Cancer Incidence
In
North Carolina
1998
Central Cancer Registry
State Center for Health Statistics
STATE OF NORTH CAROLINA
Michael F. Easley, Governor
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Carmen Hooker Odom, Secretary
STATE CENTER FOR HEALTH STATISTICS
Gustavo Fernadez, Ph.D., Director
CENTRAL CANCER REGISTRY
Dale Herman, M.S.P.H., Director
Contributing Editors
Deirdre Rogers
Karen Knight
Robert Allis
Other Contributors
Latosha Battle
Biva Chowdhury
May 2002
Table of Contents
Introduction
• Background ..........................................................................................................................1
• Purpose ...............................................................................................................................1
• Condentiality .....................................................................................................................1
Technical Notes
• Overview and Denitions....................................................................................................2
Cancer Incidence and Mortality...............................................................................2
Differences in Reporting Cancer..............................................................................3
Incidence Rates...........................................................................................................3
Race/Gender Specic................................................................................................5
Reliability of Rates .....................................................................................................5
Morphology (Cell Type) and Behavior...................................................................6
• Limitations of Data..............................................................................................................6
Small Numbers...........................................................................................................7
Interpretation..............................................................................................................7
• Comparison to National Data..............................................................................................7
• Available Cancer Information..............................................................................................8
• Support for Cancer Research and Control...........................................................................8
Evaluation
• Evaluation Form................................................................................................................9
Tables/Charts
• Table 1: Incidence Rates By Sex ...................................................................................11
• Table 2: Ten Most Frequently Diagnosed Cancers By Sex.......................................12
• Table 3: Incidence Rates By Race .................................................................................13
• Table 4: Ten Most Frequently Diagnosed Cancers By Race.....................................14
• Table 5: Cancer Incidence and Mortality Rates .........................................................15
• Table 6: Colon/Rectum Incidence Rates ....................................................................17
• Table 7: Lung/Bronchus Incidence Rates...................................................................19
• Table 8: Female Breast Incidence Rates ......................................................................21
• Table 9: Prostate Incidence Rates.................................................................................23
• Chart 1: Trends for the Four Major Cancers ..............................................................25
• Chart 2: White/Minority Trends for the Four Major Cancers.................................27
• Table 10: Five Most Frequently Diagnosed Cancers
By Age Group.................................................................................................29
Appendices
• Appendix A: Primary Site Denitions .......................................................................34
• Appendix B: Mathematical Formulae........................................................................36
• Appendix C: 1998 Population Total By County and Race ......................................37
• Appendix D: 2000 U.S. Standard Million Population..............................................39
Introduction
Background
The North Carolina Central Cancer Registry (CCR), located within the State Center for Health Statis-tics,
was established in 1986. The CCR operates under the authority granted in North Carolina General
Statute 130A-208.
Legislation declaring cancer to be a mandatorily reported disease in N.C. 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 cancer cases were reported to the CCR each year. Calendar year
1990 is the rst year for which relatively complete statewide reporting was achieved. 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.
The CCR collects, analyzes and disseminates demographic and medical characteristic information on
newly diagnosed cancer patients in North Carolina. There are 130 hospitals in North Carolina which
diagnose and treat cancer patients, approximately 50 of which have their own tumor registries. Of the
130 hospitals, 120 reported their 1998 cancer incidence data to the CCR. Incidence data are reported to
the CCR by use of magnetic media.
Purpose
Cancer in North Carolina 1998 is the ninth annual report of the CCR. This report summarizes the infor-mation
collected on cancer diagnosed among North Carolina residents in 1998. Along with the 1998
incidence data reported from the hospitals, this report includes a small number of melanoma cases
that were not hospitalized and that were reported to the CCR by dermatologists. Mortality data were
provided by the State Center for Health Statistics.
The last printed publication of cancer incidence data was volume four, 1993 cancer data. Due to prob-lems
with our software, we were unable to print volumes ve, six, seven, and eight, corresponding to
the years 1994 through 1997 respectively. However, these volumes have now been placed on the State
Center for Health Statistics web site, www.schs.state.nc.us/SCHS/healthstats/, under the title “N.C.
Cancer Incidence Reports.”
Condentiality
The CCR is committed to preserving the condentiality of information obtained for medical, educa-tional,
research, and statistical purposes. Thus the CCR demands strict condentiality and the protec-tion
of the identity of both cancer patients and reporting sources in registry data. The CCR does not
release any identifying information regarding any patients, hospitals or physicians without permission
from the reporting facility.
Cancer Incidence in North Carolina 1998
1 State Center for Health Statistics
Technical Notes
Overview and Denitions
This report presents frequency counts, age-specic rates, and age-adjusted rates to describe newly
diagnosed cases of cancer and mortality due to cancer.
Cancer Incidence and Mortality
Cancer incidence is the number of newly diagnosed cancer cases for each county, whereas cancer mor-tality
is the number of deaths due to cancer for each county (See Figure 1.).
The belief that mortality data are reliable is based on the assumption that death certicates provide
complete and accurate data on all causes of death. However, the accuracy of recording the cause of
death varies for many cancers. This variability arises partly from the fact that nearly half of all cancers
are cured. At the time of death, the history of cancer may not be known by the physician, or the cancer
may be considered not to have contributed to the death. Nonetheless, mortality data have been used
widely to analyze cancer risk in populations.
Instances of underreporting of cancer incidence are known to have occurred. In some counties, and
for some cancers (e.g., melanomas), underreporting may lead to more cancer deaths being shown than
anticipated by incidence cases. Also, survival following a cancer diagnosis varies by cancer site. For
example, survival for pancreatic cancer is very poor. Less than 10 percent of cases live ve years after
diagnosis. By contrast, roughly 85 percent of people diagnosed with breast cancer live at least ve
years. In populations with low use of health care services (e.g., rural and black populations), more
cancers are diagnosed at advanced stages when therapies are less successful, or the cases may not be
diagnosed until death.
The incidence/mortality ratio is a measure used by the CCR to evaluate its reporting. Overall, this
ratio is around 2.0. Depending on the type of cancer, its survival rate, its ability to be detected through
screening exams, and the presence of successful treatment options, this value may rise to 3.0 or 3.5 or
may drop to about 1.0.
Figure 1. Cancer Incidence and Mortality,
1998
0
1000
2000
3000
4000
5000
6000
7000
Colon and
Rectum
Lung and
Bronchus
Female Breast Prostate
Incidence
Mortality
Cancer Incidence in North Carolina 1998
2 State Center for Health Statistics
Cancer incidence, mortality, and age-adjusted rates for each county are presented in Table 5 and pre-sented
by site in Tables 6-9 for Colon/Rectum, Lung/Bronchus, Female Breast, and Prostate Cancers,
respectively.
Differences in Reporting Cancer Incidences and Mortality Data
Many people living near the Virginia border go outside North Carolina for health care. Patients often
seek secondary and tertiary care in Norfolk and Danville, Virginia. The State of North Carolina has
an exchange agreement with all 50 states for exchanging death certicates, but only has an exchange
agreement with 23 states, including our border states of Virginia and South Carolina, for exchanging
cancer incidence data.
Because death certicate data are available more quickly than incidence data, the 1998 mortality data
include deaths of North Carolina residents who died in other states; however, the incidence data does
not include all cases diagnosed out-of-state. As a result, some counties may show more deaths than
incidence cases in the data presented in Table 5.
This is a particular problem for the northeastern counties and for Caswell and Rockingham counties.
The exchange of data is an ongoing process; updated information will be made available upon request
for those counties affected by interstate migration for health care.
As noted above, some counties have been found to underreport their cancer incidence due to poor
case-nding procedures. These counties, especially rural counties where small hospitals do not have
the services of trained tumor registrars, may have inadequate case-nding. This results in incomplete
reporting of new cancer cases. In contrast, death data are considered to be complete. This also contrib-utes
to what appears to be an excess of deaths compared to the number of cases for some cancer sites
in some of the rural counties.
Incidence Rates
Two types of rates are presented in this report: age-adjusted and age-specic, each of which has a spe-ci
c purpose. Both rates are expressed in this report as annual or ve-year rates per 100,000 popula-tion.
