Cancer incidence in North Carolina: county-specific numbers |
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Cancer Incidence in North Carolina 2005 State Center for Health Statistics August 2008 Contributing Editor Gerri McLaughlin STATE OF NORTH CAROLINA Michael F. Easley, Governor DEPARTMENT OF HEALTH AND HUMAN SERVICES Dempsey Benton, Secretary DIVISION OF PUBLIC HEALTH Leah Devlin, D.D.S, MPH, Director STATE CENTER FOR HEALTH STATISTICS Paul Buescher, Ph.D., Director CENTRAL CANCER REGISTRY Karen Knight, M.S., Director Chandrika Rao, Ph.D. Asst. Director www.ncdhhs.gov N.C. DHHS is an equal opportunity provider and employer, 8/08 Table of Contents Introduction Background ....................................................................................................................................................1 Purpose ..........................................................................................................................................................1 Confidentiality................................................................................................................................................1 Technical Notes Overview and Definitions...............................................................................................................................2 Cancer Incidence and Mortality ................................................................................................................ 2 Differences in Reporting Cancer ............................................................................................................... 3 Incidence Rates......................................................................................................................................... 3 Race/Gender Specific Cases and Rates ..................................................................................................... 5 Reliability of Rates................................................................................................................................... 6 Morphology (Cell Type) and Behavior ..................................................................................................... 6 Limitations of Data ........................................................................................................................................7 Small Numbers......................................................................................................................................... 7 Interpretation ............................................................................................................................................ 8 Comparison to National Data .........................................................................................................................8 Available Cancer Information........................................................................................................................8 Support for Cancer Research and Control......................................................................................................9 Tables/Charts Table 1: Incidence Rates by Sex ..................................................................................................................10 Table 2: Ten Most Frequently Diagnosed Cancers by Sex ..........................................................................11 Table 3: Incidence Rates by Race ................................................................................................................12 Table 4: Ten Most Frequently Diagnosed Cancers by Race ........................................................................13 Table 5: Cancer Incidence and Mortality Rates by County..........................................................................14 Table 6: Colon/Rectum Incidence Rates by County ....................................................................................16 Table 7: Lung/Bronchus Incidence Rates by County...................................................................................18 Table 8: Female Breast Incidence Rates by County.....................................................................................20 Table 9: Prostate Incidence Rates By County ..............................................................................................22 Table 10: Five Most Frequently Diagnosed Cancers by Age Group…………………………….. …......... 24 Table 11: Cancer Incidence Rates by Race and Ethnicity.............................................................................26 Chart 1: Trends for the Four Major Cancers ................................................................................................27 Chart 2: White/Minority Trends for the Four Major Cancers ......................................................................29 Appendices Appendix A: Primary Site Definitions........................................................................................................31 Appendix B: Mathematical Formulae.........................................................................................................33 Appendix C: 2005 Population by County and Race....................................................................................34 Appendix D: 2000 U.S. Standard Million Population.................................................................................36 Cancer Incidence in North Carolina, 2005 State Center for Health Statistics N.C. Division of Public Health Introduction Background The North Carolina Central Cancer Registry (CCR), located within the State Center for Health Statistics, was established in 1986. The CCR operates under the authority granted in North Carolina General Statute 130A-208. 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. Calendar year 1990 is the first 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 information on newly diagnosed cancer patients in North Carolina with respect to demographics and medical characteristics. There are 132 hospitals in North Carolina which routinely diagnose and treat cancer patients; more than 58 of these hospitals have their own tumor registries. One hundred and eighty five facilities reported their 2005 incidence data to the CCR. Incidence data are reported to the CCR by a secure internet-based database. Purpose Cancer Incidence in North Carolina 2005 is the twelth annual report of the CCR. The contents of this report represent a summary of the information collected on cancer diagnosed among North Carolina residents in 2005. Previous volumes are located on the State Center for Health Statistics web site located at http://www.schs.state.nc.us/SCHS/data/cancer.cfm, under the title “Cancer Incidence in North Carolina, County-Specific Numbers.” Confidentiality The CCR is committed to preserving the confidentiality of information obtained for medical, educational, research, and statistical purposes. Thus the CCR demands strict confidentiality and the protection of the identity of both cancer patients and reporting sources in registry data. The CCR does not release any identifying information regarding patients, hospitals, or physicians except under the authority of the General Statute guidelines. Cancer Incidence in North Carolina 2005 State Center for Health Statistics N.C. Division of Public Health 1 Technical Notes Overview and Definitions This report presents frequency counts, age-specific 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 mortality is the number of deaths due to cancer for each county. See Figure 1. We assume that death certificates provide complete and accurate data on all causes of death. However, the accuracy of recording the cause of death varies for many cancers. For example, at the time of death, the history of cancer may not be known by the physician, or may not be considered to have contributed to the death. Nonetheless, mortality data have been historically used widely to analyze cancer risk in populations. Instances of under-reporting of cancer incidence have occurred. For some cancers (e.g., melanomas), under-reporting may lead to more cancer deaths being shown than incidence cases. Also, survival following a cancer diagnosis varies by cancer site. In populations with low use of health care services (e.g., rural and minority populations), more cancers are diagnosed at advanced stages when therapies are less successful; or the cases may not be diagnosed until death. Figure 1. Number of Cancer Cases and Deaths in North Carolina, 2005 0 1,000 2,000 3,000 4,000 5,000 6,000 7,000 8,000 COLON/RECTUM LUNG/BRONCHUS FEMALE BREAST PROSTATE Incidence Mortality Cancer incidence, mortality, and age-adjusted rates for each county are presented in Table 5 and presented by site in Tables 6-9 for colon/rectum, lung/bronchus, female breast, and prostate cancers, respectively. Cancer Incidence in North Carolina 2005 State Center for Health Statistics N.C. Division of Public Health 2 Differences in Reporting Cancer Incidence and Mortality Data Many people living near the Virginia border go outside North Carolina for health care. It is known that Norfolk and Danville, Virginia attract patients for secondary and tertiary care. The State of North Carolina has an exchange agreement with all 50 states for exchanging death certificates, but only has an exchange agreement for cancer incidence data with 24 states, including our border states of Virginia, Tennessee and South Carolina. Because death certificate data are available more quickly than incidence data, the 2005 mortality data include deaths of North Carolina residents who died in other states, but the incidence data may not include all cases diagnosed out-of-state. Some counties have been found to under-report their cancer incidence due to poor case-finding procedures. These counties, especially rural counties where small hospitals do not have the services of trained tumor registrars, may have inadequate case finding. This results in incomplete reporting of new cancer cases. Death data are considered to be complete. This also contributes 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. In the last few years, more cases are being diagnosed and treated outside of a hospital, in physician offices. This is particularly true for cancers of the skin and prostate, as well as some lymphoma and leukemia cases. Although physicians are required to report all cases to the CCR, many of them do not have the staff to do so. Physicians associated with a hospital will often report cases via a hospital registrar, but those not affiliated with a hospital may not report cases to the CCR. As a result, reporting for some cancers is known to be incomplete. Due to recent efforts by the CCR to improve the completeness of reporting by physician offices and pathology laboratories, the incidence of melanoma and prostate cancers has increased. Incidence Rates Two types of rates are presented in this report: age-adjusted and age-specific, each of which has a specific purpose. Both rates are expressed in this report as annual or five-year rates per 100,000 population. Age-Adjusted Rates An age-adjusted rate accurately describes the cancer experience that the population would have had if it had exactly the same age distribution as the comparison or 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-specific rate by the proportion of people within that age group in the standard population and then summing these products. Age-adjusted rates should not be compared with any other type of rate or be used as Cancer Incidence in North Carolina 2005 State Center for Health Statistics N.C. Division of Public Health 3 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 standard population used in the calculation was the 2000 United States Census population. Incidence and mortality rates for 2005 used the bridged-race population estimates obtained from the National Center for Health Statistics (NCHS), available online at http://www.cdc.gov/nchs/about/major/dvs/popbridge/popbridge.htm. Incidence reports published prior to 2005 were calculated using the State Demographer’s population estimates. Hence, rates from previous diagnosis years may differ slightly due to this factor. Age-Specific Rates The age-specific cancer incidence is the number of cancer cases that occur in the age groups from 0-4 to 85+. Age-specific rates are used to compare rates between different population groups of the same age and to examine age patterns for particular cancers. As expected, age-specific rates have a general tendency to increase with age. More than half of cancer cases occur among persons age 65 and older (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 proportionate concentrations 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, endocrine, and lymphomas are the main cancers in people under age 20. In general, North Carolina’s pediatric cancer patterns are quite consistent with national patterns. Young adults (20-44) have a 