Geneva: World Health
Organization; 2000.
8. National Cancer Institute – Surveillance, Epidemiology and End Results. Available at
http://seer.cancer.gov. Accessed April 8, 2011
9. North American Association of Central Cancer Registries Race and Ethnicity Work Group.
NAACCR Guideline for Enhancing Hispanic/Latino Identification: Revised NAACCR
Hispanic/Latino Identification Algorithm [NHIA v2.2]. Springfield (IL): North American
Association of Central Cancer Registries. August 2009.
10. Buescher PA. Problems with rates based on small numbers. Statistical Primer, No. 12, State
Center for Health Statistics, April 1997, Revised August 2008. Available at
www.schs.state.nc.us/SCHS/pdf/primer12_2.pdf. Accessed April 8, 2011.
11. Center for Disease Control and Prevention – National Center for Health Statistics – National
Vital Statistics Program - Bridged-Race Population Estimates – Vintage 2009. Available at
2008 Cancer Incidence and Mortality in North Carolina
N.C. Central Cancer Registry • State Center for Health Statistics • N.C. Division of Public Health
63
www.cdc.gov/nchs/nvss/bridged_race/data_documentation.htm#vintage2009. Accessed
April 26, 2011.