An age-adjusted rate accurately describes the cancer experience that the population would have had if
it had exactly the same age distribution as compared to the standard population. Age-adjusted rates
provide a single, summary rate for each area. The direct method was used to calculate all age-adjusted
rates in this report by multiplying each age-specic rate by the number of people within that age group
in the standard population, summing these products, and dividing by the total population in the stan-dard
population. Age-adjusted rates should not be compared with any other type of rate or be used
as absolute measurements of vital events; their sole purpose is to provide summary rates that can be
compared between populations that have different age structures. The 2000 U.S. Census population
was used in the calculations as the standard population.
The age-specic cancer incidence is the number of cancer cases that occur in each ve-year age range,
from 0-4 to 85+. Age-specic rates are calculated by dividing the number of cases for a given age
group by the total population of that age. They are used to compare rates between population groups
Cancer Incidence in North Carolina 1998
3 State Center for Health Statistics
of the same age and to examine age patterns for particular cancers. If the age categories are sufciently
narrow, these rates provide the best estimates of the risk of disease. As expected, age-specic rates
have a general tendency to increase with age (See Figure 2). North Carolina has attracted a large
number of retirement-age people over the last decade. Understanding migration patterns is important
for interpreting the data and is one reason for showing the data by age group. The largest concentra-tions
of older-age residents are in the mountain counties, along the coast, and in the sandhills (along
the mid-southern border).
Cancer patterns vary by age group. Children have a very different pattern of cancer than do adults.
Leukemia, brain cancer, bone cancer, and lymphomas dominate in people under age 20. In general,
North Carolina’s pediatric cancer patterns are quite consistent with national patterns.
Young adults (20-44) have an entirely different pattern of cancer than do children. In this age group,
lymphomas are even more common, as are some digestive and reproductive tissue cancers. All of
these cancers are quite rare, and cancer rates in these ages are generally lower than for other age
groups.
In the middle ages (45-64), cancer rates begin to rise, and the common cancers (lung, breast, and colon)
emerge. The incursion of these cancers into earlier age groups is the subject of considerable research
at this time. Much work is in progress in North Carolina on these trends.
All cancer rates are at their maximum in the 65+ age category. Prostate cancer is almost exclusively a
disease of older men.
These age-specic patterns offer signicant direction for screening priorities. For most cancers, the
prospect for a normal life expectancy is good when the diagnosis is made early in the disease process.
North Carolina legislation and federal programs are focused on increasing access to screening services
in this state. Older and underprivileged people are priority groups for these programs.
As stated previously, age-specic rates provide the best estimates of the risk of disease if the age cat-egories
are sufciently narrow. Age-specic cancer incidences and rates are presented in Table 10. The
age-specic incidence rates demonstrate how cancer is a disease primarily of the older population.
Figure 2. North Carolina Age-Specific
Cancer Incidence, 1998
43-64
36%
65+
53%
20-44
10%
0-19
1%
Cancer Incidence in North Carolina 1998
4 State Center for Health Statistics
Race/Gender Specic
The race/gender-specic cancer incidence is the number of cancer cases that occurred in each race/
gender group for each county. (See Figure 3.)
These data are provided because race is a highly relevant factor in interpreting cancer patterns in North
Carolina. Earlier, the scarcity of nonwhite cases in many counties was cited as reason for not using
site-specic incidence rates by race, as well as by gender; yet, cancer rates do vary by race. Also, race
distributions differ across the state, and racial disparity has been observed in the use of health care.
Because cancer risk is strongly associated with lifestyle and behavior, differences in ethnic and cultural
groups can provide clues to factors involved in the development of cancer such as dietary patterns,
alcohol use, and sexual and reproductive behaviors.
Cancer cases and age-adjusted rates by gender for each county are presented in Table 1 and by race for
each county in Table 3.
Reliability of Rates
Precautions should always be taken when comparing any rates based on vital events and population.
Both the size of the numbers and the characteristics of the population are important indicators of a
rate’s real value. Rates based on small numbers of events over a given period of time or for sparsely
populated geographic areas should be viewed with caution. These rates show considerable variation
from year to year, thus limiting their usefulness in comparisons and estimation of rare occurrences.
(See section “Small Numbers” or refer to Statistical Primer No. 12, “Problems with Rates Based on
Small Numbers” (April 1997) on the SCHS website, www.schs.state.nc.us/SCHS.)
Figure 3. North Carolina Race/Gender Specific Cancer
Incidence, 1998
0% 10% 20% 30% 40% 50% 60% 70% 80% 90%
Female
Male
Other
Black
White
Cancer Incidence in North Carolina 1998
5 State Center for Health Statistics
Age-adjusted rates can offer a more rened measurement for comparing experiences over geographic
areas or time periods. However, there are limitations to their use; one should be familiar with these
types of rates before using them. As already mentioned, age-adjusted rates are only to be used for
comparison purposes and only if the same standard population was used in the calculation. This pub-lication
uses the 2000 U.S. Census as the standard population.
For assistance in interpreting these data, please contact the statistical staff at the CCR, (919) 715-4555.
Morphology (Cell Type) and Behavior
Interpretations of melanoma data should be treated with caution, since the thoroughness of
case-nding is suspect due to the likelihood that cases may be treated outside of hospitals and not
reported to the CCR. 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 mela-noma
of the skin. Also, lymphomas are not grouped consistently by all researchers. The specic mor-phology
codes for these categories have been provided in the Appendix in the table “Primary Site
Denitions” to clarify counting of these cases. The lymphoma category includes all lymphoma cases
with the morphology codes shown, regardless of body site.
In these data, only malignant brain tumors are included, although data on benign and unspecied
types are also reported to the CCR. Only invasive cervical cancer cases have been included; data on in
situ cases are collected but are excluded from this report due to suspicions of incompleteness.
Limitations of Data
The user should be cautious when making county-to-county comparisons of the data in this report.
Underreporting in areas close to neighboring states and underreporting for cancers that may not be
diagnosed in hospitals must be considered when interpreting cancer incidence data. In addition, com-parison
of rates (computed with the number of cases and population data) is problematic. The age
distributions and racial percentages in counties vary considerably. These factors (age, race) have too
much effect on the cancer data from county to county to allow useful comparisons of risk.
Consider a comparison of Moore and Cabarrus counties. In 1998, over 22 percent of the Moore County
population was at least 65 years old, while less than 14 percent of the Cabarrus County population was
65 and over. A larger proportion of the Moore County population can be expected to have cancer than
the Cabarrus County population just because of the difference in the age pattern for these two coun-ties.
On the other hand, over 66 percent of Robeson County’s population was comprised of minorities,
while nearly 97 percent of Watauga County’s population is white. This difference in the racial compo-sition
of the populations of the two counties can also have a marked inuence on the patterns of cancer
incidence and mortality. Age-adjusted rates control for differences in the age structures of popula-tions,
but they do not control for differences in racial composition.
Cancer Incidence in North Carolina 1998
6 State Center for Health Statistics
Small Numbers
Small numbers of cases are a problem for statistical reports of health data. Even for the most common
cancers, some counties can expect to have only one or two cases in a year. For example, Tyrrell County,
which has the smallest population of any county in the state, can expect to have only one case of female
lung cancer each year (based on state lung cancer rates). Between 1995 and 1997, one case of female
lung cancer in Tyrrell County has been reported to the CCR. If three cases should be reported in 1998,
it would appear that the county had an excessive amount of lung cancer in 1998. However, over the
four-year period, the county would average exactly what was expected.
All statistics are subject to chance variation. Rates based on an unusually small or large number of
events over a specied period of time or for a sparsely populated geographic area should be of particu-lar
concern and caution. When small events or populations are evident in studying rates, multiple-year
summary rates will sometimes provide a much better perspective or measurement of an outcome.
Expanding the period of time studied enlarges the absolute numbers and adds more credence to a
statement regarding a rate.
Interpretation
This descriptive report is intended to serve as a baseline for future reference. Because of the limita-tions
described above, this publication should not be regarded as a denitive description of the cancer
incidence in North Carolina. With additional training of hospital staff, the addition of other reporting
facilities, and with collaboration from neighboring states, some of the problems of underreporting have
declined. Although there are important limitations in the use of these data, the observed number of
cases within a gender group in a specic county can be used for:
• planning health services at the county level;
• identifying high incidence of cancer sites within a county;
• educating the public;
• motivating hospitals and other facilities to report incidence data accurately and in a
timely manner.