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 younger age groups is the subject of considerable research at this time. All cancer rates are at a maximum in the 70+ age categories. Prostate cancer is almost exclusively a disease of older men. These age-specific patterns offer significant 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 the access to screening services in this state. Older and underprivileged people are priority groups for these programs. Cancer Incidence in North Carolina 2005 State Center for Health Statistics N.C. Division of Public Health 4 Age-specific cancer incidence and rates are presented in Table 10. The age-specific incidence rates demonstrate how cancer is a disease primarily of the older population. Figure 2: Percentage of North Carolina Cancer Cases by Age Group, 2005 0 to19 1% 20 to 44 9% 65 and older 51% 45 to 64 39% 0 to19 20 to 44 45 to 64 65 and older Race/Gender Specific Cases and Rates The race/gender-specific cancer incidence is the number of cancer cases that occurred in each race/gender group. See Figure 3. These data are provided because race is an important factor in interpreting cancer patterns in North Carolina. Cancer rates vary by race, race distributions vary across the state, and health care use has been found to vary by race. Because cancer risk is strongly associated with lifestyle and behavior, differences among 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 involved in the development of cancer. Cancer cases and age-adjusted rates for North Carolina are presented by gender in Table 1 and by race in Table 3. Cancer Incidence in North Carolina 2005 State Center for Health Statistics N.C. Division of Public Health 5 Figure 3: Number of North Carolina Cancer Cases by Gender and Race, 2005 0 2,000 4,000 6,000 8,000 10,000 12,000 14,000 16,000 18,000 Female Male Number of Cases Other Black White Reliability of Rates Precautions should always be taken when comparing rates. Both the size of the numbers and the size 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 the section titled “Small Numbers” on page 7. Age-adjusted rates offer a standard method to compare cancer risk across geographic areas or time periods. However, there are limitations to their use and one should be familiar with these types of rates before using them. As already mentioned, age-adjusted rates are to be used only for comparison purposes and only if the same standard population was used in the calculation. This publication uses the 2000 U.S. Census as the standard population. For assistance in interpreting these data, please contact the CCR statistical staff at (919) 715- 4574. Morphology (Cell Type) and Behavior The specific morphology codes for these primary site categories have been provided in the Appendix in the table “Primary Site Definitions” to clarify counting of these cases. The lymphoma category includes all lymphoma cases with the morphology codes shown regardless of body site. 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. Please note that lymphomas are not grouped consistently by all researchers. In these data, only malignant tumors are included. Data on benign central nervous system and brain and unspecified types are also reported to the CCR and are included in this report. Only invasive cervical cancer cases are Cancer Incidence in North Carolina 2005 State Center for Health Statistics N.C. Division of Public Health 6 included. Also, in situ cancers except those of the urinary bladder and female breast are excluded in the report. Limitations of Data The user should be cautious when making county-to-county comparisons of the data in this report. Under-reporting in areas close to neighboring states and under-reporting for cancers that may not be diagnosed in hospitals must be considered when interpreting cancer incidence data. In addition, comparison of rates (computed with the number of cases and population data) can be problematic. The age distributions and racial percentages in counties vary considerably. Consider a comparison of Henderson and Orange counties. In 2005 over 22% percent of the Henderson County population was at least 65 years old, while less than 10% percent of the Orange County population was 65 and over. A larger proportion of the Henderson County population can be expected to have cancer than the Orange County population just because of the difference in the age pattern for these two counties. The use of age-adjusted rates will facilitate comparisons of risk. On the other hand, almost 65% percent of Hertford County’s population was comprised of minorities while over 97% percent of Ashe County’s population is white. This difference in the racial composition of the populations of the two counties can also have a marked influence on the patterns of cancer incidence and mortality. Age-adjusted rates control for differences in the age structures of populations, but they do not control for differences in racial composition. Interpretations of melanoma data should be treated with caution since the thoroughness of case-finding is suspect due to the likelihood that cases may be treated outside of hospitals and not reported to the CCR. 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 2001 and 2005, there were 6 cases of female breast cancer in Tyrrell County reported to the CCR. The majority of the cases were reported in 2001. It would appear that the county had an excessive amount of breast cancer in females in 2001. However, over the five-year period, the county averages to what was expected. All statistics are subject to chance variation. Rates based on a very small number of events over a specified period of time or for a sparsely populated geographic area should be of particular concern and caution. 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. Cancer Incidence in North Carolina 2005 State Center for Health Statistics N.C. Division of Public Health 7 Interpretation This descriptive report is intended to serve as a baseline report for future reference. Because of the limitations described above, this publication should not be regarded as a definitive description of the cancer incidence in North Carolina. With additional training of hospital staff, collaboration from neighboring states, and increased physician and pathology laboratories reporting, the problems of under-reporting have declined. Although there are important limitations in the use of these data, the observed number of cases within a gender group in a specific county can be used for: ♦ planning health services at the county level; ♦ identifying high cancer incidence within a county; ♦ educating the public; ♦ motivating facilities such as hospitals and physicians to report incidence data accurately and in a timely manner; and ♦ encouraging more hospitals to organize tumor registries to provide better service to their cancer patients. Comparison to National Data This report was prepared to provide data for evaluation of cancer incidence and mortality patterns in North Carolina. The Annual Report to the Nation on the Status of Cancer, 1975-2004, produced by the North American Association of Cancer Registries (NAACCR) and the National Program of Cancer Registries (NPCR) at http://www.cdc.gov/cancer/npcr/index.htm) is available for comparison with North Carolina’s observed incidence cases for 2004 and previous years. Available Cancer Information Cancer is the second leading cause of death (first being heart disease) in the United States. In 2006, cancer was the leading cause of death in North Carolina. It is estimated that by the year 2015, cancer will be the leading cause of death in the United States. Cancer is expected to strike one in three people sometime during their lifetime. For more information about cancer, contact a local office of the American Cancer Society or call 1-800- ACS-2345. Many communities 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 programs. Another source of information on cancer is the Cancer Information Service, 1-800-4CANCER (1-800-422-6237). The Cancer Information Service, located at Duke University, is a national program funded by the National Cancer Institute that provides cancer information. The CCR produces other reports on cancer in North Carolina, many of which are available on the website at http://www.schs.state.nc.us/SCHS/CCR/. A notable one is the American Cancer Cancer Incidence in North Carolina 2005 State Center for Health Statistics N.C. Division of Public Health 8 Society’s South Atlantic Division Cancer Facts and Figures available on the website at http://health.state.ga.us/pdfs/chronic/cancer/ACSSAD07.pdf. Also, other units with the State Center for Health Statistics (SCHS) publish many reports on other diseases and on health care measures. For more information about other reports from the CCR please call (919) 715-4574. For information from other programs 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 within the state. One feature of this participation is the rapid identification of cancer patients for projects that are designed to collect information before the patient’s first 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 for cancer survivors. Still others are working to understand and reduce the racial/ethnic gaps in cancer diagnosis and mortality. The state Comprehensive Cancer Control Program and the Breast and Cervical Cancer Control Program are located in the Chronic Disease and Injury Section of the North Carolina Division of Public Health and are state agencies committed to reducing the cancer burden among North Carolinians. The CCR provides statistical and data analysis support for these programs. Also, the CCR is associated with organizations such as the American Cancer Society and the state’s Advisory Committee for Cancer Coordination and Control. Cancer Incidence in North Carolina 2005 State Center for Health Statistics N.C. Division of Public Health 9 Site Cases Rate 1 Cases Rate 1 All Sites 21,689 563.3 21,640 447.0 Oral Cavity and Pharynx 713 17.5 306 6.3 Lip 29 0.8 * * Tongue 183 4.5 81 1.7 Salivary Glands 60 1.6 36 0.8 Floor of Mouth 41 1.0 20 0.4 Nasopharynx 30 0.7 * * Oropharynx 47 1.1 11 0.2 Hypopharynx 60 1.5 24 0.5 Other Mouth and Pharynx 263 6.3 116 2.4 Digestive System 3,913 102.6 3,389 68.5 Esophagus 318 8.1 114 2.3 Stomach 322 8.6 193 3.9 Small Instestine 105 2.6 85 1.7 Colon and Rectum 2,197 57.9 2,067 41.8 Anus and Anal Canal 48 1.2 84 1.7 Liver and Intrahepatic Bile Duct 324 8.2 141 2.9 Gallbladder 17 0.5 53 1.0 Pancreas 490 13.2 506 10.2 Other Digestive Organs 92 2.5 146 3.0 Respiratory System 4,258 112.6 2,992 60.8 Larynx 330 8.3 90 1.9 Lung and Bronchus 3,845 102.0 2,854 57.9 Other Respiratory Organs 83 2.2 48 1.0 Bones and Joints 45 1.1 31 0.7 Soft Tissues 159 4.0 127 2.7 Melanoma of the Skin 944 24.2 757 16.2 Breast 64 1.6 7,098 147.5 Invasive Breast 51 1.3 5,786 120.3 In Situ Breast 13 0.3 1,312 27.3 Female Genital System . . 2,148 44.6 Cervix Uteri . . 378 8.2 Uterus (Corpus, NOS) . . 1,004 20.5 Ovary . . 599 12.4 Other Female Genital Organs . . 167 3.4 Male Genital System 6,021 153.5 . . Prostate 5,780 147.8 . . Testis 201 4.6 . . Penis 29 0.8 . . Other Male Genital Organs 11 0.3 . . Urinary System 2,157 57.6 1,011 20.6 Bladder (incl. in situ) 1,248 34.6 437 8.8 Kidney and Renal Pelvis 872 22.0 549 11.3 Ureter 29 0.8 18 0.4 Other Urinary System * * * * Eye and Orbit 51 1.3 37 0.8 Brain and CNS (incudes benign brain/CNS) 580 14.3 749 15.7 Endocrine System 293 7.0 755 16.7 Thyroid 178 4.2 611 13.5 Other Endocrine and Thymus 115 2.7 144 3.2 Lymphomas 951 24.6 838 17.4 Hodgkins Disease 119 2.8 105 2.3 Non-Hodgkin's Lymphoma 832 21.8 733 15.1 Multiple Myeloma 283 7.4 249 5.0 Leukemia 526 13.9 467 9.7 Acute Lymphocytic Leukemia 60 1.4 49 1.2 Chronic Lymphocytic Leukemia 178 4.8 140 2.8 Acute Myeloid Leukemia 147 3.8 148 3.1 Chronic Myeloid Leukemia 60 1.6 48 1.0 Other Leukemia 81 2.3 82 1.7 Ill-Defined and Unspecified 654 17.9 328 12.5 All Other Cancers-Uncategorized 77 2.1 58 1.2 1 Rates per 100,000 Population and are age-adjusted to the 2000 U.S. Census Table 1: 2005 Incidence Rates By Sex Males Females * Cases less than 5 are suppressed. In situ cancers except those of the urinary bladder and female breast are excluded Rates are based on the bridged-race population estimates obtained from the National Center for Health Statistics (Vintage 2006, available online at http://www.cdc.gov/nchs/about/major/dvs/popbridge/popbridge.htm) Cancer Incidence in North Carolina 2005 State Center for Health Statistics N.C. Division of Public Health 10 Cancer Cases Rate¹ Deaths Rate¹ Prostate 28,757 156.1 4,341 30.2 Lung/Bronchus 18,082 100.9 15,010 85.4 Colon/Rectum 10,285 57.4 3,759 22.2 Bladder 5,950 34.8 1,078 7.0 Melanoma (skin) 3,975 21.3 740 4.1 Kidney 3,854 20.5 1,161 6.7 3,822 20.9 1,533 9.0 Oral Cavity 3,311 17.2 771 4.2 Leukemia 2,477 13.8 1,606 9.6 Pancreas 2,259 12.8 2,237 12.8 Cancer Cases Rate¹ Deaths Rate¹ Female Breast 34,156 148.2 6,026 25.6 Lung/Bronchus 12,832 54.4 9,846 41.5 Colon/Rectum 