Comparison to National Data
This report provides data for evaluation of cancer incidence and mortality patterns in North Carolina.
While comparisons to national data would be desirable, there is no reliable national database for com-parison
with North Carolina 1998 observed incidence cases.
The National Cancer Institute operates a series of population-based registries (the Surveillance, Epide-miology
and End Results [SEER] registries). The most recent available SEER data are for 1973-1998.
It is not valid to compare total population rates with the corresponding ones provided by the SEER
program, since the racial compositions of the two populations are dissimilar. These SEER registries are
intended to provide a 14 percent sample of the nation. The nonwhite population of the SEER registries
is mainly urban, while North Carolina’s nonwhite population is heavily rural. Differences between
cancer rates in urban and rural populations have been observed. However, a comparison of the North
Carolina and SEER data may be obtained by request. In general, North Carolina cancer rates are quite
consistent with the nation’s, except for variations that are most likely due to North Carolina’s larger
rural and black populations.
Cancer Incidence in North Carolina 1998
7 State Center for Health Statistics
Available Cancer Information
Cancer and diabetes are the only two leading causes of death in the United States that are increasing.
These increases are largely the result of the aging of the population and the decline in mortality from
other causes of death (e.g., heart disease and stroke). It is estimated that by the year 2015, cancer will
be the leading cause of death in the U.S.
Cancer is expected to strike one in three people sometime during their lifetime. For more information
about cancer, contact a local ofce of the American Cancer Society or call 1-800-ACS-2345. Many com-munities
also have hospital-based cancer programs through which local data and/or cancer-related
services may be obtained. In many counties, local health departments have active cancer control pro-grams.
Another source of information on cancer and resources for patients is the Cancer Information
Service, at Duke University, 1-800-4CANCER (1-800-422-6237).
The CCR produces other reports on cancer in North Carolina. A notable one is North Carolina Cancer
Facts and Figures. This report is published annually in collaboration with the North Carolina Division
of the American Cancer Society. Also, other units with the State Center for Health Statistics (SCHS)
publish many reports on other diseases and on health care and environmental quality measures. Many
reports are available on the SCHS website, www.schs.state.nc.us/SCHS. For more information about
other reports from the CCR please call (919) 715-4555. For other sections of the SCHS, please call (919)
733-4728 or write:
State Center for Health Statistics
1908 Mail Service Center
Raleigh, NC 27699-1908
Support for Cancer Research and Control
The CCR is actively involved with cancer research programs at universities in North Carolina, as well
as with federal agencies and research institutes located in the state. One feature of this participation is
the rapid identication of cancer patients for projects that are designed to collect information before the
patient’s rst course of treatment is completed (e.g., genetic studies). Several organizations in North
Carolina work to prevent cancer or to provide for early detection. Others work to promote a higher
quality of life for cancer patients undergoing treatment and cancer survivors. Still others are working
to understand and reduce disparities in cancer diagnosis and mortality.
One program to promote access to cancer screening tests is the N.C. Division of Public Health’s Breast
and Cervical Cancer Control Program. The CCR provides statistical and data analysis support for the
state’s Cancer Control Program, which funds cancer treatment for economically disadvantaged North
Carolinians. The CCR is associated with other organizations such as the American Cancer Society and
the state’s Advisory Committee for Cancer Coordination and Control.
The CCR is in the process of developing a publication outlining its research projects with North Caro-lina
universities and other cancer research institutes.
Cancer Incidence in North Carolina 1998
8 State Center for Health Statistics
EVALUATION
Cancer Incidence In North Carolina
1998
Evaluation Form
In an attempt to provide you with the most benecial information possible, we
are enclosing this evaluation form. Please complete the form and mail to the
following address: North Carolina Central Cancer Registry, 1908 Mail Service
Center, Raleigh, NC 27699-1908. We appreciate any feedback you can provide.
Do you feel that the terminology used in this publication is clearly explained in
the Introduction of this publication?
What tables/charts do you nd most useful and why?
What tables/charts do you nd least useful and why?
Please describe in detail any charts/tables you would like to see added to this
publication.
Additional comments or suggestions:
Cancer Incidence in North Carolina 1998
9 State Center for Health Statistics
TABLES/CHARTS
Cancer Incidence
In
North Carolina
1998
Males Females
Site Cases Rate1 Cases Rate1
All Sites 16,644 514.0 16,627 391.4
Oral Cavity and Pharynx 532 15.7 265 6.2
Lip 55 1.6 18 0.4
Tongue 117 3.4 61 1.4
Salivary Glands 49 1.6 25 0.6
Floor of Mouth 57 1.6 24 0.6
Nasopharynx 24 0.7 * **
Oropharynx 22 0.6 10 0.2
Hypopharynx 59 1.7 18 0.4
Other Mouth & Pharynx 149 4.4 100 2.3
Digestive System 3,068 97.2 2,817 64.1
Esophagus 226 6.8 75 1.7
Stomach 267 8.5 193 4.4
Small Intestine 61 1.8 54 1.2
Colon & Rectum 1,880 59.9 1,911 43.4
Anus & Anal Canal 27 0.8 51 1.2
Liver & Intrahepatic Bile Duct 148 4.6 83 1.9
Gallbladder 18 0.6 31 0.7
Pancreas 390 12.5 357 8.1
Other Digestive Organs 51 1.6 62 1.4
Respiratory System 3,750 115.4 2,100 48.3
Larynx 319 9.6 83 2.0
Lung & Bronchus 3,344 103.1 1,983 45.6
Other Respiratory Organs 87 2.7 34 0.8
Bones and Joints 39 1.1 39 1.0
Soft Tissues 119 3.5 91 2.2
Melanoma of the Skin 573 17.1 462 11.2
Breast 59 1.9 6,132 146.8
Invasive Breast 59 1.9 5,163 123.4
Insitu Breast - - 969 23.4
Female Genital System - - 1,956 46.6
Cervix Uteri - - 373 9.2
Uterus (Corpus, NOS) - - 834 19.7
Ovary - - 592 14.0
Other Female Genital Organs - - 157 3.7
Male Genital System 4,829 147.0 - -
Prostate 4,625 141.5 - -
Testis 166 4.3 - -
Penis 34 1.1 - -
Other Male Genital Organs * ** - -
Urinary System 1,569 50.4 707 16.2
Bladder 1,002 33.1 374 8.4
Kidney & Renal Pelvis 534 16.0 314 7.4
Ureter 23 0.9 14 0.3
Other Urinary System 10 0.4 * **
Eye & Orbit 37 1.1 25 0.6
Brain & CNS 242 6.9 226 5.5
Endocrine System 120 3.4 280 7.0
Thyroid 95 2.7 263 6.6
Other Endocrine & Thymus 25 0.7 17 0.4
Lymphomas 719 21.6 633 14.8
Hodgkin’s Disease 106 2.9 88 2.2
Non-Hodgkin’s Lymphoma 613 18.7 545 12.6
Multiple Myeloma 200 6.4 160 3.7
Leukemia 386 12.0 296 7.1
Acute Lymphocytic Leukemia 44 1.2 38 1.0
Chronic Lymphocytic Leukemia 108 3.4 75 1.7
Acute Myeloid Leukemia 115 3.7 91 2.2
Chronic Myeloid Leukemia 50 1.5 44 1.0
Other Leukemia 69 2.1 48 1.1
Ill-Dened & Unspecied 345 11.3 402 9.1
1 Rates Per 100,000 Population
Age-Adjusted to the 2000 U.S. Census
* Less than 10 Cases Observed.
** Rates based on less than 10 cases are unstable and therefore suppressed.
Table 1: Incidence Rates By Sex
1998
Cancer Incidence in North Carolina 1998
11 State Center for Health Statistics
Table 2: Ten Most Frequently Diagnosed Cancers By Sex
1994-1998
1 Rates Per 100,000 Population
Age-Adjusted to the 2000 U.S. Census
Females
Incidence Mortality
Cancer Cases Rate1 Cases Rate1
Female Breast 27472 138.2 5825 28.7
Lung/Bronchus 9702 46.6 7832 37.3
Colon/Rectum 8818 42.1 3905 18.3
Corpus Uteri 4129 20.3 875 4.1
Ovary 2923 14.6 1744 8.3
Non-Hodgkin’s Lymphoma 2581 12.5 1393 6.6
Cervix Uteri 1906 9.8 685 3.4
Melanoma(Skin) 1877 9.5 419 2.1
Pancreas 1730 8.2 1949 9.1
Bladder 1651 7.8 462 2.1
Males
Incidence Mortality
Cancer Cases Rate1 Cases Rate1
Prostate 22069 143.3 4981 41.5
Lung/Bronchus 16963 110.3 14941 99.9
Colon/Rectum 8730 59.1 3588 25.7
Bladder 4595 31.8 884 6.8
Non-Hodgkin’s Lymphoma 2757 17.7 1411 9.6
Oral Cavity 2747 17.2 774 5.0
Kidney 2453 15.5 990 6.7
Melanoma(Skin) 2419 15.2 590 4.0
Leukemia 1940 12.7 1465 10.3
Pancreas 1725 11.7 1837 12.7
Cancer Incidence in North Carolina 1998
12 State Center for Health Statistics
Table 3: Incidence Rates By Race
1998
Whites Minorities
Site Cases Rate1 Cases Rate1
All Sites 27,072 435.4 6,130 441.2
Oral Cavity & Pharynx 615 9.9 179 12.4
Lip 71 1.1 * **
Tongue 135 2.2 42 2.9
Salivary Glands 63 1.0 11 0.7
Floor of Mouth 56 0.9 25 1.7
Nasopharynx 24 0.4 * **
Oropharynx 23 0.4 * **
Hypopharynx 45 0.7 31 2.2
Other Mouth & Pharynx 198 3.2 50 3.5
Digestive System 4,614 74.3 1,262 93.7
Esophagus 220 3.5 82 5.9
Stomach 299 4.8 161 12.0
Small Intestine 86 1.4 29 2.1
Colon & Rectum 3,054 49.1 729 54.4
Anus & Anal Canal 66 1.1 12 0.9
Liver & Intrahepatic Bile Duct 183 2.9 46 3.3
Gallbladder 32 0.5 17 1.3
Pancreas 578 9.3 168 12.6
Other Digestive Organs 96 1.6 18 1.3
Respiratory System 4,892 77.3 954 69.8
Larynx 308 4.9 93 6.6
Lung & Bronchus 4,480 70.7 844 61.9
Other Respiratory Organs 104 1.7 17 1.2
Bones and Joints 62 1.1 16 0.9
Soft Tissues 157 2.6 53 3.2
Melanoma of the Skin 1,016 16.7 12 0.9
Breast 5,038 81.9 1,143 79.6
Invasive Breast 4,244 68.9 968 67.3
In Situ Breast 794 12.9 175 12.3
Female Genital System 1,586 25.8 365 26.1
Cervix Uteri 258 4.3 114 7.8
Uterus (Corpus, NOS) 700 11.3 131 9.5
Ovary 497 8.1 94 6.8
Other Female Genital Organs 131 2.2 26 2.0
Male Genital System 3,676 57.6 1,136 84.5
Prostate 3,494 54.6 1,115 83.2
Testis 152 2.6 13 0.7
Penis 26 0.4 * **
Other Male Genital Organs * ** * **
Urinary System 1,962 31.5 309 22.5
Bladder 1,245 20.0 126 9.6
Kidney & Renal Pelvis 670 10.8 178 12.6
Ureter 35 0.6 * **
Other Urinary System 12 0.2 * **
Eye & Orbit 54 0.9 8 0.4
Brain & CNS 415 6.9 52 3.3
Endocrine System 319 5.3 78 4.9
Thyroid 288 4.8 67 4.2
Other Endocrine & Thymus 31 0.5 11 0.7
Lymphomas 1,152 18.8 201 13.0
Hodgkin’s Disease 151 2.5 43 2.4
Non-Hodgkin’s Lymphoma 1,001 16.3 158 10.6
Multiple Myeloma 252 4.1 106 7.7
Leukemia 573 9.5 107 7.4
Acute Lymphocytic Leukemia 70 1.3 12 0.6
Chronic Lymphocytic Leukemia 153 2.5 30 2.3
Acute Myeloid Leukemia 180 3.0 25 1.8
Chronic Myeloid Leukemia 76 1.2 18 1.2
Other Leukemia 94 1.6 22 1.5
Ill-Dened & Unspecied 604 9.8 141 10.4
1 Rates Per 100,000 Population
Age-Adjusted to the 2000 U.S. Census
* Less than 10 cases observed.