9,959 41.9 3,793 15.6 Corpus Uteri 4,839 20.7 961 4.0 3,520 15.0 1,407 5.8 Melanoma (Skin) 3,022 13.4 463 2.0 Ovary 2,850 12.2 2,080 8.7 Endocrine 2,554 11.6 129 0.6 Kidney 2,327 10.0 643 2.7 Pancreas 2,311 9.6 2,246 9.3 1 Rates per 100,000 Population are age-adjusted to the 2000 U.S. Census Non-Hodgkin's Lymphoma Table 2: 2001 - 2005 Ten Most Frequently Diagnosed Cancers By Sex Males Incidence Mortality In situ cancers except those of the urinary bladder and female breast are excluded. Rates are based on the bridged-race population estimates obtained from the National Center for Health Statistics (Vintage 2006, available online at http://www.cdc.gov/nchs/about/major/dvs/popbridge/popbridge.htm) Non-Hodgkin's Lymphoma Females Incidence Mortality Cancer Incidence in North Carolina 2005 State Center for Health Statistics N.C. Division of Public Health 11 Site Cases Rate 1 Cases Rate 1 All Sites 34,559 490.1 8,504 484.7 Oral Cavity and Pharynx 786 11.1 230 12.3 Lip 36 0.5 * * Tongue 224 3.2 39 2.2 Salivary Glands 73 1.0 23 1.3 Floor of Mouth 51 0.7 10 0.5 Nasopharynx 27 0.4 12 0.6 Oropharynx 32 0.4 26 1.4 Hypopharynx 61 0.8 23 1.2 Other Mouth and Pharynx 282 4.0 95 5.1 Digestive System 5,611 79.5 1,651 97.1 Esophagus 333 4.7 96 5.5 Stomach 334 4.8 180 11.0 Small Instestine 140 2.0 49 2.7 Colon and Rectum 3,353 47.5 891 52.3 Anus and Anal Canal 114 1.6 18 0.9 Liver and Intrahepatic Bile Duct 323 4.6 137 7.5 Gallbladder 53 0.8 17 1.1 Pancreas 757 10.7 231 14.3 Other Digestive Organs 204 2.9 32 1.9 Respiratory System 5,949 83.6 1,271 74.9 Larynx 300 4.1 118 6.9 Lung and Bronchus 5,539 77.9 1,132 66.9 Other Respiratory Organs 110 1.6 21 1.2 Bones and Joints 64 1.0 12 0.6 Soft Tissues 219 3.2 64 3.2 Melanoma of the Skin 1,652 23.9 15 0.9 Breast 5,625 79.7 1,508 81.9 Invasive Breast 4,585 65.1 1,229 67.0 In Situ Breast 1,040 14.7 279 14.9 Female Genital System 1,694 24.0 440 24.8 Cervix Uteri 272 7.8 102 9.6 Uterus (Corpus, NOS) 799 20.7 200 20.2 Ovary 485 12.8 110 10.5 Other Female Genital Organs 138 3.6 28 2.6 Male Genital System 4,458 61.9 1,513 88.6 Prostate 4,253 132.0 1,478 214.5 Testis 178 5.4 23 2.3 Penis 21 0.7 * * Other Male Genital Organs * * * * Urinary System 2,674 37.9 486 28.2 Bladder (incl. in situ) 1,505 21.4 175 11.0 Kidney and Renal Pelvis 1,113 15.7 305 16.9 Ureter 46 0.7 * * Other Urinary System 10 0.1 * * Eye and Orbit 80 1.2 * * Brain and CNS (includes benign brain/CNS) 1,104 16.0 218 11.6 Endocrine System 834 12.3 209 10.4 Thyroid 640 9.5 144 7.1 Other Endocrine and Thymus 194 2.8 65 3.3 Lymphomas 1,523 21.9 259 13.6 Hodgkins Disease 180 2.7 42 1.9 Non-Hodgkin's Lymphoma 1,343 19.2 217 11.7 Multiple Myeloma 350 5.0 179 10.6 Leukemia 836 12.1 147 8.2 Acute Lymphocytic Leukemia 87 1.4 19 0.9 Chronic Lymphocytic Leukemia 272 3.8 43 2.6 Acute Myeloid Leukemia 260 3.7 33 1.8 Chronic Myeloid Leukemia 86 1.3 22 1.2 Other Leukemia 131 1.9 30 1.7 Ill-Defined and Unspecified 998 14.3 266 15.9 All Other Cancers-Uncategorized 102 1.5 29 1.4 In situ cancers except those of the urinary bladder and female breast are excluded. Table 3: 2005 Incidence Rates By Race Whites Minorities 1 Rates per 100,000 Population and are age-adjusted to the 2000 U.S. Census * Cases less than 5 are suppressed. Rates are based on the bridged-race population estimates obtained from the National Center for Health Statistics (Vintage 2006, available online at http://www.cdc.gov/nchs/about/major/dvs/popbridge/popbridge.htm) Cancer Incidence in North Carolina 2005 State Center for Health Statistics N.C. Division of Public Health 12 Cancer Cases Rate1 Deaths Rate1 Female Breast 27,342 150.5 4,458 23.6 Lung/Bronchus 25,545 74.9 20,408 60.1 Prostate 21,053 138.2 2,854 23.8 Colon/Rectum 15,853 46.9 5,753 17.2 Bladder 7,198 21.3 1,374 4.1 Melanoma (skin) 6,843 20.5 1,159 3.5 6,240 18.6 2,549 7.6 Kidney 4,874 14.3 1,461 4.3 Corpus Uteri 3,854 20.9 666 3.4 Leukemia 3,726 11.3 2,420 7.3 Cancer Cases Rate1 Deaths Rate1 Prostate 7,534 237.4 1,487 63.5 Female Breast 6,717 136.0 1,568 32.2 Lung/Bronchus 5,317 66.9 4,448 57.0 Colon/Rectum 4,341 54.5 1,799 23.4 Kidney 1,299 15.4 343 4.4 1,084 12.5 391 5.0 Oral Cavity 1,081 12.3 320 3.8 Pancreas 1,055 13.7 1,019 13.5 Corpus Uteri 974 20.7 295 6.5 Bladder 828 11.0 256 3.5 1 Rates per 100,000 Population are age-adjusted to the 2000 U.S. Census Non-Hodgkin's Lymphoma Minorities Table 4: 2001-2005 Ten Most Frequently Diagnosed Cancers By Race Whites Incidence Mortality Incidence Mortality In situ cancers except those of the urinary bladder and female breast are excluded. Rates are based on the bridged-race population estimates obtained from the National Center for Health Statistics (Vintage 2006, available online at http://www.cdc.gov/nchs/about/major/dvs/popbridge/popbridge.htm) Non-Hodgkin's Lymphoma Cancer Incidence in North Carolina 2005 State Center for Health Statistics N.C. Division of Public Health 13 County Cases Rate 1 Deaths Rate 1 NORTH CAROLINA 43,335 492.2 16,675 192.5 Alamance 748 495.9 295 188.8 Alexander 197 507.3 62 167.7 Alleghany 57 362.8 28 175.4 Anson 117 417.8 57 201.6 Ashe 180 515.9 65 179.5 Avery 110 496.5 44 190.9 Beaufort 318 544.8 148 249.3 Bertie 106 450.7 54 224.9 Bladen 165 440.7 88 244.5 Brunswick 528 460.4 238 204.6 Buncombe 1,316 505.2 479 179.5 Burke 439 431.4 212 207.2 Cabarrus 820 581.2 297 215.1 Caldwell 442 499.9 181 205.5 Camden 48 554.9 16 178.0 Carteret 434 526.2 169 202.3 Caswell 96 349.3 54 189.0 Catawba 795 497.4 290 183.3 Chatham 285 451.0 97 147.8 Cherokee 165 433.6 78 198.2 Chowan 80 426.5 48 239.4 Clay 79 556.0 22 132.7 Cleveland 563 508.1 194 174.5 Columbus 286 455.4 113 179.9 Craven 562 553.8 214 211.1 Cumberland 1,179 478.6 464 201.5 Currituck 81 349.9 46 201.9 Dare 150 379.8 72 189.6 Davidson 844 503.4 330 200.5 Davie 223 503.5 74 164.3 Duplin 224 418.0 121 225.1 Durham 1,084 516.7 383 190.7 Edgecombe 340 604.7 131 238.9 Forsyth 1,770 527.4 667 200.6 Franklin 249 481.1 123 250.8 Gaston 1,132 544.9 402 197.9 Gates 39 297.0 31 250.2 Graham 40 355.0 20 178.7 Granville 326 620.2 127 246.4 Greene 89 454.2 46 236.3 Guilford 2,313 517.2 766 172.8 Halifax 321 490.5 151 226.1 Harnett 404 454.9 151 178.9 Haywood 430 560.3 159 189.4 Henderson 682 493.4 277 183.8 Hertford 120 435.4 75 278.3 Hoke 152 526.3 58 220.1 Hyde 38 577.6 20 279.9 Iredell 684 468.9 271 189.3 Jackson 174 454.0 67 176.7 Report includes benign brain/CNS. Table 5 : 2005 Total Cancer Incidence and Mortality Rates By County Rates are based on the bridged-race population estimates obtained from the National Center for Health Statistics (Vintage 2006, available online at http://www.cdc.gov/nchs/about/major/dvs/popbridge/popbridge.htm) * Cases less than 5 are suppressed. 1 Rates per 100,000 Population and are age-adjusted to the 2000 U.S. Census In situ cancers are excluded. Cancer Incidence in North Carolina 2005 State Center for Health Statistics N.C. Division of Public Health 14 County Cases Rate 1 Deaths Rate 1 NORTH CAROLINA 43,335 492.2 16,675 192.5 Johnston 591 459.9 220 185.7 Jones 45 350.8 22 164.5 Lee 286 469.0 104 172.3 Lenoir 392 572.3 145 205.0 Lincoln 374 526.4 142 208.0 McDowell 255 510.7 93 183.9 Macon 192 399.4 92 177.0 Madison 123 471.7 61 225.4 Martin 154 517.8 70 228.2 Mecklenburg 3,042 461.2 1,052 177.0 Mitchell 104 478.9 42 179.6 Montgomery 115 384.3 51 169.6 Moore 604 524.1 246 195.9 Nash 498 500.5 194 196.4 New Hanover 902 471.0 344 179.1 Northampton 112 383.7 68 223.6 Onslow 560 553.4 211 221.6 Orange 549 527.2 185 187.3 Pamlico 96 523.9 41 218.5 Pasquotank 191 481.7 88 215.4 Pender 225 416.5 106 199.7 Perquimans 89 529.9 32 187.2 Person 209 511.1 90 222.2 Pitt 616 512.0 246 209.5 Polk 108 369.7 69 194.1 Randolph 716 490.7 269 188.5 Richmond 258 507.2 102 196.8 Robeson 536 465.9 243 218.4 Rockingham 524 474.8 211 189.1 Rowan 733 495.6 295 193.4 Rutherford 387 497.0 169 208.3 Sampson 281 434.3 117 182.7 Scotland 125 335.2 85 234.5 Stanly 366 545.4 131 195.4 Stokes 248 480.1 97 189.6 Surry 437 501.8 192 210.9 Swain 52 337.0 30 178.6 Transylvania 205 450.6 87 186.3 Tyrrell 24 523.5 15 308.0 Union 627 471.2 219 184.8 Vance 220 495.6 95 215.3 Wake 2,871 485.1 888 172.6 Warren 110 447.9 43 170.2 Washington 73 434.9 35 205.1 Watauga 193 486.4 71 171.1 Wayne 493 426.3 239 211.7 Wilkes 402 499.7 160 194.7 Wilson 389 476.5 163 198.1 Yadkin 185 429.0 88 204.7 Yancey 110 445.0 42 165.3 Report includes benign brain/CNS. Rates are based on the bridged-race population estimates obtained from the National Center for Health Statistics (Vintage 2006, available online at http://www.cdc.gov/nchs/about/major/dvs/popbridge/popbridge.htm) 1 Rates per 100,000 Population and are age-adjusted to the 2000 U.S. Census In situ cancers are excluded. Table 5 (continued) : 2005 Total Cancer Incidence and Mortality Rates By County * Cases less than 5 are suppressed. Cancer Incidence in North Carolina 2005 State Center for Health Statistics N.C. Division of Public Health 15 County Cases Rate ¹ NORTH CAROLINA 4,265 48.8 Alamance 80 52.2 Alexander 18 47.3 Alleghany 6 35.4 Anson 15 54.7 Ashe 13 34.8 Avery 5 21.0 Beaufort 42 71.7 Bertie 14 58.6 Bladen 22 59.7 Brunswick 57 48.7 Buncombe 134 50.0 Burke 46 45.3 Cabarrus 91 65.9 Caldwell 47 52.2 Camden 6 62.1 Carteret 29 35.6 Caswell 14 52.0 Catawba 83 52.8 Chatham 22 34.8 Cherokee 26 68.7 Chowan 7 38.3 Clay 12 81.5 Cleveland 60 54.9 Columbus 24 37.3 Craven 58 55.2 Cumberland 112 48.7 Currituck 8 32.5 Dare 12 27.5 Davidson 83 49.2 Davie 30 67.6 Duplin 19 35.4 Durham 93 45.0 Edgecombe 52 90.9 Forsyth 151 45.2 Franklin 33 66.9 Gaston 124 59.7 Gates 5 36.9 Graham * * Granville 30 60.4 Greene 5 25.2 Guilford 207 46.6 Halifax 37 54.6 Harnett 51 60.5 Haywood 42 52.8 Henderson 55 39.1 Hertford 14 49.7 Hoke 11 42.2 Hyde * * Iredell 61 42.2 Jackson 20 53.7 Rates are based on the bridged-race population estimates obtained from the National Center for Health Statistics (Vintage 2006, available online at http://www.cdc.gov/nchs/about/major/dvs/popbridge/popbridge.htm) Table 6: 2005 Colon/Rectum Cancer Incidence Rates By County 1 Rates per 100,000 Population and are age-adjusted to the 2000 U.S. Census * Cases less than 5 are suppressed. In situ cancers are excluded. Cancer Incidence in North Carolina 2005 State Center for Health Statistics N.C. Division of Public Health 16 County Cases Rate ¹ NORTH CAROLINA 4,265 48.8 Johnston 62 47.4 Jones 6 43.7 Lee 35 55.9 Lenoir 46 67.6 Lincoln 36 53.6 McDowell 16 32.1 Macon 29 53.3 Madison * * Martin 20 65.6 Mecklenburg 279 44.3 Mitchell 11 45.5 Montgomery 13 41.5 Moore 58 48.2 Nash 57 57.0 New Hanover 74 38.4 Northampton 9 34.9 Onslow 47 52.5 Orange 33 30.6 Pamlico 8 40.7 Pasquotank 16 41.0 Pender 17 30.1 Perquimans 9 52.5 Person 13 31.6 Pitt 61 51.2 Polk 11 42.4 Randolph 73 50.7 Richmond 26 52.7 Robeson 59 50.1 Rockingham 61 54.7 Rowan 86 57.3 Rutherford 48 59.9 Sampson 29 44.6 Scotland 15 42.0 Stanly 32 46.6 Stokes 30 58.8 Surry 39 43.8 Swain * * Transylvania 23 44.8 Tyrrell * * Union 58 43.7 Vance 33 74.9 Wake 255 45.2 Warren 8 28.9 Washington 6 36.7 Watauga 22 57.2 Wayne 49 42.5 Wilkes 30 37.0 Wilson 49 60.0 Yadkin 29 67.8 Yancey 12 49.4 Rates are based on the bridged-race population estimates obtained from the National Center for Health Statistics (Vintage 2006, available online at http://www.cdc.gov/nchs/about/major/dvs/popbridge/popbridge.htm) 1 Rates per 100,000 Population and are age-adjusted to the 2000 U.S. Census * Cases less than 5 are suppressed. In situ cancers are excluded. Table 6 (continued) : 2005 Colon/Rectum Cancer Incidence Rates By County Cancer Incidence in North Carolina 2005 State Center for Health Statistics N.C. Division of Public Health 17 County Cases Rate ¹ NORTH CAROLINA 6,699 76.4 Alamance 111 72.6 Alexander 35 87.5 Alleghany 10 58.9 Anson 22 77.8 Ashe 30 80.6 Avery 20 88.6 Beaufort 61 98.6 Bertie 17 73.8 Bladen 27 71.8 Brunswick 106 89.6 Buncombe 206 78.1 Burke 75 72.3 Cabarrus 122 89.9 Caldwell 69 77.7 Camden 9 99.3 Carteret 55 65.0 Caswell 14 52.2 Catawba 126 79.6 Chatham 35 53.8 Cherokee 28 69.5 Chowan 12 63.1 Clay 13 86.9 Cleveland 88 78.3 Columbus 42 65.5 Craven 100 97.8 Cumberland 204 86.1 Currituck 17 73.0 Dare 20 52.4 Davidson 149 87.7 Davie 26 56.7 Duplin 36 65.6 Durham 156 76.7 Edgecombe 52 90.7 Forsyth 279 83.4 Franklin 37 71.3 Gaston 203 97.3 Gates 11 81.7 Graham 5 44.9 Granville 50 96.3 Greene 15 76.3 Guilford 325 73.6 Halifax 55 82.6 Harnett 60 67.3 Haywood 74 88.4 Henderson 110 73.1 Hertford 16 57.2 Hoke 20 70.5 Hyde 6 85.5 Iredell 117 81.3 Jackson 23 58.8 Table 7: 2005 Lung/Bronchus Cancer Incidence Rates By County Rates are based on the bridged-race population estimates obtained from the National Center for Health Statistics (Vintage 2006, available online at http://www.cdc.gov/nchs/about/major/dvs/popbridge/popbridge.htm) 1 Rates per 100,000 Population and are age-adjusted to the 2000 U.S. Census * Rates based on less than 10 cases are unstable and therefore suppressed. In situ cancers are excluded. Cancer Incidence in North Carolina 2005 State Center for Health Statistics N.C. Division of Public