** Rates based on less than 10 cases are unstable and therefore suppressed.
Cancer Incidence in North Carolina 1998
13 State Center for Health Statistics
Table 4: Ten Most Frequently Diagnosed Cancers By Race
1994-1998
Whites
Incidence Mortality
Cancer Cases Rate 1 Cases Rate1
Female Breast 22469 140.8 4345 26.3
Lung/Bronchus 22162 73.4 18674 62.1
Prostate 16731 129.1 3216 32.8
Colon/Rectum 14204 48.3 5769 19.9
Bladder 5629 19.0 1126 3.9
Non-Hodgkin’s Lymphoma 4559 15.5 2419 8.3
Melanoma(Skin) 4208 14.4 970 3.3
Corpus Uteri 3399 20.9 596 3.5
Kidney 3141 10.6 1244 4.2
Oral Cavity 3115 10.6 839 2.9
Minorities
Incidence Mortality
Cancer Cases Rate 1 Cases Rate1
Prostate 5230 212.1 1765 86.5
Female Breast 4950 124.6 1480 37.7
Lung/Bronchus 4490 69.1 4099 63.9
Colon/Rectum 3318 51.9 1724 27.6
Oral Cavity 916 13.5 330 4.9
Pancreas 853 13.5 957 15.3
Non-Hodgkin’s Lymphoma 770 11.0 385 5.8
Kidney 750 11.0 315 4.8
Corpus Uteri 721 18.2 279 7.1
Stomach 717 11.3 548 8.8
1Rates Per 100,000 Population
Age-Adjusted to the 2000 U.S. Census
Cancer Incidence in North Carolina 1998
14 State Center for Health Statistics
Incidence Mortality
County Cases Rate1 Cases Rate1
North Carolina 33282 437.6 15327 204.0
Alamance 581 411.7 273 190.0
Alexander 154 474.9 70 219.1
Alleghany 63 447.4 32 220.2
Anson 107 392.7 54 190.9
Ashe 126 396.5 69 202.0
Avery 55 300.3 29 152.9
Beaufort 206 404.5 106 202.4
Bertie 96 426.5 50 222.0
Bladen 95 273.5 66 183.5
Brunswick 339 389.5 149 178.6
Buncombe 905 388.5 482 200.4
Burke 416 444.2 193 204.5
Cabarrus 591 474.5 237 191.8
Caldwell 347 428.6 145 181.4
Camden 30 394.5 20 300.3
Carteret 389 548.1 159 229.0
Caswell 98 368.7 70 254.0
Catawba 661 482.3 292 218.0
Chatham 172 319.2 112 205.7
Cherokee 107 331.0 74 222.7
Chowan 71 371.3 36 187.5
Clay 16 132.8 24 186.3
Cleveland 470 456.1 229 223.5
Columbus 222 374.6 118 200.2
Craven 494 574.1 201 235.9
Cumberland 878 427.3 408 216.2
Currituck 82 465.1 37 212.9
Dare 153 537.4 43 153.7
Davidson 590 399.0 253 172.1
Davie 164 446.6 71 189.1
Duplin 219 452.1 101 208.5
Durham 814 489.4 404 250.4
Edgecombe 148 274.6 133 248.3
Forsyth 1588 536.7 628 212.9
Franklin 139 313.8 88 202.4
Gaston 875 480.3 362 201.1
Gates 31 275.0 25 233.5
Graham 25 256.5 17 166.5
Granville 165 366.5 112 253.5
Greene 70 349.4 29 149.2
Guilford 2047 522.0 776 199.7
Halifax 281 470.8 129 214.8
Harnett 302 379.5 178 227.1
Haywood 273 374.6 137 176.0
Henderson 571 461.1 232 185.2
Hertford 133 550.4 58 237.9
Hoke 80 311.9 44 185.2
Hyde 22 313.2 12 161.7
Iredell 526 430.5 223 183.2
Jackson 96 285.6 74 215.0
1 Rates Per 100,000 Population
Age-Adjusted to the 2000 U.S. Census
Table 5: Cancer Incidence And Mortality Rates
1998
INCIDENCE
Cancer Incidence in North Carolina 1998
15 State Center for Health Statistics
Incidence Mortality
County Cases Rate1 Cases Rate1
Johnston 421 386.0 230 213.1
Jones 52 478.1 29 264.3
Lee 221 415.4 107 203.7
Lenoir 359 548.3 137 204.0
Lincoln 264 439.6 119 201.4
McDowell 169 356.4 102 213.4
Macon 147 310.8 69 147.1
Madison 95 410.1 39 157.7
Martin 98 334.9 63 211.5
Mecklenburg 2383 458.2 970 200.5
Mitchell 67 328.9 46 220.0
Montgomery 118 463.9 62 250.5
Moore 416 393.9 215 190.6
Nash 473 535.9 176 199.9
New Hanover 783 496.2 301 193.4
Northampton 103 388.1 52 185.8
Onslow 425 538.0 169 249.1
Orange 375 435.4 181 222.6
Pamlico 87 492.0 43 238.1
Pasquotank 166 461.1 68 185.0
Pender 191 434.2 85 197.0
Perquimans 55 360.4 35 226.3
Person 122 329.0 70 185.4
Pitt 501 487.2 203 202.9
Polk 106 385.8 45 157.7
Randolph 445 346.3 233 183.7
Richmond 217 446.0 98 194.9
Robeson 337 326.6 216 218.4
Rockingham 492 481.7 243 233.5
Rowan 485 347.0 289 201.1
Rutherford 341 483.1 152 209.4
Sampson 230 386.3 122 201.9
Scotland 148 448.8 58 178.6
Stanly 310 506.6 117 185.8
Stokes 189 423.1 96 220.2
Surry 398 492.9 185 224.8
Swain 47 335.7 28 189.2
Transylvania 149 356.5 94 213.3
Tyrrell 23 482.8 8 151.4
Union 314 324.3 182 203.8
Vance 189 459.4 118 283.0
Wake 1985 453.4 760 191.9
Warren 76 313.4 65 254.0
Washington 43 286.4 54 362.2
Watauga 168 455.9 69 185.7
Wayne 493 465.7 247 241.1
Wilkes 320 445.1 142 196.3
Wilson 316 430.5 161 223.5
Yadkin 209 500.2 80 185.9
Yancey 78 365.3 30 129.3
1 Rates Per 100,000 Population
Age-Adjusted to the 2000 U.S. Census
Table 5: Cancer Incidence And Mortality Rates
1998
MORTALITY
Cancer Incidence in North Carolina 1998
16 State Center for Health Statistics
County Cases Rate1
North Carolina 3792 50.3
Alamance 72 50.1
Alexander 13 41.1
Alleghany * **
Anson 19 70.1
Ashe 18 52.3
Avery * **
Beaufort 33 63.9
Bertie 19 84.3
Bladen 12 34.2
Brunswick 30 34.5
Buncombe 107 45
Burke 40 42.7
Cabarrus 45 36.2
Caldwell 36 44.6
Camden * **
Carteret 38 56.4
Caswell * **
Catawba 87 64.9
Chatham 20 36.5
Cherokee 15 42.1
Chowan * **
Clay * **
Cleveland 57 55
Columbus 31 51.8
Craven 63 71.2
Cumberland 102 53.8
Currituck 12 75.1
Dare 17 63.2
Davidson 68 46.6
Davie 17 45
Duplin 22 44.9
Durham 80 48.3
Edgecombe 17 31.9
Forsyth 168 57
Franklin 11 24.7
Gaston 117 65.1
Gates * **
Graham * **
Granville 13 29.1
Greene 11 55.7
Guilford 195 49.7
Halifax 50 83.4
Harnett 48 60.8
Haywood 29 39.3
Henderson 64 49.9
Hertford 21 85.2
Hoke * **
Hyde * **
Iredell 61 49.6
Jackson * **
1 Rates Per 100,000 Population
Age-Adjusted to the 2000 U.S. Census
* Less than 10 cases observed
** Rates based on less than 10 cases are unstable and therefore suppressed.
Table 6: Colon/Rectum Incidence Rates
1998 COLON/RECTUM
Cancer Incidence in North Carolina 1998
17 State Center for Health Statistics
County Cases Rate1
Johnston 44 40.6
Jones * **
Lee 28 54.3
Lenoir 60 92.6
Lincoln 34 57.2
McDowell 30 63
Macon 18 36
Madison 10 38.5
Martin 17 57
Mecklenburg 226 45.6
Mitchell 12 53.3
Montgomery 11 43.8
Moore 53 47.2
Nash 74 84.7
New Hanover 90 57.4
Northampton 17 65.2
Onslow 41 58.9
Orange 29 34.3
Pamlico * **
Pasquotank 22 61
Pender 17 39.3
Perquimans * **
Person 11 29.6
Pitt 61 62
Polk 10 35
Randolph 47 37
Richmond 36 72.6
Robeson 28 28.5
Rockingham 60 57.7
Rowan 56 39.8
Rutherford 42 57.5
Sampson 43 72.8
Scotland 15 46.9
Stanly 43 70.4
Stokes 17 40
Surry 45 55.3
Swain * **
Transylvania 18 37.3
Tyrrell * **
Union 40 43.6
Vance 20 48.7
Wake 180 44.3
Warren 11 44.8
Washington 10 64.8
Watauga 20 53.7
Wayne 64 62.7
Wilkes 43 59.3
Wilson 36 49.9
Yadkin 25 59.2
Yancey * **
1 Rates Per 100,000 Population
Age-Adjusted to the 2000 U.S. Census
* Less than 10 cases observed
** Rates based on less than 10 cases are unstable and therefore suppressed.
Table 6: Colon/Rectum Incidence Rates
1998 COLON/RECTUM
Cancer Incidence in North Carolina 1998
18 State Center for Health Statistics
County Cases Rate1
North Carolina 5328 69.4
Alamance 85 59.1
Alexander 29 86.3
Alleghany * **
Anson 12 42.1
Ashe 18 54.5
Avery * **
Beaufort 39 73.8
Bertie 13 55.1
Bladen 20 54.7
Brunswick 74 79.2
Buncombe 122 51.4
Burke 75 77.9
Cabarrus 97 77.2
Caldwell 50 61.1
Camden * **
Carteret 75 100.7
Caswell 18 65.1
Catawba 105 75.8
Chatham 20 36.9
Cherokee 20 59.6
Chowan * **
Clay * **
Cleveland 82 77.8
Columbus 51 86.4
Craven 72 83.7
Cumberland 162 80.6
Currituck 17 94.4
Dare 18 67.8
Davidson 100 65.6
Davie 25 65.8
Duplin 36 72.3
Durham 133 82
Edgecombe 20 37
Forsyth 255 85.3
Franklin 22 49.2
Gaston 162 87.7
Gates * **
Graham * **
Granville 30 66.3
Greene * **
Guilford 315 80.3
Halifax 44 72
Harnett 48 59.4
Haywood 45 59.9
Henderson 84 65.4
Hertford 21 85.5
Hoke 17 69.1
Hyde * **
Iredell 86 69.3
Jackson 17 47.9
Rates Per 100,000 Population
Age-Adjusted to the 2000 U.S. Census
* Less than 10 cases observed
** Rates based on less than 10 cases are unstable and therefore suppressed.
Table 7: Lung/Bronchus Incidence Rates
1998 LUNG/BRONCHUS
Cancer Incidence in North Carolina 1998
19 State Center for Health Statistics
County Cases Rate1
Johnston 87 79
Jones * **
Lee 34 63
Lenoir 57 84.8
Lincoln 37 62.2
McDowell 33 67.6
Macon 19 39.2
Madison 16 66.4
Martin 13 43
Mecklenburg 338 67.7
Mitchell * **
Montgomery 19 74
Moore 69 58.3
Nash 78 87.2
New Hanover 114 71.9
Northampton 20 73.3
Onslow 85 113.6
Orange 35 43.2
Pamlico 16 93
Pasquotank 20 52.3
Pender 36 78.2
Perquimans 14 95.8
Person 17 44.7
Pitt 77 76.1
Polk 17 60.7
Randolph 77 59.5
Richmond 47 92.9
Robeson 59 56.6
Rockingham 100 95.8
Rowan 94 66.4
Rutherford 57 78.7
Sampson 34 55.5
Scotland 20 60.1
Stanly 44 70.8
Stokes 34 74.7
Surry 72 86.2
Swain * **
Transylvania 19 46.7
Tyrrell * **
Union 37 39.7
Vance 43 104
Wake 236 57.5
Warren 14 57
Washington * **
Watauga 24 63.7
Wayne 101 94.5
Wilkes 52 69.3
Wilson 52 69.5
Yadkin 34 77.4
Yancey 14 63.5
Rates Per 100,000 Population
Age-Adjusted to the 2000 U.S. Census
* Less than 10 cases observed
** Rates based on less than 10 cases are unstable and therefore suppressed.
Table 7: Lung/Bronchus Incidence Rates
1998 LUNG/BRONCHUS
Cancer Incidence in North Carolina 1998
20 State Center for Health Statistics
County Cases Rate1
North Carolina 6134 146.9
Alamance 98 128.9
Alexander 30 168.3
Alleghany 15 205.1
Anson 29 185.4
Ashe 15 96.4
Avery * **
Beaufort 38 132.2
Bertie 23 193
Bladen 24 132.1
Brunswick 39 92.2
Buncombe 176 141.8
Burke 66 130.1
Cabarrus 104 151.6
Caldwell 66 148.6
Camden * **
Carteret 87 235.8
Caswell 16 118.6
Catawba 121 160.4
Chatham 37 123.3
Cherokee 18 113.9
Chowan 14 132.2
Clay * **
Cleveland 68 118.2
Columbus 30 96.4
Craven 93 202.1
Cumberland 174 146.1
Currituck 12 127
Dare 23 153
Davidson 112 140.4
Davie 27 141.2
Duplin 30 117.4
Durham 179 185.5
Edgecombe 29 89.5
Forsyth 289 173.1
Franklin 35 145.6
Gaston 159 158.2
Gates * **
Graham * **
Granville 27 111.8
Greene * **
Guilford 375 170.3
Halifax 40 123.4
Harnett 51 121.7
Haywood 52 141.7
Henderson 108 168.9
Hertford 23 171.9
Hoke * **
Hyde * **
Iredell 81 122.6
Jackson 18 100.1
1 Rates Per 100,000 Population
Age-Adjusted to the 2000 U.S. Census
* Less than 10 cases observed
** Rates based on less than 10 cases are unstable and therefore suppressed.
Table 8: Female Breast Incidence Rate
1998 FEMALE
BREAST
Cancer Incidence in North Carolina 1998
21 State Center for Health Statistics
County Cases Rate1
Johnston 68 115.3
Jones * **
Lee 35 122.2
Lenoir 69 182.9
Lincoln 45 140.3
McDowell 25 96.2
Macon 24 111
Madison 17 130.7
Martin 23 144.2
Mecklenburg 490 163.2
Mitchell * **
Montgomery 29 220.6
Moore 74 137.9
Nash 81 162.3
New Hanover 124 143.7
Northampton 12 85.9
Onslow 68 159.5
Orange 103 210
Pamlico 10 113.7
Pasquotank 28 139.8
Pender 30 131.2
Perquimans * **
Person 25 130.4
Pitt 116 195.2
Polk 25 184.1
Randolph 67 94.9
Richmond 32 120.4
Robeson 50 85.2
Rockingham 90 156.3
Rowan 80 106.6
Rutherford 61 161.8
Sampson 36 111.4
Scotland 25 131
Stanly 59 172.1
Stokes 29 120
Surry 73 166.6
Swain * **
Transylvania 27 134.3
Tyrrell * **
Union 62 113.7
Vance 24 103.9
Wake 470 181.9
Warren 16 124.9
Washington * **
Watauga 26 129.1
Wayne 75 127.1
Wilkes 44 115.1
Wilson 76 183.9
Yadkin 33 145.5
Yancey 17 156.8
1 Rates Per 100,000 Population
Age-Adjusted to the 2000 U.S. Census
* Less than 10 cases observed
** Rates based on less than 10 cases are unstable and therefore suppressed.
Table 8: Female Breast Incidence Rates
1998 FEMALE
BREAST
Cancer Incidence in North Carolina 1998
22 State Center for Health Statistics
County Cases Rate1
North Carolina 4625 141.5
Alamance 96 161.8
Alexander 11 80.9
Alleghany * **
Anson * **
Ashe 23 152.1
Avery * **
Beaufort 19 78.5
Bertie 14 146.1
Bladen * **
Brunswick 53 113.9
Buncombe 120 116.4
Burke 51 125.3
Cabarrus 84 158.7
Caldwell 39 112
Camden * **
Carteret 68 197.2
Caswell 15 119.3
Catawba 84 139.1
Chatham 27 113.8
Cherokee 13 87.2
Chowan 11 126.1
Clay * **
Cleveland 69 162
Columbus 19 69
Craven 94 243
Cumberland 108 120.5
Currituck * **
Dare 25 173.9
Davidson 77 118.7
Davie 21 129.4
Duplin 36 162.1
Durham 138 212.9
Edgecombe 20 92.3
Forsyth 211 174
Franklin 19 94.2
Gaston 110 145.2
Gates * **
Graham * **
Granville 23 119.4
Greene 11 124.3
Guilford 314 190.2
Halifax 39 151.8
Harnett 35 107.2
Haywood 31 87.8
Henderson 76 123.7
Hertford 24 246.8
Hoke 14 114.7
Hyde * **
Iredell 98 184.8
Jackson 21 140.2
1 Rates Per 100,000 Population
Age-Adjusted to the 2000 U.S. Census
* Less than 10 cases observed
** Rates based on less than 10 cases are unstable and therefore suppressed.
Table 9: Prostate Incidence Rates
1998
PROSTATE
Cancer Incidence in North Carolina 1998
23 State Center for Health Statistics
County Cases Rate1
Johnston 48 100.2
Jones 10 209.1
Lee 25 95
Lenoir 51 195.9
Lincoln 34 135
McDowell 20 91.6
Macon 26 114.3
Madison * **
Martin 11 85.9
Mecklenburg 326 153.6
Mitchell * **
Montgomery 13 116.2
Moore 61 111.2
Nash 63 187.5
New Hanover 107 156.6
Northampton 26 224.3
Onslow 66 211.1
Orange 57 159.2
Pamlico 26 307.1
Pasquotank 27 184.8
Pender 23 116.6
Perquimans 11 150.3
Person 14 94.1
Pitt 54 128.3
Polk * **
Randolph 65 116.3
Richmond 17 84.1
Robeson 60 141.9
Rockingham 54 126.7
Rowan 63 99.7
Rutherford 47 149.9
Sampson 34 128.4
Scotland 34 272.1
Stanly 41 155.2
Stokes 22 109.2
Surry 46 132.3
Swain 10 141.8
Transylvania 25 125.2
Tyrrell * **
Union 36 76.6
Vance 25 153.9
Wake 281 160.2
Warren 13 109.9
Washington * **
Watauga 24 145.7
Wayne 71 166.5
Wilkes 33 104.8
Wilson 37 113.2
Yadkin 39 210.8
Yancey 10 94.7
1 Rates Per 100,000 Population
Age-Adjusted to the 2000 U.S. Census
* Less than 10 cases observed
** Rates based on less than 10 cases are unstable and therefore suppressed.
Table 9: Prostate Incidence Rates
1998
PROSTATE
Cancer Incidence in North Carolina 1998
24 State Center for Health Statistics
Chart 1: Trends For The Four Major Cancers
1990-1998
* Rates Per 100,000 Population
Age-Adjusted to the 2000 U.S. Census
Lung/Bronchus Cancer
0
10
20
30
40
50
60
70
80
90
1990 1991 1992 1993 1994 1995 1996 1997 1998
Rate*
Incidence
Mortality
Colon/Rectum Cancer
0
10
20
30
40
50
60
1990 1991 1992 1993 1994 1995 1996 1997 1998
Rate*
Incidence
Mortality
Cancer Incidence in North Carolina 1998
25 State Center for Health Statistics
Chart 1: Trends For The Four Major Cancers
1990-1998
Female Breast Cancer
0
20
40
60
80
100
120
140
160
1990 1991 1992 1993 1994 1995 1996 1997 1998
Rate*
Incidence
Mortality
* Rates Per 100,000 Population
Age-Adjusted to the 2000 U.S. Census
Cancer Incidence in North Carolina 1998
26 State Center for Health Statistics
Chart 2: White/Minority Trends For The Four Major Cancers
1990-1998
Lung/Bronchus Cancer
50
55
60
65
70
75
80
85
90
1990 1991 1992 1993 1994 1995 1996 1997 1998
Rate*
White Incidence
White Mortality
Minority Incidence
Minority Mortality
Colon/Rectum Cancer
0
10
20
30
40
50
60
1990 1991 1992 1993 1994 1995 1996 1997 1998