Health 18 County Cases Rate ¹ NORTH CAROLINA 6,699 76.4 Johnston 84 68.7 Jones 11 84.3 Lee 44 70.1 Lenoir 48 68.0 Lincoln 71 99.2 McDowell 53 104.2 Macon 29 61.1 Madison 23 86.6 Martin 25 80.0 Mecklenburg 379 63.5 Mitchell 15 60.9 Montgomery 25 83.2 Moore 104 83.6 Nash 75 74.2 New Hanover 167 87.3 Northampton 15 50.2 Onslow 94 97.2 Orange 67 67.5 Pamlico 18 98.1 Pasquotank 30 74.8 Pender 43 77.4 Perquimans 12 68.7 Person 36 89.1 Pitt 91 77.4 Polk 16 52.4 Randolph 112 75.6 Richmond 53 100.5 Robeson 91 82.5 Rockingham 101 90.7 Rowan 133 89.0 Rutherford 56 71.9 Sampson 46 68.3 Scotland 25 71.0 Stanly 67 101.8 Stokes 33 62.2 Surry 92 101.2 Swain 9 58.7 Transylvania 22 44.9 Tyrrell * * Union 88 71.1 Vance 37 83.4 Wake 306 57.9 Warren 8 30.9 Washington 11 66.6 Watauga 15 36.2 Wayne 90 77.9 Wilkes 53 65.3 Wilson 70 85.9 Yadkin 21 46.4 Yancey 25 96.9 Table 7 (continued) : 2005 Lung/Bronchus Cancer Incidence Rates By County 1 Rates per 100,000 Population and are age-adjusted to the 2000 U.S. Census * Cases less than 5 are suppressed. In situ cancers are excluded. Rates are based on the bridged-race population estimates obtained from the National Center for Health Statistics (Vintage 2006, available online at http://www.cdc.gov/nchs/about/major/dvs/popbridge/popbridge.htm) Cancer Incidence in North Carolina 2005 State Center for Health Statistics N.C. Division of Public Health 19 County Cases Rate ¹ NORTH CAROLINA 7,098 147.5 Alamance 105 129.5 Alexander 30 142.5 Alleghany * * Anson 15 114.0 Ashe 19 108.9 Avery 19 167.1 Beaufort 39 125.4 Bertie 22 175.5 Bladen 27 127.3 Brunswick 92 155.9 Buncombe 208 143.0 Burke 68 125.1 Cabarrus 121 153.1 Caldwell 76 161.1 Camden 9 196.3 Carteret 73 164.1 Caswell 12 87.7 Catawba 125 142.0 Chatham 48 143.9 Cherokee 23 108.9 Chowan 18 170.5 Clay 14 199.2 Cleveland 99 163.1 Columbus 43 128.0 Craven 76 147.2 Cumberland 226 159.2 Currituck 12 104.2 Dare 31 145.6 Davidson 134 147.6 Davie 28 117.6 Duplin 38 130.0 Durham 184 157.2 Edgecombe 63 198.0 Forsyth 308 166.7 Franklin 51 178.5 Gaston 156 137.0 Gates 7 93.3 Graham 5 81.8 Granville 39 138.7 Greene 15 138.6 Guilford 371 149.0 Halifax 57 165.5 Harnett 71 147.1 Haywood 70 179.0 Henderson 95 133.1 Hertford 21 144.5 Hoke 20 119.7 Hyde 7 218.7 Iredell 105 132.0 Jackson 29 134.9 Rates are based on the bridged-race population estimates obtained from the National Center for Health Statistics (Vintage 2006, available online at http://www.cdc.gov/nchs/about/major/dvs/popbridge/popbridge.htm) Table 8: 2005 Female Breast Cancer Incidence Rates By County 1 Rates per 100,000 Population and are age-adjusted to the 2000 U.S. Census * Cases less than 5 are suppressed. Cancer Incidence in North Carolina 2005 State Center for Health Statistics N.C. Division of Public Health 20 County Cases Rate ¹ NORTH CAROLINA 7,098 147.5 Johnston 107 147.8 Jones 5 79.3 Lee 53 164.2 Lenoir 62 159.7 Lincoln 60 155.3 McDowell 41 148.4 Macon 25 95.7 Madison 18 128.7 Martin 27 170.2 Mecklenburg 596 157.0 Mitchell 11 94.1 Montgomery 17 113.2 Moore 96 170.7 Nash 75 137.4 New Hanover 137 134.3 Northampton 21 124.4 Onslow 92 161.7 Orange 95 163.2 Pamlico 16 168.5 Pasquotank 32 145.3 Pender 33 120.7 Perquimans 19 201.1 Person 35 153.6 Pitt 106 158.7 Polk 15 88.0 Randolph 91 116.9 Richmond 29 99.7 Robeson 77 118.5 Rockingham 79 130.9 Rowan 124 161.9 Rutherford 62 149.5 Sampson 46 136.6 Scotland 13 61.8 Stanly 58 164.1 Stokes 34 118.8 Surry 58 127.6 Swain 12 145.8 Transylvania 33 137.4 Tyrrell 6 257.1 Union 103 135.9 Vance 31 123.8 Wake 561 163.9 Warren 25 225.7 Washington 11 108.3 Watauga 28 131.4 Wayne 97 151.6 Wilkes 58 136.3 Wilson 59 128.6 Yadkin 23 99.1 Yancey 16 116.7 Rates are based on the bridged-race population estimates obtained from the National Center for Health Statistics (Vintage 2006, available online at http://www.cdc.gov/nchs/about/major/dvs/popbridge/popbridge.htm) Table 8 (continued) : 2005 Female Breast Cancer Incidence Rates By County 1 Rates per 100,000 Population and are age-adjusted to the 2000 U.S. Census * Cases less than 5 are suppressed. Cancer Incidence in North Carolina 2005 State Center for Health Statistics N.C. Division of Public Health 21 County Cases Rate ¹ NORTH CAROLINA 5,780 147.8 Alamance 94 148.3 Alexander 33 190.4 Alleghany 11 134.6 Anson 16 128.6 Ashe 33 201.1 Avery 16 157.7 Beaufort 43 153.2 Bertie 16 174.1 Bladen 23 127.4 Brunswick 46 76.0 Buncombe 147 125.7 Burke 56 121.9 Cabarrus 104 173.7 Caldwell 49 128.4 Camden 10 259.6 Carteret 69 166.3 Caswell 15 124.9 Catawba 122 168.5 Chatham 44 152.2 Cherokee 20 105.8 Chowan * * Clay 15 193.3 Cleveland 70 144.6 Columbus 53 187.5 Craven 82 173.7 Cumberland 140 132.0 Currituck 9 71.3 Dare 19 101.3 Davidson 101 128.1 Davie 24 111.1 Duplin 26 112.9 Durham 169 187.8 Edgecombe 40 180.3 Forsyth 202 140.8 Franklin 27 118.2 Gaston 151 167.9 Gates * * Graham * * Granville 42 168.1 Greene 16 179.7 Guilford 370 192.9 Halifax 45 160.3 Harnett 34 85.6 Haywood 62 167.9 Henderson 84 127.4 Hertford 18 138.8 Hoke 19 158.1 Hyde 7 245.8 Iredell 110 169.9 Jackson 21 114.9 Rates are based on the bridged-race population estimates obtained from the National Center for Health Statistics (Vintage 2006, available online at http://www.cdc.gov/nchs/about/major/dvs/popbridge/popbridge.htm) Table 9: 2005 Prostate Cancer Incidence Rates By County 1 Rates per 100,000 Population and are age-adjusted to the 2000 U.S. Census * Rates based on less than 10 cases are unstable and therefore suppressed. In situ cancers are excluded. Cancer Incidence in North Carolina 2005 State Center for Health Statistics N.C. Division of Public Health 22 County Cases Rate ¹ NORTH CAROLINA 5,780 147.8 Johnston 76 144.9 Jones 6 89.3 Lee 39 140.3 Lenoir 68 233.7 Lincoln 52 160.0 McDowell 33 140.0 Macon 21 83.6 Madison 22 189.7 Martin 21 171.1 Mecklenburg 423 143.9 Mitchell 11 114.4 Montgomery 12 85.6 Moore 99 173.5 Nash 69 152.4 New Hanover 92 101.5 Northampton 23 182.8 Onslow 66 146.1 Orange 82 170.6 Pamlico 17 182.7 Pasquotank 24 139.3 Pender 28 112.2 Perquimans 14 171.6 Person 26 148.5 Pitt 86 177.0 Polk 13 99.2 Randolph 97 150.1 Richmond 28 132.2 Robeson 95 188.8 Rockingham 64 130.3 Rowan 80 123.3 Rutherford 40 115.6 Sampson 21 72.7 Scotland 21 112.1 Stanly 44 148.0 Stokes 15 66.7 Surry 49 122.0 Swain 5 65.7 Transylvania 29 128.2 Tyrrell * * Union 80 136.7 Vance 25 135.2 Wake 420 162.0 Warren 21 181.1 Washington 12 160.5 Watauga 27 131.8 Wayne 53 106.3 Wilkes 78 205.4 Wilson 42 122.4 Yadkin 26 133.7 Yancey 10 84.2 Rates are based on the bridged-race population estimates obtained from the National Center for Health Statistics (Vintage 2006, available online at http://www.cdc.gov/nchs/about/major/dvs/popbridge/popbridge.htm) 1 Rates per 100,000 Population and are age-adjusted to the 2000 U.S. Census * Rates based on less than 10 cases are unstable and therefore suppressed. In situ cancers are excluded. Table 9 (continued) : 2005 Prostate Cancer Incidence Rates By County Cancer Incidence in North Carolina 2005 State Center for Health Statistics N.C. Division of Public Health 23 Table 10: Five Most Frequently Diagnosed Cancers By Age Group, 2005 The cancers listed are the five most frequently diagnosed cancers for each age group. Different age groups are at higher risks for different types of cancer. As age increases, the risk of cancer increases. Ages 0-14 Ages 15-19 Type Cases Rate* Type Cases Rate* Leukemia 81 4.5 Brain/CNS (includes benign brain/CNS) 29 4.9 Brain/CNS (includes benign brain/CNS) 77 4.3 Endocrine 23 3.9 Endocrine 23 1.3 Melanoma(Skin) 15 2.5 NH Lymphoma 16 0.9 Hodgkin's Disease 14 2.4 Kidney 16 0.9 Leukemia 12 2.0 Ages 20-24 Ages 25-29 Type Cases Rate* Type Cases Rate* Melanoma(Skin) 42 7.0 Endocrine 58 9.3 Endocrine 37 6.2 Melanoma(Skin) 35 5.6 Hodgkin's Disease 28 4.7 Testes 1 33 10.1 Testes 1 21 6.7 Brain/CNS (includes benign brain/CNS) 32 5.1 Brain/CNS (includes benign brain/CNS) 18 3.0 NH Lymphoma 28 4.5 Ages 30-34 Ages 35-39 Type Cases Rate* Type Cases Rate* Female Breast 1 100 32.4 Female Breast 1 239 75.6 Endocrine 85 13.5 Endocrine 90 14.1 Melanoma(Skin) 67 10.7 Melanoma(Skin) 85 13.3 Brain/CNS (includes benign brain/CNS) 56 8.9 Colon/Rectum 56 8.8 Testes 1 40 12.5 Brain/CNS (includes benign brain/CNS) 54 8.5 Ages 40-44 Ages 45-49 Type Cases Rate* Type Cases Rate* Female Breast 1 514 152.6 Female Breast 1 785 241.1 Colon/Rectum 147 22.1 Lung/Bronchus 273 42.9 Melanoma(Skin) 130 19.5 Colon/rectum 211 33.1 Endocrine 128 19.2 Prostate 1 160 51.5 Lung/Bronchus 105 15.8 Melanoma(Skin) 145 22.8 1 Sex specific populations are used to calculate rates for sex-specific cancers. In situ cancers except those of the urinary bladder and female breast are excluded. Report includes benign brain/CNS. Rates are based on the bridged-race population estimates obtained from the National Center for Health Statistics (Vintage 2006, available online at http://www.cdc.gov/nchs/about/major/dvs/popbridge/popbridge.htm) Cancer Incidence in North Carolina 2005 State Center for Health Statistics N.C. Division of Public Health 24 Table 10 (continued) : Five Most Frequently Diagnosed Cancers By Age Group, 2005 Ages 50-54 Ages 55-59 Type Cases Rate* Type Cases Rate Female Breast 1 805 273.7 Female Breast 1 979 371.4 Prostate 1 452 164.2 Prostate 1 796 324.6 Lung/Bronchus 432 75.9 Lung/Bronchus 723 142.1 Colon/Rectum 362 63.6 Colon/Rectum 443 87.1 Melanoma(Skin) 168 29.5 Kidney 220 43.2 Ages 60-64 Ages 65-69 Type Cases Rate* Type Cases Rate* Prostate 1 998 543.5 Prostate 1 1,100 780.1 Lung/Bronchus 944 243.9 Lung/Bronchus 1,023 333.1 Female Breast 1 879 432.0 Female Breast 1 751 452.2 Colon/Rectum 514 132.8 Colon/Rectum 535 174.2 Bladder 183 47.3 Bladder 237 77.2 Ages 70-74 Ages 75-79 Type Cases Rate* Type Cases Rate* Lung/Bronchus 1,077 417.3 Lung/Bronchus 1,015 483.6 Prostate 1 1,019 896.5 Prostate 1 664 768.2 Female Breast 1 688 476.3 Colon/Rectum 586 279.2 Colon/Rectum 547 211.9 Female Breast 1 568 460.1 Bladder 251 97.2 Bladder 281 133.9 Ages 80-84 Ages 85+ Type Cases Rate* Type Cases Rate* Lung/Bronchus 669 441.3 Lung/Bronchus 390 306.1 Female Breast 1 443 459.4 Colon/Rectum 386 302.9 Colon/Rectum 427 281.6 Female Breast 1 313 345.6 Prostate 1 324 587.1 Prostate 1 228 618.8 Bladder 230 151.7 Bladder 163 127.9 1 Sex specific populations are used to calculate rates for sex-specific cancers. In situ cancers except those of the urinary bladder and female breast are excluded. Report includes benign brain/CNS. Rates are based on the bridged-race population estimates obtained from the National Center for Health Statistics (Vintage 2006, available online at http://www.cdc.gov/nchs/about/major/dvs/popbridge/popbridge.htm) Cancer Incidence in North Carolina 2005 State Center for Health Statistics N.C. Division of Public Health 25 Table 11: 2001-2005 Cancer Incidence Rates by Race and Ethnicity, Per 100,000 Population Age-Adjusted to the US 2000 Census * Counts less than five are suppressed. Rates based on counts less than 16 are unstable. Use with caution. Sites Whites African Americans American Indians Hispanics Total Cases Rate Cases Rate Cases Rate Cases Rate Cases Rate ORAL CAVITY 3,679 10.8 1,001 12.7 30 6.8 54 6.7 4,774 11.2 ESOPHAGUS 1,554 4.6 453 6.1 13 3.0 14 2.5 2,038 4.8 STOMACH 1,678 5.0 736 10.4 21 5.2 59 8.0 2,495 6.0 COLON/RECTUM 15,853 46.9 4,053 56.3 125 33.2 173 29.5 20,246 48.6 LIVER 1,401 4.1 406 5.3 15 3.8 41 6.6 1,902 4.5 GALLBLADDER 265 0.8 104 1.5 * * * * 374 0.9 PANCREAS 3,499 10.4 1,013 14.5 15 4.3 45 8.5 4,570 11.0 LARYNX 1,467 4.3 495 6.6 8 1.9 16 2.4 1,986 4.7 LUNG/BRONCHUS 25,545 74.9 4,957 69.0 229 57.9 179 35.8 30,914 73.8 BONE 304 1.0 67 0.7 * * 21 0.7 384 0.9 SOFT TISSUE 913 2.8 247 3.0 13 2.8 36 2.1 1,191 2.8 MELANOMA (SKIN) 6,843 20.5 56 0.8 9 2.1 31 3.6 6,998 16.6 FEMALE BREAST 27,342 150.5 6,188 140.0 212 87.3 415 106.8 34,156 148.2 CERVIX UTERI 1,205 7.2 453 10.1 19 7.7 101 19.0 1,746 7.9 CORPUS UTERI 3854 20.9 872 20.6 37 17.0 68 20.7 4839 20.7 OVARY 2394 13.0 400 9.1 12 5.1 50 14.1 2,850 12.2 PROSTATE 21,053 138.2 7080 248.2 265 154.1 208 85.5 28,759 156.1 TESTES 905 5.6 61 1.4 9 3.4 71 3.4 1,003 4.7 BLADDER 7,198 21.3 756 11.0 33 10.5 45 10.8 8,044 19.4 KIDNEY 4,874 14.3 1,195 15.8 55 14.1 88 12.9 6,183 14.6 ENDOCRINE 2,803 8.5 583 7.0 18 3.8 119 7.9 3,516 8.3 MULTIPLE MYELOMA 1,611 4.8 754 10.6 15 3.7 25 4.0 2,404 5.8 LEUKEMIA 3,726 11.3 611 8.0 26 6.6 134 8.3 4,464 10.8 BRAIN/OTHER CNS (includes benign brain/CNS) 3,541 10.7 566 7.1 33 7.2 99 8.0 4,209 10.0 HODGKINS DISEASE 847 2.6 218 2.4 10 1.9 34 1.3 1,098 2.6 NON-HODGKINS LYMPHOMA 6,240 18.6 956 12.3 34 7.9 122 15.2 7,342 17.6 OTHER CANCERS 9,375 28.0 2,027 27.9 104 27.1 153 21.2 11,657 28.1 ALL CANCERS 159,969 472.5 36,308 492.7 1,365 337.8 2,403 314.7 200,142 475.9 Hispanic ethnicity is independent of race, so the counts will not sum to the total. Hispanic ethnicity is determined by self-report and the National Hispanic Identification Algorithm available online at Http:// www.naaccr.org/filesystem/pdf/NHIA%20v2%2009-21-05.pdf American Indian rate is known to be underreported. Previous analyses by the North Carolina Central Cancer Registry indicates approximately 17% of patients of American Indian race are reported as a different race. Incidence is assumed to be under-estimated as a result of misclassification. Incidence rates for 2001-2005 used the Bridged-race population estimates obtained from the National Center for Health Statistics (Vintage 2006, available online at http://www.cdc.gov/nchs/about/major/dvs/popbridge/popbridge.htm). Cancer Incidence in North Carolina 2005 State Center for Health Statistics N.C. Division of Public Health 26 Chart 1: Trends For The Four Major Cancers 1990-2005 * Rates per 100,000 Population Age-Adjusted to the 2000 U.S. Census Colon/Rectum Cancer 0 10 20 30 40 50 60 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 Rate* Incidence Mortality Lung/Bronchus Cancer 0 10 20 30 40 50 60 70 80 90 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 Rate* Incidence Mortality Cancer Incidence in North Carolina 2005 State Center for Health Statistics N.C. Division of Public Health 27 Includes in situ breast cancers. Chart 1 (continued) : Trends For The Four Major Cancers 1990-2005 * Rates per 100,000 Population Age-Adjusted to the 2000 U.S. Census Prostate Cancer 0 50 100 150 200 250 1990 1992 1994 1996 1998 2000 2002 2004 Rate* Incidence Mortality Female Breast Cancer 0 20 40 60 80 100 120 140 160 180 1990 1992 1994 1996 1998 2000 2002 2004 Rate* Incidence Mortality Cancer Incidence in North Carolina 2005 State Center for Health Statistics N.C. Division of Public Health 28 * Rates per 100,000 Population Age-Adjusted to the 2000 U.S. Census Chart 2: White and Minority Trends For The Four Major Cancers 1990-2005 Lung/Bronchus Cancer 0 10 20 30 40 50 60 70 80 90 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 Rate* White Incidence Minority Incidence White Mortality Minority Mortality Colon/Rectum Cancer 0 10 20 30 40 50 60 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 Rate* White Incidence Minority Incidence White Mortality Minority Mortality Cancer Incidence in North Carolina 2005 State Center for Health Statistics N.C. Division of Public Health 29 Chart 2 (continued) : White and Minority Trends For The Four Major Cancers 1990-2005 * Rates per 100,000 Population Age-Adjusted to the 2000 U.S. Census Prostate Cancer 0 50 100 150 200 250 300 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 Rate* White Incidence Minority Incidence White Mortality Minority Mortality Female Breast Cancer 0 20 40 60 80 100 120 140 160 180 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 Rate* White Incidence Minority Incidence White Mortality Minortiy Mortality Cancer Incidence in North Carolina 2005 State Center for Health Statistics N.C. Division of Public Health 30 Cancer Incidence in North Carolina 2005 State Center for Health Statistics N.C. Division of Public Health 31 Appendix A Primary Site Definitions International Classification of Disease for Oncology (ICD-O-3) Codes for Newly Diagnosed Neoplasms1 Primary Site ICD-O-3 All Sites C000-C809 Oral Cavity and Pharynx: C000-C148 Lips C000-C009 Tongue C019-C029 Salivary Glands C079-C089 Floor of Mouth C040-C049 Nasopharynx C110-C119 Oropharynx C100-C109 Hypopharynx C129-C139 Other Mouth and Pharynx C030-C039, C050-C069, C090-C099, C140, C142-C148 Digestive System: C150-C269, C480-C488 Esophagus C150-C159 Stomach C160-C169 Small Intestine C170-C179 Colon and Rectum C180-C209, C260 Anus, Anal Cavity and Anorectum C210-C212, C218 Liver and Intrahepatic Bile Duct C220-C221 Gallbladder C239 Pancreas C250-C259 Other Digestive Organs C240-C249, C268-C269, C480-C488 Respiratory System: C300-C399 Larynx C320-C329 Lung and Bronchus C340-C349 Other Respiratory Organs C300-C319, C339, C381-C399 Bones and Joints C400-C419 Soft Tissues C380, C470-C479, C490-C499 Skin C440-C449 Melanoma of Skin C440-C449 (M8720-M8790) Other Skin C440-C449 (Other histology) Breast C500-C509 Invasive C500-C509 (Behavior=3) In Situ C500-C509 (Behavior=2) Female Genital Organs: C530-C589 Cervix Uteri C530-C539 Uterus (Corpus, NOS) C540-C559 Ovary C569 Other Female Genital Organs C510-C529, C570-C589 Cancer Incidence in North Carolina 2005 State Center for Health Statistics N.C. Division of Public Health 32 Appendix A (Continued) Primary Site Definitions International Classification of Disease for Oncology (ICD-O-3) Codes for Newly Diagnosed Neoplasms1 Male Genital Organs: C600-C639 Prostate C619 Testis C620-C629 Penis C600-C609 Other Male Genital Organs C630-C639 Urinary System: C649-C689 Bladder C670-C679 Kidney and Renal Pelvis C649, C659 Ureter C669 Other Urinary System C680-C689 Eye & Orbit: C690-C699 Brain & Central Nervous System (CNS): C700-C729 Endocrine System: C379, C739-C759 Thyroid C739 Other Endocrine and Thymus C379, C740-C759 Lymphomas: M9590-M9717 Hodgkin’s Disease M9650-M9667 Non-Hodgkin’s M9590-M9596, M9670-M9671, M9673,M9675,M9678-M9680,M9684,M9687,M9689-M9691,M9695,M9698- M9702,M9705,M9708-M9709,M9714-M9719,M9727-M9729,M9823,M9827 Multiple Myeloma: M9731-M9732,M9734 Leukemia: M9800-M9948 Acute Lymphocytic M9826, M9835-M9837 Chronic Lymphocytic M9823 Acute Myeloid M9840, M9861, M9866, M9867, M9871-M9874, M9895-M9897,M9910,M9920 Chronic Myeloid M9863,M9875,M9876, M9945,M9946 Other Leukemia M9733, M9742,M9800-M9801,M9805, M9827,M9831, M9870, M9931, M9948, M9963-M9964 Ill-Defined & Unspecified M9740-M9741,M9750-M9758,M9760- M9769,M9950-M9960-M9962,M9970,M9975,M9980,M9982-M9978,M9989 1 Based on the SEER Incidence Site ICD-O-3 Recode, 1/27/2003 http://seer.cancer.gov/siterecode/ Note: Except for lymphoma, multiple myeloma, and leukemia, all categorized sites exclude M9590-M9989 unless otherwise stated. Cancer Incidence in North Carolina 2005 State Center for Health Statistics N.C. Division of Public Health 33 Appendix B Formulae Mathematical definitions: 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-specific rate: ri = (ci/ri)*100,000 where ri is the age-specific rate for age group (i), ci is the count of cases for that age group (i) and ri is the count of persons at risk (i.e., the population) for that age group (i); rates in all tables are presented per 100,000 population. Observed: ♦ Male Observed = Number of new cases of cancer among males �� Female Observed = Number of new cases of cancer among females 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-specific rate for age group. Appendix C: Population By County And Race/Gender North Carolina, 2005 County White Males White Females Minority Males Minority Females NORTH CAROLINA 3,208,831 3,265,515 1,040,559 1,157,554 Alamance 54,036 56,859 13,618 15,714 Alexander 16,652 16,397 1,596 1,170 Alleghany 5,262 5,376 136 90 Anson 6,459 6,261 6,701 6,268 Ashe 12,297 12,635 196 165 Avery 8,635 8,059 898 108 Beaufort 15,870 16,904 5,963 7,141 Bertie 3,429 3,631 5,594 6,677 Bladen 9,849 10,096 6,016 6,924 Brunswick 37,754 38,891 5,894 6,569 Buncombe 95,445 102,945 9,517 10,473 Burke 39,335 40,180 5,586 4,371 Cabarrus 62,068 63,305 11,556 12,656 Caldwell 36,498 37,703 2,544 2,589 Camden 3,697 3,815 689 769 Carteret 28,102 29,323 2,650 2,774 Caswell 7,672 7,487 4,233 4,098 Catawba 65,891 67,108 8,904 9,442 Chatham 24,005 24,248 4,630 5,206 Cherokee 11,900 12,798 521 504 Chowan 4,404 4,707 2,398 2,975 Clay 4,657 4,942 69 87 Cleveland 36,962 39,439 10,022 11,576 Columbus 17,274 18,229 8,790 10,106 Craven 34,018 34,366 12,051 13,394 Cumberland 84,566 85,216 60,077 69,168 Currituck 10,499 10,647 931 1,039 Dare 16,249 16,137 690 644 Davidson 67,806 69,730 7,986 9,011 Davie 17,759 18,202 1,518 1,536 Duplin 19,131 18,150 6,681 7,876 Durham 69,439 68,025 48,694 56,196 Edgecombe 11,006 11,536 14,150 17,309 Forsyth 114,349 120,002 42,055 49,320 Franklin 19,471 19,275 7,542 8,332 Gaston 79,895 84,022 15,071 17,249 Gates 3,467 3,468 2,048 2,197 Graham 3,548 3,758 345 353 Granville 17,990 16,194 10,646 8,594 Greene 6,148 5,717 4,215 3,994 Guilford 140,663 147,516 72,582 82,778 Halifax 11,144 12,162 15,285 17,036 Harnett 38,646 39,371 12,275 13,473 Haywood 26,268 28,372 692 752 Henderson 45,020 47,939 2,063 2,153 Hertford 4,063 4,317 7,295 7,861 Hoke 10,593 10,289 9,585 10,208 Hyde 1,762 1,638 1,171 871 Iredell 59,159 60,310 9,839 11,154 Jackson 14,749 15,639 2,455 2,381 Johnston 60,879 60,142 12,177 13,126 Jones 3,293 3,382 1,675 1,950 2005 North Carolina bridged-race population estimates obtained from the National Center for Health Statistics (Vintage 2006, available online at http://www.cdc.gov/nchs/about/major/dvs/popbridge/popbridge.htm). Cancer Incidence in North Carolina 2005 State Center for Health Statistics N.C. Public Division of Public Health 34 Appendix C (continued) : Population By County And Race/Gender North Carolina, 2005 County White Males White Females Minority Males Minority Females NORTH CAROLINA 3,208,831 3,265,515 1,040,559 1,157,554 Lee 21,787 21,754 5,695 6,511 Lenoir 16,423 17,197 11,057 13,201 Lincoln 32,208 32,435 2,459 2,646 McDowell 20,157 20,604 1,411 1,023 Macon 14,790 16,246 494 403 Madison 9,720 10,118 231 142 Martin 6,367 6,953 4,973 6,176 Mecklenburg 262,984 258,552 129,125 145,708 Mitchell 7,643 7,918 103 98 Montgomery 10,636 10,536 3,164 3,020 Moore 32,858 34,961 6,241 7,282 Nash 27,497 29,178 16,179 18,339 New Hanover 71,527 74,674 15,057 17,785 Northampton 4,224 4,397 5,985 6,795 Onslow 64,628 51,873 17,396 16,611 Orange 45,450 48,981 11,095 13,010 Pamlico 4,834 4,840 1,630 1,475 Pasquotank 11,009 11,414 7,598 8,239 Pender 18,215 18,060 4,997 5,185 Perquimans 4,328 4,576 1,420 1,722 Person 12,941 13,361 5,074 5,825 Pitt 44,223 46,236 23,600 28,226 Polk 8,438 9,379 601 644 Randolph 63,369 64,809 4,837 5,161 Richmond 15,316 15,474 7,759 8,157 Robeson 23,568 22,949 38,923 42,312 Rockingham 35,800 37,791 8,864 10,049 Rowan 55,177 56,450 11,227 11,928 Rutherford 26,865 28,965 3,783 4,041 Sampson 21,467 21,285 9,681 10,423 Scotland 9,123 9,745 8,822 9,386 Stanly 25,180 25,687 4,160 4,004 Stokes 21,168 22,151 1,200 1,271 Surry 33,615 35,214 1,748 1,845 Swain 4,426 4,789 2,010 2,024 Transylvania 13,386 14,486 843 917 Tyrrell 1,268 1,153 1,031 694 Union 70,758 70,351 10,850 11,524 Vance 10,376 10,938 10,263 11,969 Wake 280,398 274,886 92,961 102,620 Warren 3,940 3,897 5,914 6,009 Washington 3,209 3,360 3,096 3,618 Watauga 20,421 20,637 684 692 Wayne 37,092 36,981 18,833 20,921 Wilkes 31,422 32,091 1,818 1,797 Wilson 22,277 22,904 14,228 16,766 Yadkin 17,739 18,359 774 817 Yancey 8,851 9,060 150 136 2005 North Carolina bridged-race population estimates obtained from the National Center for Health Statistics (Vintage 2006, available online at http://www.cdc.gov/nchs/about/major/dvs/popbridge/popbridge.htm). Cancer Incidence in North Carolina 2005 State Center for Health Statistics N.C. Public Division of Public Health 35 Cancer Incidence in North Carolina 2005 State Center for Health Statistics N.C. Division of Public Health 36 Appendix D: U.S. Standard Million Population 2000 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 Source: U.S. Bureau of the Census, Census of Population: 2000.
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Title | Cancer incidence in North Carolina: county-specific numbers |
Date | 2008-08 |
Description | 2005 |
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Pres File Name-M | pubs_pubh_serial_cancerincidence2005.pdf |