Rate*
White Incidence
White Mortality
Minority Incidence
Minority Mortality
* Rates Per 100,000 Population
Age-Adjusted to the 2000 U.S. Census
Cancer Incidence in North Carolina 1998
27 State Center for Health Statistics
Chart 2: White/Minority Trends For The Four Major Cancers
1990-1998
Female Breast Cancer
0
20
40
60
80
100
120
140
160
1990 1991 1992 1993 1994 1995 1996 1997 1998
Rate*
White Incidence
White Mortality
Minority Incidence
Minority Mortality
Female Breast Cancer
0
20
40
60
80
100
120
140
160
1990 1991 1992 1993 1994 1995 1996 1997 1998
Rate*
White Incidence
White Mortality
Minority Incidence
Minority Mortality
* Rates Per 100,000 Population
Age-Adjusted to the 2000 U.S. Census
Cancer Incidence in North Carolina 1998
28 State Center for Health Statistics
Type Cases Rate*
Melanoma(Skin) 36 6.3
Endocrine 34 6.0
Testes1 28 9.7
Female Breast1 27 9.6
Hodgkin’s Disease 27 4.7
Cervix Uteri1 20 7.1
Ages
25-29
Ages
20-24
Type Cases Rate*
Melanoma(Skin) 27 5.1
Hodgkin’s Disease 22 4.1
Testes1 21 7.6
Endocrine 10 1.9
Brain/CNS # **
Soft Tissue # **
Type Cases Rate*
Leukemia 64 4.1
Brain/CNS 52 3.4
Soft Tissue 17 1.1
Kidney 16 1.0
Endocrine 15 1.0
Ages
0-14
Type Cases Rate*
Non-Hodgkin’s Lymphoma 14 2.8
Hodgkin’s Disease 13 2.6
Brain/CNS 12 2.4
Leukemia # **
Bone # **
Endocrine # **
Ages
15-19
*Rates Per 100,000 Population
# Less than 10 cases observed.
** Rates based on less than 10 cases are unstable and therefore suppressed.
1 Sex-specic populations are used to calculate rates for sex-specic cancers.
Table 10: Five Most Frequently Diag-nosed
Cancers By Age Group
1998
The cancers listed are the
ve most frequently diag-nosed
cancers for each age
group. Different age groups
are at higher risks for dif-ferent
types of cancer. As
age increases, risk of cancer
increases.
Cancer Incidence in North Carolina 1998
29 State Center for Health Statistics
Table 10: Five Most Frequently Diag-nosed
Cancers By Age Group
1998
Ages
30-34
Type Cases Rate*
Female Breast1 94 32.8
Melanoma(Skin) 48 8.4
Testes1 36 12.7
Endocrine 32 5.6
Cervix Uteri1 32 11.2
Colon/Rectum 28 4.9
Type Cases Rate*
Female Breast1 254 82.8
Melanoma(Skin) 66 10.9
Colon/Rectum 64 10.6
Cervix Uteri1 42 13.7
Non-Hodgkin’s Lymphoma 41 6.8
Ages
35-39
Type Cases Rate*
Female Breast1 431 142.8
Lung/Bronchus 106 18.0
Melanoma(Skin) 101 17.1
Colon/Rectum 87 14.8
Endocrine 48 8.1
Ages
40-44
Ages
45-49
Type Cases Rate*
Female Breast1 637 232.8
Lung/Bronchus 190 35.6
Colon/Rectum 162 30.4
Prostate1 86 33.1
Melanoma(Skin) 82 15.4
Non-Hodgkin’s Lymphoma 82 15.4
*Rates Per 100,000 Population
** Rates based on less than 10 cases are unstable and therefore suppressed.
1 Sex-specic populations are used to calculate rates for sex-specic cancers.
Cancer Incidence in North Carolina 1998
30 State Center for Health Statistics
Table 10: Five Most Frequently Diag-nosed
Cancers By Age Group
1998
Ages
50-54
Type Cases Rate*
Female Breast1 694 291.9
Prostate1 504 287.3
Lung/Bronchus 362 78.4
Colon/Rectum 281 60.8
Melanoma(Skin) 96 20.8
Ages
55-59
Type Cases Rate*
Prostate1 728 496.1
Female Breast1 681 357.4
Lung/Bronchus 529 144.5
Colon/Rectum 301 82.2
Kidney 115 31.4
Ages
60-64
Type Cases Rate*
Prostate1 952 748.8
Lung/Bronchus 776 246.3
Female Breast1 674 400.4
Colon/Rectum 428 135.8
Bladder 147 46.7
Ages
65-69
Type Cases Rate*
Prostate1 952 748.8
Lung/Bronchus 950 335.0
Female Breast1 684 437.2
Colon/Rectum 527 185.8
Bladder 220 77.6
*Rates Per 100,000 Population
** Rates based on less than 10 cases are unstable and therefore suppressed.
1 Sex-specic populations are used to calculate rates for sex-specic cancers.
Cancer Incidence in North Carolina 1998
31 State Center for Health Statistics
Table 10: Five Most Frequently Diag-nosed
Cancers By Age Group
1998
*Rates Per 100,000 Population
** Rates based on less than 10 cases are unstable and therefore suppressed.
1 Sex-specic populations are used to calculate rates for sex-specic cancers.
Ages
70-74
Type Cases Rate*
Lung/Bronchus 1009 398.4
Prostate1 945 879.3
Female Breast1 717 491.8
Colon/Rectum 592 233.8
Bladder 224 88.4 Ages
75-79
Type Cases Rate*
Lung/Bronchus 774 396.9
Prostate1 657 873.4
Female Breast1 592 494.2
Colon/Rectum 533 273.3
Bladder 236 121.0
Ages
80-84
Type Cases Rate*
Colon/Rectum 415 331.2
Lung/Bronchus 407 324.9
Female Breast1 387 468.4
Prostate1 264 618.7
Bladder 151 120.5 Ages
85+
Type Cases Rate*
Colon/Rectum 354 339.5
Female Breast1 257 333.9
Lung/Bronchus 173 165.9
Prostate1 142 520.1
Bladder 133 127.6
Cancer Incidence in North Carolina 1998
32 State Center for Health Statistics
APPENDICES
Cancer Incidence
In
North Carolina
1998
Appendix A: Primary Site Denitions
International Classication of Disease for Oncology (ICD-O-2) Codes for Newly Diagnosed
Neoplasms
Primary Site ICD-O-2
All Sites C000-C809
Oral Cavity and Pharynx: C000-C148
v Lips C000-C009
v Tongue C019-C029
v Salivary Glands C079-C089
v Floor of Mouth C040-C049
v Nasopharynx C110-C119
v Oropharynx C100-C109
v Hypopharynx C129-C139, C141
v Other Mouth and Pharynx C030-C039, C050-C069, C090-C099, C140,
C142-C148
Digestive System: C150-C269, C480-C488
v Esophagus C150-C159
v Stomach C160-C169
v Small Intestine C170-C179
v Colon and Rectum C180-C209, C260
v Anus, Anal Cavity and Anorectum C210-C218
v Liver and Intrahepatic Bile Duct C220-C221
v Gallbladder C239
v Pancreas C250-C259
v Other Digestive Organs C240-C249, C268-C269, C480-C488
Respiratory System: C300-C399
v Larynx C320-C329
v Lung and Bronchus C340-C349
v Other Respiratory Organs C300-C319, C339, C381-C399
Bones and Joints C400-C419
Soft Tissues C380, C470-C479, C490- C499
Skin C440-C449
v Melanoma of Skin C440-C449 (M8720-M8790)
v Other Skin C440-C449 (Other histology)
Breast C500-C509
v Invasive C500-C509 (Behavior=3)
v In Situ C500-C509 (Behavior=2)
Female Genital Organs: C530-C589
v Cervix Uteri C530-C539
v Uterus (Corpus, NOS) C540-C559
v Ovary C569
v Other Female Genital Organs C510-C529, C570-C589
Male Genital Organs: C600-C639
v Prostate C619
v Testis C620-C629
v Penis C600-C609
v Other Male Genital Organs C510-C529, C570-C589
Cancer Incidence in North Carolina 1998
34 State Center for Health Statistics
Appendix A: Primary Site Denitions
International Classication of Disease for Oncology (ICD-O-2) Codes for Newly Diagnosed
Neoplasms
Primary Site ICD-O-2
Urinary System: C649-C689
v Bladder C670-C679
v Kidney and Renal Pelvis C649-C659
v Ureter C669
v Other Urinary System C630-C639
Eye & Orbit: C690-C699
Brain & Central Nervous System (CNS): C700-C729
Endocrine System: C379, C739-C759
v Thyroid C739
v Other Endocrine and Thymus C379, C740-C759
Lymphomas: M9590-M9714
v Hodgkin’s Disease M9650-M9667
v Non-Hodgkin’s M9590-M9595, M9670-M9714
Multiple Myeloma: M9730-M9732
Leukemia: M9800-M9941
v Acute Lymphocytic M9821
v Chronic Lymphocytic M9823
v Acute Myeloid M9861, M9867
v Chronic Myeloid M9863, M9868
v Other Leukemia M9800-M9820, M9822, M9824-M9860,
M9862, M9864-M9866, M9870-M9941
Ill-Dened & Unspecied C760-C768, C809
M9720-M9723, M9740-M9741, M9760-
M9764, M9950-M9989
C420-C424 (M8000-M9589)
C770-C779 (M8000-M9589)
Note: Except for lymphoma, multiple myeloma, and leukemia, all categorized sites exclude
M9590-M9989 unless otherwise stated.