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Full Text | Cancer Incidence in North Carolina 2005 State Center for Health Statistics August 2008 Contributing Editor Gerri McLaughlin STATE OF NORTH CAROLINA Michael F. Easley, Governor DEPARTMENT OF HEALTH AND HUMAN SERVICES Dempsey Benton, Secretary DIVISION OF PUBLIC HEALTH Leah Devlin, D.D.S, MPH, Director STATE CENTER FOR HEALTH STATISTICS Paul Buescher, Ph.D., Director CENTRAL CANCER REGISTRY Karen Knight, M.S., Director Chandrika Rao, Ph.D. Asst. Director www.ncdhhs.gov N.C. DHHS is an equal opportunity provider and employer, 8/08 Table of Contents Introduction Background ....................................................................................................................................................1 Purpose ..........................................................................................................................................................1 Confidentiality................................................................................................................................................1 Technical Notes Overview and Definitions...............................................................................................................................2 Cancer Incidence and Mortality ................................................................................................................ 2 Differences in Reporting Cancer ............................................................................................................... 3 Incidence Rates......................................................................................................................................... 3 Race/Gender Specific Cases and Rates ..................................................................................................... 5 Reliability of Rates................................................................................................................................... 6 Morphology (Cell Type) and Behavior ..................................................................................................... 6 Limitations of Data ........................................................................................................................................7 Small Numbers......................................................................................................................................... 7 Interpretation ............................................................................................................................................ 8 Comparison to National Data .........................................................................................................................8 Available Cancer Information........................................................................................................................8 Support for Cancer Research and Control......................................................................................................9 Tables/Charts Table 1: Incidence Rates by Sex ..................................................................................................................10 Table 2: Ten Most Frequently Diagnosed Cancers by Sex ..........................................................................11 Table 3: Incidence Rates by Race ................................................................................................................12 Table 4: Ten Most Frequently Diagnosed Cancers by Race ........................................................................13 Table 5: Cancer Incidence and Mortality Rates by County..........................................................................14 Table 6: Colon/Rectum Incidence Rates by County ....................................................................................16 Table 7: Lung/Bronchus Incidence Rates by County...................................................................................18 Table 8: Female Breast Incidence Rates by County.....................................................................................20 Table 9: Prostate Incidence Rates By County ..............................................................................................22 Table 10: Five Most Frequently Diagnosed Cancers by Age Group…………………………….. …......... 24 Table 11: Cancer Incidence Rates by Race and Ethnicity.............................................................................26 Chart 1: Trends for the Four Major Cancers ................................................................................................27 Chart 2: White/Minority Trends for the Four Major Cancers ......................................................................29 Appendices Appendix A: Primary Site Definitions........................................................................................................31 Appendix B: Mathematical Formulae.........................................................................................................33 Appendix C: 2005 Population by County and Race....................................................................................34 Appendix D: 2000 U.S. Standard Million Population.................................................................................36 Cancer Incidence in North Carolina, 2005 State Center for Health Statistics N.C. Division of Public Health Introduction Background The North Carolina Central Cancer Registry (CCR), located within the State Center for Health Statistics, was established in 1986. The CCR operates under the authority granted in North Carolina General Statute 130A-208. 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. Calendar year 1990 is the first 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 information on newly diagnosed cancer patients in North Carolina with respect to demographics and medical characteristics. There are 132 hospitals in North Carolina which routinely diagnose and treat cancer patients; more than 58 of these hospitals have their own tumor registries. One hundred and eighty five facilities reported their 2005 incidence data to the CCR. Incidence data are reported to the CCR by a secure internet-based database. Purpose Cancer Incidence in North Carolina 2005 is the twelth annual report of the CCR. The contents of this report represent a summary of the information collected on cancer diagnosed among North Carolina residents in 2005. Previous volumes are located on the State Center for Health Statistics web site located at http://www.schs.state.nc.us/SCHS/data/cancer.cfm, under the title “Cancer Incidence in North Carolina, County-Specific Numbers.” Confidentiality The CCR is committed to preserving the confidentiality of information obtained for medical, educational, research, and statistical purposes. Thus the CCR demands strict confidentiality and the protection of the identity of both cancer patients and reporting sources in registry data. The CCR does not release any identifying information regarding patients, hospitals, or physicians except under the authority of the General Statute guidelines. Cancer Incidence in North Carolina 2005 State Center for Health Statistics N.C. Division of Public Health 1 Technical Notes Overview and Definitions This report presents frequency counts, age-specific 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 mortality is the number of deaths due to cancer for each county. See Figure 1. We assume that death certificates provide complete and accurate data on all causes of death. However, the accuracy of recording the cause of death varies for many cancers. For example, at the time of death, the history of cancer may not be known by the physician, or may not be considered to have contributed to the death. Nonetheless, mortality data have been historically used widely to analyze cancer risk in populations. Instances of under-reporting of cancer incidence have occurred. For some cancers (e.g., melanomas), under-reporting may lead to more cancer deaths being shown than incidence cases. Also, survival following a cancer diagnosis varies by cancer site. In populations with low use of health care services (e.g., rural and minority populations), more cancers are diagnosed at advanced stages when therapies are less successful; or the cases may not be diagnosed until death. Figure 1. Number of Cancer Cases and Deaths in North Carolina, 2005 0 1,000 2,000 3,000 4,000 5,000 6,000 7,000 8,000 COLON/RECTUM LUNG/BRONCHUS FEMALE BREAST PROSTATE Incidence Mortality Cancer incidence, mortality, and age-adjusted rates for each county are presented in Table 5 and presented by site in Tables 6-9 for colon/rectum, lung/bronchus, female breast, and prostate cancers, respectively. Cancer Incidence in North Carolina 2005 State Center for Health Statistics N.C. Division of Public Health 2 Differences in Reporting Cancer Incidence and Mortality Data Many people living near the Virginia border go outside North Carolina for health care. It is known that Norfolk and Danville, Virginia attract patients for secondary and tertiary care. The State of North Carolina has an exchange agreement with all 50 states for exchanging death certificates, but only has an exchange agreement for cancer incidence data with 24 states, including our border states of Virginia, Tennessee and South Carolina. Because death certificate data are available more quickly than incidence data, the 2005 mortality data include deaths of North Carolina residents who died in other states, but the incidence data may not include all cases diagnosed out-of-state. Some counties have been found to under-report their cancer incidence due to poor case-finding procedures. These counties, especially rural counties where small hospitals do not have the services of trained tumor registrars, may have inadequate case finding. This results in incomplete reporting of new cancer cases. Death data are considered to be complete. This also contributes 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. In the last few years, more cases are being diagnosed and treated outside of a hospital, in physician offices. This is particularly true for cancers of the skin and prostate, as well as some lymphoma and leukemia cases. Although physicians are required to report all cases to the CCR, many of them do not have the staff to do so. Physicians associated with a hospital will often report cases via a hospital registrar, but those not affiliated with a hospital may not report cases to the CCR. As a result, reporting for some cancers is known to be incomplete. Due to recent efforts by the CCR to improve the completeness of reporting by physician offices and pathology laboratories, the incidence of melanoma and prostate cancers has increased. Incidence Rates Two types of rates are presented in this report: age-adjusted and age-specific, each of which has a specific purpose. Both rates are expressed in this report as annual or five-year rates per 100,000 population. Age-Adjusted Rates An age-adjusted rate accurately describes the cancer experience that the population would have had if it had exactly the same age distribution as the comparison or 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-specific rate by the proportion of people within that age group in the standard population and then summing these products. Age-adjusted rates should not be compared with any other type of rate or be used as Cancer Incidence in North Carolina 2005 State Center for Health Statistics N.C. Division of Public Health 3 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 standard population used in the calculation was the 2000 United States Census population. Incidence and mortality rates for 2005 used the bridged-race population estimates obtained from the National Center for Health Statistics (NCHS), available online at http://www.cdc.gov/nchs/about/major/dvs/popbridge/popbridge.htm. Incidence reports published prior to 2005 were calculated using the State Demographer’s population estimates. Hence, rates from previous diagnosis years may differ slightly due to this factor. Age-Specific Rates The age-specific cancer incidence is the number of cancer cases that occur in the age groups from 0-4 to 85+. Age-specific rates are used to compare rates between different population groups of the same age and to examine age patterns for particular cancers. As expected, age-specific rates have a general tendency to increase with age. More than half of cancer cases occur among persons age 65 and older (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 proportionate concentrations 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, endocrine, and lymphomas are the main cancers in people under age 20. In general, North Carolina’s pediatric cancer patterns are quite consistent with national patterns. Young adults (20-44) have a 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 younger age groups is the subject of considerable research at this time. All cancer rates are at a maximum in the 70+ age categories. Prostate cancer is almost exclusively a disease of older men. These age-specific patterns offer significant 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 the access to screening services in this state. Older and underprivileged people are priority groups for these programs. Cancer Incidence in North Carolina 2005 State Center for Health Statistics N.C. Division of Public Health 4 Age-specific cancer incidence and rates are presented in Table 10. The age-specific incidence rates demonstrate how cancer is a disease primarily of the older population. Figure 2: Percentage of North Carolina Cancer Cases by Age Group, 2005 0 to19 1% 20 to 44 9% 65 and older 51% 45 to 64 39% 0 to19 20 to 44 45 to 64 65 and older Race/Gender Specific Cases and Rates The race/gender-specific cancer incidence is the number of cancer cases that occurred in each race/gender group. See Figure 3. These data are provided because race is an important factor in interpreting cancer patterns in North Carolina. Cancer rates vary by race, race distributions vary across the state, and health care use has been found to vary by race. Because cancer risk is strongly associated with lifestyle and behavior, differences among 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 involved in the development of cancer. Cancer cases and age-adjusted rates for North Carolina are presented by gender in Table 1 and by race in Table 3. Cancer Incidence in North Carolina 2005 State Center for Health Statistics N.C. Division of Public Health 5 Figure 3: Number of North Carolina Cancer Cases by Gender and Race, 2005 0 2,000 4,000 6,000 8,000 10,000 12,000 14,000 16,000 18,000 Female Male Number of Cases Other Black White Reliability of Rates Precautions should always be taken when comparing rates. Both the size of the numbers and the size 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 the section titled “Small Numbers” on page 7. Age-adjusted rates offer a standard method to compare cancer risk across geographic areas or time periods. However, there are limitations to their use and one should be familiar with these types of rates before using them. As already mentioned, age-adjusted rates are to be used only for comparison purposes and only if the same standard population was used in the calculation. This publication uses the 2000 U.S. Census as the standard population. For assistance in interpreting these data, please contact the CCR statistical staff at (919) 715- 4574. Morphology (Cell Type) and Behavior The specific morphology codes for these primary site categories have been provided in the Appendix in the table “Primary Site Definitions” to clarify counting of these cases. The lymphoma category includes all lymphoma cases with the morphology codes shown regardless of body site. 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. Please note that lymphomas are not grouped consistently by all researchers. In these data, only malignant tumors are included. Data on benign central nervous system and brain and unspecified types are also reported to the CCR and are included in this report. Only invasive cervical cancer cases are Cancer Incidence in North Carolina 2005 State Center for Health Statistics N.C. Division of Public Health 6 included. Also, in situ cancers except those of the urinary bladder and female breast are excluded in the report. Limitations of Data The user should be cautious when making county-to-county comparisons of the data in this report. Under-reporting in areas close to neighboring states and under-reporting for cancers that may not be diagnosed in hospitals must be considered when interpreting cancer incidence data. In addition, comparison of rates (computed with the number of cases and population data) can be problematic. The age distributions and racial percentages in counties vary considerably. Consider a comparison of Henderson and Orange counties. In 2005 over 22% percent of the Henderson County population was at least 65 years old, while less than 10% percent of the Orange County population was 65 and over. A larger proportion of the Henderson County population can be expected to have cancer than the Orange County population just because of the difference in the age pattern for these two counties. The use of age-adjusted rates will facilitate comparisons of risk. On the other hand, almost 65% percent of Hertford County’s population was comprised of minorities while over 97% percent of Ashe County’s population is white. This difference in the racial composition of the populations of the two counties can also have a marked influence on the patterns of cancer incidence and mortality. Age-adjusted rates control for differences in the age structures of populations, but they do not control for differences in racial composition. Interpretations of melanoma data should be treated with caution since the thoroughness of case-finding is suspect due to the likelihood that cases may be treated outside of hospitals and not reported to the CCR. 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 2001 and 2005, there were 6 cases of female breast cancer in Tyrrell County reported to the CCR. The majority of the cases were reported in 2001. It would appear that the county had an excessive amount of breast cancer in females in 2001. However, over the five-year period, the county averages to what was expected. All statistics are subject to chance variation. Rates based on a very small number of events over a specified period of time or for a sparsely populated geographic area should be of particular concern and caution. 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. Cancer Incidence in North Carolina 2005 State Center for Health Statistics N.C. Division of Public Health 7 Interpretation This descriptive report is intended to serve as a baseline report for future reference. Because of the limitations described above, this publication should not be regarded as a definitive description of the cancer incidence in North Carolina. With additional training of hospital staff, collaboration from neighboring states, and increased physician and pathology laboratories reporting, the problems of under-reporting have declined. Although there are important limitations in the use of these data, the observed number of cases within a gender group in a specific county can be used for: ♦ planning health services at the county level; ♦ identifying high cancer incidence within a county; ♦ educating the public; ♦ motivating facilities such as hospitals and physicians to report incidence data accurately and in a timely manner; and ♦ encouraging more hospitals to organize tumor registries to provide better service to their cancer patients. Comparison to National Data This report was prepared to provide data for evaluation of cancer incidence and mortality patterns in North Carolina. The Annual Report to the Nation on the Status of Cancer, 1975-2004, produced by the North American Association of Cancer Registries (NAACCR) and the National Program of Cancer Registries (NPCR) at http://www.cdc.gov/cancer/npcr/index.htm) is available for comparison with North Carolina’s observed incidence cases for 2004 and previous years. Available Cancer Information Cancer is the second leading cause of death (first being heart disease) in the United States. In 2006, cancer was the leading cause of death in North Carolina. It is estimated that by the year 2015, cancer will be the leading cause of death in the United States. Cancer is expected to strike one in three people sometime during their lifetime. For more information about cancer, contact a local office of the American Cancer Society or call 1-800- ACS-2345. Many communities 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 programs. Another source of information on cancer is the Cancer Information Service, 1-800-4CANCER (1-800-422-6237). The Cancer Information Service, located at Duke University, is a national program funded by the National Cancer Institute that provides cancer information. The CCR produces other reports on cancer in North Carolina, many of which are available on the website at http://www.schs.state.nc.us/SCHS/CCR/. A notable one is the American Cancer Cancer Incidence in North Carolina 2005 State Center for Health Statistics N.C. Division of Public Health 8 Society’s South Atlantic Division Cancer Facts and Figures available on the website at http://health.state.ga.us/pdfs/chronic/cancer/ACSSAD07.pdf. Also, other units with the State Center for Health Statistics (SCHS) publish many reports on other diseases and on health care measures. For more information about other reports from the CCR please call (919) 715-4574. For information from other programs 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 within the state. One feature of this participation is the rapid identification of cancer patients for projects that are designed to collect information before the patient’s first 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 for cancer survivors. Still others are working to understand and reduce the racial/ethnic gaps in cancer diagnosis and mortality. The state Comprehensive Cancer Control Program and the Breast and Cervical Cancer Control Program are located in the Chronic Disease and Injury Section of the North Carolina Division of Public Health and are state agencies committed to reducing the cancer burden among North Carolinians. The CCR provides statistical and data analysis support for these programs. Also, the CCR is associated with organizations such as the American Cancer Society and the state’s Advisory Committee for Cancer Coordination and Control. Cancer Incidence in North Carolina 2005 State Center for Health Statistics N.C. Division of Public Health 9 Site Cases Rate 1 Cases Rate 1 All Sites 21,689 563.3 21,640 447.0 Oral Cavity and Pharynx 713 17.5 306 6.3 Lip 29 0.8 * * Tongue 183 4.5 81 1.7 Salivary Glands 60 1.6 36 0.8 Floor of Mouth 41 1.0 20 0.4 Nasopharynx 30 0.7 * * Oropharynx 47 1.1 11 0.2 Hypopharynx 60 1.5 24 0.5 Other Mouth and Pharynx 263 6.3 116 2.4 Digestive System 3,913 102.6 3,389 68.5 Esophagus 318 8.1 114 2.3 Stomach 322 8.6 193 3.9 Small Instestine 105 2.6 85 1.7 Colon and Rectum 2,197 57.9 2,067 41.8 Anus and Anal Canal 48 1.2 84 1.7 Liver and Intrahepatic Bile Duct 324 8.2 141 2.9 Gallbladder 17 0.5 53 1.0 Pancreas 490 13.2 506 10.2 Other Digestive Organs 92 2.5 146 3.0 Respiratory System 4,258 112.6 2,992 60.8 Larynx 330 8.3 90 1.9 Lung and Bronchus 3,845 102.0 2,854 57.9 Other Respiratory Organs 83 2.2 48 1.0 Bones and Joints 45 1.1 31 0.7 Soft Tissues 159 4.0 127 2.7 Melanoma of the Skin 944 24.2 757 16.2 Breast 64 1.6 7,098 147.5 Invasive Breast 51 1.3 5,786 120.3 In Situ Breast 13 0.3 1,312 27.3 Female Genital System . . 2,148 44.6 Cervix Uteri . . 378 8.2 Uterus (Corpus, NOS) . . 1,004 20.5 Ovary . . 599 12.4 Other Female Genital Organs . . 167 3.4 Male Genital System 6,021 153.5 . . Prostate 5,780 147.8 . . Testis 201 4.6 . . Penis 29 0.8 . . Other Male Genital Organs 11 0.3 . . Urinary System 2,157 57.6 1,011 20.6 Bladder (incl. in situ) 1,248 34.6 437 8.8 Kidney and Renal Pelvis 872 22.0 549 11.3 Ureter 29 0.8 18 0.4 Other Urinary System * * * * Eye and Orbit 51 1.3 37 0.8 Brain and CNS (incudes benign brain/CNS) 580 14.3 749 15.7 Endocrine System 293 7.0 755 16.7 Thyroid 178 4.2 611 13.5 Other Endocrine and Thymus 115 2.7 144 3.2 Lymphomas 951 24.6 838 17.4 Hodgkins Disease 119 2.8 105 2.3 Non-Hodgkin's Lymphoma 832 21.8 733 15.1 Multiple Myeloma 283 7.4 249 5.0 Leukemia 526 13.9 467 9.7 Acute Lymphocytic Leukemia 60 1.4 49 1.2 Chronic Lymphocytic Leukemia 178 4.8 140 2.8 Acute Myeloid Leukemia 147 3.8 148 3.1 Chronic Myeloid Leukemia 60 1.6 48 1.0 Other Leukemia 81 2.3 82 1.7 Ill-Defined and Unspecified 654 17.9 328 12.5 All Other Cancers-Uncategorized 77 2.1 58 1.2 1 Rates per 100,000 Population and are age-adjusted to the 2000 U.S. Census Table 1: 2005 Incidence Rates By Sex Males Females * Cases less than 5 are suppressed. In situ cancers except those of the urinary bladder and female breast are excluded Rates are based on the bridged-race population estimates obtained from the National Center for Health Statistics (Vintage 2006, available online at http://www.cdc.gov/nchs/about/major/dvs/popbridge/popbridge.htm) Cancer Incidence in North Carolina 2005 State Center for Health Statistics N.C. Division of Public Health 10 Cancer Cases Rate¹ Deaths Rate¹ Prostate 28,757 156.1 4,341 30.2 Lung/Bronchus 18,082 100.9 15,010 85.4 Colon/Rectum 10,285 57.4 3,759 22.2 Bladder 5,950 34.8 1,078 7.0 Melanoma (skin) 3,975 21.3 740 4.1 Kidney 3,854 20.5 1,161 6.7 3,822 20.9 1,533 9.0 Oral Cavity 3,311 17.2 771 4.2 Leukemia 2,477 13.8 1,606 9.6 Pancreas 2,259 12.8 2,237 12.8 Cancer Cases Rate¹ Deaths Rate¹ Female Breast 34,156 148.2 6,026 25.6 Lung/Bronchus 12,832 54.4 9,846 41.5 Colon/Rectum 9,959 41.9 3,793 15.6 Corpus Uteri 4,839 20.7 961 4.0 3,520 15.0 1,407 5.8 Melanoma (Skin) 3,022 13.4 463 2.0 Ovary 2,850 12.2 2,080 8.7 Endocrine 2,554 11.6 129 0.6 Kidney 2,327 10.0 643 2.7 Pancreas 2,311 9.6 2,246 9.3 1 Rates per 100,000 Population are age-adjusted to the 2000 U.S. Census Non-Hodgkin's Lymphoma Table 2: 2001 - 2005 Ten Most Frequently Diagnosed Cancers By Sex Males Incidence Mortality In situ cancers except those of the urinary bladder and female breast are excluded. Rates are based on the bridged-race population estimates obtained from the National Center for Health Statistics (Vintage 2006, available online at http://www.cdc.gov/nchs/about/major/dvs/popbridge/popbridge.htm) Non-Hodgkin's Lymphoma Females Incidence Mortality Cancer Incidence in North Carolina 2005 State Center for Health Statistics N.C. Division of Public Health 11 Site Cases Rate 1 Cases Rate 1 All Sites 34,559 490.1 8,504 484.7 Oral Cavity and Pharynx 786 11.1 230 12.3 Lip 36 0.5 * * Tongue 224 3.2 39 2.2 Salivary Glands 73 1.0 23 1.3 Floor of Mouth 51 0.7 10 0.5 Nasopharynx 27 0.4 12 0.6 Oropharynx 32 0.4 26 1.4 Hypopharynx 61 0.8 23 1.2 Other Mouth and Pharynx 282 4.0 95 5.1 Digestive System 5,611 79.5 1,651 97.1 Esophagus 333 4.7 96 5.5 Stomach 334 4.8 180 11.0 Small Instestine 140 2.0 49 2.7 Colon and Rectum 3,353 47.5 891 52.3 Anus and Anal Canal 114 1.6 18 0.9 Liver and Intrahepatic Bile Duct 323 4.6 137 7.5 Gallbladder 53 0.8 17 1.1 Pancreas 757 10.7 231 14.3 Other Digestive Organs 204 2.9 32 1.9 Respiratory System 5,949 83.6 1,271 74.9 Larynx 300 4.1 118 6.9 Lung and Bronchus 5,539 77.9 1,132 66.9 Other Respiratory Organs 110 1.6 21 1.2 Bones and Joints 64 1.0 12 0.6 Soft Tissues 219 3.2 64 3.2 Melanoma of the Skin 1,652 23.9 15 0.9 Breast 5,625 79.7 1,508 