Cancer Incidence in North Carolina 1998
35 State Center for Health Statistics
Appendix B: Mathematical Formulae
Mathematical denitions:
Age Group (I):
0-4 45-49
5-9 50-54
10-14 55-59
15-19 60-64
20-24 65-69
25-29 70-74
30-34 74-79
35-39 80-84
40-44 85+
Age-specic rate:
rig = (cig/nig)*100,000
where rig is the age-specic rate for age group (i) and/or gender group (g), cig is the count of cases for
that age group (i) and/or gender group (g), and nig is the count of persons at risk (i.e., the population)
for that age group (i) and/or gender group (g); rates in all tables are presented per 100,000.
Observed:
♦ Male Observed = Number of males with cancer
♦ Female Observed = Number of females with cancer
Age-adjusted rate:
85+
A.A.R. = Σ (wIrI)
I=0-4
where wI is the proportion of the age group in the 2000 U.S. Standard and rI is the age-specic
rate for age group.
Cancer Incidence in North Carolina 1998
36 State Center for Health Statistics
County White Males White Females Minority Males Minority Females
Alamance 46480 50232 11403 13549
Alexander 14979 14901 944 1078
Alleghany 4685 4999 80 90
Anson 5953 6307 5314 6450
Ashe 11415 12092 91 100
Avery 7550 7575 136 58
Beaufort 14447 15528 6135 7434
Bertie 3453 3843 5676 7060
Bladen 8537 9388 5742 7103
Brunswick 27661 28588 5151 5914
Buncombe 84012 91852 8210 9210
Burke 37737 38932 3729 3698
Cabarrus 51330 53570 7525 8249
Caldwell 34949 35991 2189 2275
Camden 2607 2427 661 683
Carteret 26656 27208 2536 2866
Caswell 6695 7020 4179 4486
Catawba 57535 60086 6666 7262
Chatham 17697 18629 4505 5107
Cherokee 10431 11326 556 469
Chowan 4373 4819 2282 2908
Clay 3912 4232 45 49
Cleveland 34485 36878 9667 10776
Columbus 16273 18002 8104 9787
Craven 33018 32115 11180 12695
Cumberland 95261 84976 53919 58588
Currituck 7800 7684 840 840
Dare 13492 13689 497 462
Davidson 62518 63785 7158 7913
Davie 14403 14922 1391 1440
Duplin 14703 14976 6674 7897
Durham 58081 61887 36994 43806
Edgecombe 10290 11407 14401 18604
Forsyth 101284 111065 35731 41616
Franklin 14792 15401 6586 7659
Gaston 75249 79299 12235 14262
Gates 3079 2978 1848 2088
Graham 3413 3437 280 332
Granville 14227 14235 7838 8210
Greene 5592 5333 3754 3666
Guilford 130943 142793 52747 61620
Halifax 11844 12892 14343 16343
Harnett 31272 32567 9265 10486
Haywood 24020 26585 485 528
Henderson 36945 40497 1668 1775
Hertford 3898 4366 5927 7371
Hoke 6698 6175 8452 8713
Hyde 1965 1978 832 966
Iredell 46725 48642 8392 9757
Jackson 12310 13572 1852 1824
Appendix C: Population Total By County And Race
North Carolina, 1998
Cancer Incidence in North Carolina 1998
37 State Center for Health Statistics
County White Males White Females Minority Males Minority Females
Johnston 43919 45258 8484 10056
Jones 2807 3022 1539 1897
Lee 18012 18739 5598 6409
Lenoir 16641 17820 10569 13561
Lincoln 26786 27345 2427 2526
McDowell 18605 19406 1048 1054
Macon 13110 14379 338 325
Madison 9204 9394 109 85
Martin 6742 7357 5296 6237
Mecklenburg 217222 226271 83966 97068
Mitchell 6951 7611 34 29
Montgomery 9035 8669 3702 3315
Moore 27707 30449 5941 6717
Nash 29201 31152 12717 15042
New Hanover 56678 61266 13616 16810
Northampton 4322 4400 5626 6404
Onslow 66562 46908 19795 15742
Orange 42629 47096 9232 10331
Pamlico 4569 4724 1226 1577
Pasquotank 10065 11177 6115 7409
Pender 13870 14222 4557 5465
Perquimans 3785 3897 1492 1773
Person 11223 11986 4732 5357
Pitt 40610 42936 19576 23521
Polk 7215 8312 536 604
Randolph 56786 58845 4105 4406
Richmond 14757 15705 6994 8051
Robeson 18608 20114 35397 40311
Rockingham 33922 36775 8712 10242
Rowan 50593 52426 10298 11400
Rutherford 25743 27290 3348 3675
Sampson 16890 17912 8361 10149
Scotland 9090 10051 7158 8902
Stanly 23505 24849 3415 3837
Stokes 20185 20819 1082 1112
Surry 31132 33566 1428 1802
Swain 4180 4190 1992 1806
Transylvania 13031 13788 724 773
Tyrrell 1126 1184 741 844
Union 45710 46617 8354 9429
Vance 10545 11582 9013 10550
Wake 217950 223920 62833 70125
Warren 3718 3826 5377 5995
Washington 3243 3554 2912 3394
Watauga 19352 20408 609 567
Wayne 39730 35635 17705 20230
Wilkes 29482 30509 1529 1797
Wilson 20148 21836 12148 15251
Yadkin 16590 17534 737 796
Yancey 7927 8469 104 80
North Carolina 2809087 2916881 850162 970960
Appendix C: Population Total By County And Race
North Carolina, 1998
Cancer Incidence in North Carolina 1998
38 State Center for Health Statistics
Ages 0-4 69135
Ages 5-9 72532
Ages 10-14 73032
Ages 15-19 72168
Ages 20-24 66478
Ages 25-29 64530
Ages 30-34 71044
Ages 35-39 80762
Ages 40-44 81851
Ages 45-49 72118
Ages 50-54 62716
Ages 55-59 48454
Ages 60-64 38793
Ages 65-69 34264
Ages 70-74 31773
Ages 75-79 27000
Ages 80-84 17842
Ages 85+ 15508
Appendix D: U.S. Standard Million Population
2000
Source: U.S. Bureau of the Census, Census of Population: 2000.
Cancer Incidence in North Carolina 1998
39 State Center for Health Statistics