81.9 Invasive Breast 4,585 65.1 1,229 67.0 In Situ Breast 1,040 14.7 279 14.9 Female Genital System 1,694 24.0 440 24.8 Cervix Uteri 272 7.8 102 9.6 Uterus (Corpus, NOS) 799 20.7 200 20.2 Ovary 485 12.8 110 10.5 Other Female Genital Organs 138 3.6 28 2.6 Male Genital System 4,458 61.9 1,513 88.6 Prostate 4,253 132.0 1,478 214.5 Testis 178 5.4 23 2.3 Penis 21 0.7 * * Other Male Genital Organs * * * * Urinary System 2,674 37.9 486 28.2 Bladder (incl. in situ) 1,505 21.4 175 11.0 Kidney and Renal Pelvis 1,113 15.7 305 16.9 Ureter 46 0.7 * * Other Urinary System 10 0.1 * * Eye and Orbit 80 1.2 * * Brain and CNS (includes benign brain/CNS) 1,104 16.0 218 11.6 Endocrine System 834 12.3 209 10.4 Thyroid 640 9.5 144 7.1 Other Endocrine and Thymus 194 2.8 65 3.3 Lymphomas 1,523 21.9 259 13.6 Hodgkins Disease 180 2.7 42 1.9 Non-Hodgkin's Lymphoma 1,343 19.2 217 11.7 Multiple Myeloma 350 5.0 179 10.6 Leukemia 836 12.1 147 8.2 Acute Lymphocytic Leukemia 87 1.4 19 0.9 Chronic Lymphocytic Leukemia 272 3.8 43 2.6 Acute Myeloid Leukemia 260 3.7 33 1.8 Chronic Myeloid Leukemia 86 1.3 22 1.2 Other Leukemia 131 1.9 30 1.7 Ill-Defined and Unspecified 998 14.3 266 15.9 All Other Cancers-Uncategorized 102 1.5 29 1.4 In situ cancers except those of the urinary bladder and female breast are excluded. Table 3: 2005 Incidence Rates By Race Whites Minorities 1 Rates per 100,000 Population and are age-adjusted to the 2000 U.S. Census * Cases less than 5 are suppressed. Rates are based on the bridged-race population estimates obtained from the National Center for Health Statistics (Vintage 2006, available online at http://www.cdc.gov/nchs/about/major/dvs/popbridge/popbridge.htm) Cancer Incidence in North Carolina 2005 State Center for Health Statistics N.C. Division of Public Health 12 Cancer Cases Rate1 Deaths Rate1 Female Breast 27,342 150.5 4,458 23.6 Lung/Bronchus 25,545 74.9 20,408 60.1 Prostate 21,053 138.2 2,854 23.8 Colon/Rectum 15,853 46.9 5,753 17.2 Bladder 7,198 21.3 1,374 4.1 Melanoma (skin) 6,843 20.5 1,159 3.5 6,240 18.6 2,549 7.6 Kidney 4,874 14.3 1,461 4.3 Corpus Uteri 3,854 20.9 666 3.4 Leukemia 3,726 11.3 2,420 7.3 Cancer Cases Rate1 Deaths Rate1 Prostate 7,534 237.4 1,487 63.5 Female Breast 6,717 136.0 1,568 32.2 Lung/Bronchus 5,317 66.9 4,448 57.0 Colon/Rectum 4,341 54.5 1,799 23.4 Kidney 1,299 15.4 343 4.4 1,084 12.5 391 5.0 Oral Cavity 1,081 12.3 320 3.8 Pancreas 1,055 13.7 1,019 13.5 Corpus Uteri 974 20.7 295 6.5 Bladder 828 11.0 256 3.5 1 Rates per 100,000 Population are age-adjusted to the 2000 U.S. Census Non-Hodgkin's Lymphoma Minorities Table 4: 2001-2005 Ten Most Frequently Diagnosed Cancers By Race Whites Incidence Mortality Incidence Mortality In situ cancers except those of the urinary bladder and female breast are excluded. Rates are based on the bridged-race population estimates obtained from the National Center for Health Statistics (Vintage 2006, available online at http://www.cdc.gov/nchs/about/major/dvs/popbridge/popbridge.htm) Non-Hodgkin's Lymphoma Cancer Incidence in North Carolina 2005 State Center for Health Statistics N.C. Division of Public Health 13 County Cases Rate 1 Deaths Rate 1 NORTH CAROLINA 43,335 492.2 16,675 192.5 Alamance 748 495.9 295 188.8 Alexander 197 507.3 62 167.7 Alleghany 57 362.8 28 175.4 Anson 117 417.8 57 201.6 Ashe 180 515.9 65 179.5 Avery 110 496.5 44 190.9 Beaufort 318 544.8 148 249.3 Bertie 106 450.7 54 224.9 Bladen 165 440.7 88 244.5 Brunswick 528 460.4 238 204.6 Buncombe 1,316 505.2 479 179.5 Burke 439 431.4 212 207.2 Cabarrus 820 581.2 297 215.1 Caldwell 442 499.9 181 205.5 Camden 48 554.9 16 178.0 Carteret 434 526.2 169 202.3 Caswell 96 349.3 54 189.0 Catawba 795 497.4 290 183.3 Chatham 285 451.0 97 147.8 Cherokee 165 433.6 78 198.2 Chowan 80 426.5 48 239.4 Clay 79 556.0 22 132.7 Cleveland 563 508.1 194 174.5 Columbus 286 455.4 113 179.9 Craven 562 553.8 214 211.1 Cumberland 1,179 478.6 464 201.5 Currituck 81 349.9 46 201.9 Dare 150 379.8 72 189.6 Davidson 844 503.4 330 200.5 Davie 223 503.5 74 164.3 Duplin 224 418.0 121 225.1 Durham 1,084 516.7 383 190.7 Edgecombe 340 604.7 131 238.9 Forsyth 1,770 527.4 667 200.6 Franklin 249 481.1 123 250.8 Gaston 1,132 544.9 402 197.9 Gates 39 297.0 31 250.2 Graham 40 355.0 20 178.7 Granville 326 620.2 127 246.4 Greene 89 454.2 46 236.3 Guilford 2,313 517.2 766 172.8 Halifax 321 490.5 151 226.1 Harnett 404 454.9 151 178.9 Haywood 430 560.3 159 189.4 Henderson 682 493.4 277 183.8 Hertford 120 435.4 75 278.3 Hoke 152 526.3 58 220.1 Hyde 38 577.6 20 279.9 Iredell 684 468.9 271 189.3 Jackson 174 454.0 67 176.7 Report includes benign brain/CNS. Table 5 : 2005 Total Cancer Incidence and Mortality Rates By County Rates are based on the bridged-race population estimates obtained from the National Center for Health Statistics (Vintage 2006, available online at http://www.cdc.gov/nchs/about/major/dvs/popbridge/popbridge.htm) * Cases less than 5 are suppressed. 1 Rates per 100,000 Population and are age-adjusted to the 2000 U.S. Census In situ cancers are excluded. Cancer Incidence in North Carolina 2005 State Center for Health Statistics N.C. Division of Public Health 14 County Cases Rate 1 Deaths Rate 1 NORTH CAROLINA 43,335 492.2 16,675 192.5 Johnston 591 459.9 220 185.7 Jones 45 350.8 22 164.5 Lee 286 469.0 104 172.3 Lenoir 392 572.3 145 205.0 Lincoln 374 526.4 142 208.0 McDowell 255 510.7 93 183.9 Macon 192 399.4 92 177.0 Madison 123 471.7 61 225.4 Martin 154 517.8 70 228.2 Mecklenburg 3,042 461.2 1,052 177.0 Mitchell 104 478.9 42 179.6 Montgomery 115 384.3 51 169.6 Moore 604 524.1 246 195.9 Nash 498 500.5 194 196.4 New Hanover 902 471.0 344 179.1 Northampton 112 383.7 68 223.6 Onslow 560 553.4 211 221.6 Orange 549 527.2 185 187.3 Pamlico 96 523.9 41 218.5 Pasquotank 191 481.7 88 215.4 Pender 225 416.5 106 199.7 Perquimans 89 529.9 32 187.2 Person 209 511.1 90 222.2 Pitt 616 512.0 246 209.5 Polk 108 369.7 69 194.1 Randolph 716 490.7 269 188.5 Richmond 258 507.2 102 196.8 Robeson 536 465.9 243 218.4 Rockingham 524 474.8 211 189.1 Rowan 733 495.6 295 193.4 Rutherford 387 497.0 169 208.3 Sampson 281 434.3 117 182.7 Scotland 125 335.2 85 234.5 Stanly 366 545.4 131 195.4 Stokes 248 480.1 97 189.6 Surry 437 501.8 192 210.9 Swain 52 337.0 30 178.6 Transylvania 205 450.6 87 186.3 Tyrrell 24 523.5 15 308.0 Union 627 471.2 219 184.8 Vance 220 495.6 95 215.3 Wake 2,871 485.1 888 172.6 Warren 110 447.9 43 170.2 Washington 73 434.9 35 205.1 Watauga 193 486.4 71 171.1 Wayne 493 426.3 239 211.7 Wilkes 402 499.7 160 194.7 Wilson 389 476.5 163 198.1 Yadkin 185 429.0 88 204.7 Yancey 110 445.0 42 165.3 Report includes benign brain/CNS. Rates are based on the bridged-race population estimates obtained from the National Center for Health Statistics (Vintage 2006, available online at http://www.cdc.gov/nchs/about/major/dvs/popbridge/popbridge.htm) 1 Rates per 100,000 Population and are age-adjusted to the 2000 U.S. Census In situ cancers are excluded. Table 5 (continued) : 2005 Total Cancer Incidence and Mortality Rates By County * Cases less than 5 are suppressed. Cancer Incidence in North Carolina 2005 State Center for Health Statistics N.C. Division of Public Health 15 County Cases Rate ¹ NORTH CAROLINA 4,265 48.8 Alamance 80 52.2 Alexander 18 47.3 Alleghany 6 35.4 Anson 15 54.7 Ashe 13 34.8 Avery 5 21.0 Beaufort 42 71.7 Bertie 14 58.6 Bladen 22 59.7 Brunswick 57 48.7 Buncombe 134 50.0 Burke 46 45.3 Cabarrus 91 65.9 Caldwell 47 52.2 Camden 6 62.1 Carteret 29 35.6 Caswell 14 52.0 Catawba 83 52.8 Chatham 22 34.8 Cherokee 26 68.7 Chowan 7 38.3 Clay 12 81.5 Cleveland 60 54.9 Columbus 24 37.3 Craven 58 55.2 Cumberland 112 48.7 Currituck 8 32.5 Dare 12 27.5 Davidson 83 49.2 Davie 30 67.6 Duplin 19 35.4 Durham 93 45.0 Edgecombe 52 90.9 Forsyth 151 45.2 Franklin 33 66.9 Gaston 124 59.7 Gates 5 36.9 Graham * * Granville 30 60.4 Greene 5 25.2 Guilford 207 46.6 Halifax 37 54.6 Harnett 51 60.5 Haywood 42 52.8 Henderson 55 39.1 Hertford 14 49.7 Hoke 11 42.2 Hyde * * Iredell 61 42.2 Jackson 20 53.7 Rates are based on the bridged-race population estimates obtained from the National Center for Health Statistics (Vintage 2006, available online at http://www.cdc.gov/nchs/about/major/dvs/popbridge/popbridge.htm) Table 6: 2005 Colon/Rectum Cancer Incidence Rates By County 1 Rates per 100,000 Population and are age-adjusted to the 2000 U.S. Census * Cases less than 5 are suppressed. In situ cancers are excluded. Cancer Incidence in North Carolina 2005 State Center for Health Statistics N.C. Division of Public Health 16 County Cases Rate ¹ NORTH CAROLINA 4,265 48.8 Johnston 62 47.4 Jones 6 43.7 Lee 35 55.9 Lenoir 46 67.6 Lincoln 36 53.6 McDowell 16 32.1 Macon 29 53.3 Madison * * Martin 20 65.6 Mecklenburg 279 44.3 Mitchell 11 45.5 Montgomery 13 41.5 Moore 58 48.2 Nash 57 57.0 New Hanover 74 38.4 Northampton 9 34.9 Onslow 47 52.5 Orange 33 30.6 Pamlico 8 40.7 Pasquotank 16 41.0 Pender 17 30.1 Perquimans 9 52.5 Person 13 31.6 Pitt 61 51.2 Polk 11 42.4 Randolph 73 50.7 Richmond 26 52.7 Robeson 59 50.1 Rockingham 61 54.7 Rowan 86 57.3 Rutherford 48 59.9 Sampson 29 44.6 Scotland 15 42.0 Stanly 32 46.6 Stokes 30 58.8 Surry 39 43.8 Swain * * Transylvania 23 44.8 Tyrrell * * Union 58 43.7 Vance 33 74.9 Wake 255 45.2 Warren 8 28.9 Washington 6 36.7 Watauga 22 57.2 Wayne 49 42.5 Wilkes 30 37.0 Wilson 49 60.0 Yadkin 29 67.8 Yancey 12 49.4 Rates are based on the bridged-race population estimates obtained from the National Center for Health Statistics (Vintage 2006, available online at http://www.cdc.gov/nchs/about/major/dvs/popbridge/popbridge.htm) 1 Rates per 100,000 Population and are age-adjusted to the 2000 U.S. Census * Cases less than 5 are suppressed. In situ cancers are excluded. Table 6 (continued) : 2005 Colon/Rectum Cancer Incidence Rates By County Cancer Incidence in North Carolina 2005 State Center for Health Statistics N.C. Division of Public Health 17 County Cases Rate ¹ NORTH CAROLINA 6,699 76.4 Alamance 111 72.6 Alexander 35 87.5 Alleghany 10 58.9 Anson 22 77.8 Ashe 30 80.6 Avery 20 88.6 Beaufort 61 98.6 Bertie 17 73.8 Bladen 27 71.8 Brunswick 106 89.6 Buncombe 206 78.1 Burke 75 72.3 Cabarrus 122 89.9 Caldwell 69 77.7 Camden 9 99.3 Carteret 55 65.0 Caswell 14 52.2 Catawba 126 79.6 Chatham 35 53.8 Cherokee 28 69.5 Chowan 12 63.1 Clay 13 86.9 Cleveland 88 78.3 Columbus 42 65.5 Craven 100 97.8 Cumberland 204 86.1 Currituck 17 73.0 Dare 20 52.4 Davidson 149 87.7 Davie 26 56.7 Duplin 36 65.6 Durham 156 76.7 Edgecombe 52 90.7 Forsyth 279 83.4 Franklin 37 71.3 Gaston 203 97.3 Gates 11 81.7 Graham 5 44.9 Granville 50 96.3 Greene 15 76.3 Guilford 325 73.6 Halifax 55 82.6 Harnett 60 67.3 Haywood 74 88.4 Henderson 110 73.1 Hertford 16 57.2 Hoke 20 70.5 Hyde 6 85.5 Iredell 117 81.3 Jackson 23 58.8 Table 7: 2005 Lung/Bronchus Cancer Incidence Rates By County Rates are based on the bridged-race population estimates obtained from the National Center for Health Statistics (Vintage 2006, available online at http://www.cdc.gov/nchs/about/major/dvs/popbridge/popbridge.htm) 1 Rates per 100,000 Population and are age-adjusted to the 2000 U.S. Census * Rates based on less than 10 cases are unstable and therefore suppressed. In situ cancers are excluded. Cancer Incidence in North Carolina 2005 State Center for Health Statistics N.C. Division of Public Health 18 County Cases Rate ¹ NORTH CAROLINA 6,699 76.4 Johnston 84 68.7 Jones 11 84.3 Lee 44 70.1 Lenoir 48 68.0 Lincoln 71 99.2 McDowell 53 104.2 Macon 29 61.1 Madison 23 86.6 Martin 25 80.0 Mecklenburg 379 63.5 Mitchell 15 60.9 Montgomery 25 83.2 Moore 104 83.6 Nash 75 74.2 New Hanover 167 87.3 Northampton 15 50.2 Onslow 94 97.2 Orange 67 67.5 Pamlico 18 98.1 Pasquotank 30 74.8 Pender 43 77.4 Perquimans 12 68.7 Person 36 89.1 Pitt 91 77.4 Polk 16 52.4 Randolph 112 75.6 Richmond 53 100.5 Robeson 91 82.5 Rockingham 101 90.7 Rowan 133 89.0 Rutherford 56 71.9 Sampson 46 68.3 Scotland 25 71.0 Stanly 67 101.8 Stokes 33 62.2 Surry 92 101.2 Swain 9 58.7 Transylvania 22 44.9 Tyrrell * * Union 88 71.1 Vance 37 83.4 Wake 306 57.9 Warren 8 30.9 Washington 11 66.6 Watauga 15 36.2 Wayne 90 77.9 Wilkes 53 65.3 Wilson 70 85.9 Yadkin 21 46.4 Yancey 25 96.9 Table 7 (continued) : 2005 Lung/Bronchus Cancer Incidence Rates By County 1 Rates per 100,000 Population and are age-adjusted to the 2000 U.S. Census * Cases less than 5 are suppressed. In situ cancers are excluded. Rates are based on the bridged-race population estimates obtained from the National Center for Health Statistics (Vintage 2006, available online at http://www.cdc.gov/nchs/about/major/dvs/popbridge/popbridge.htm) Cancer Incidence in North Carolina 2005 State Center for Health Statistics N.C. Division of Public Health 19 County Cases Rate ¹ NORTH CAROLINA 7,098 147.5 Alamance 105 129.5 Alexander 30 142.5 Alleghany * * Anson 15 114.0 Ashe 19 108.9 Avery 19 167.1 Beaufort 39 125.4 Bertie 22 175.5 Bladen 27 127.3 Brunswick 92 155.9 Buncombe 208 143.0 Burke 68 125.1 Cabarrus 121 153.1 Caldwell 76 161.1 Camden 9 196.3 Carteret 73 164.1 Caswell 12 87.7 Catawba 125 142.0 Chatham 48 143.9 Cherokee 23 108.9 Chowan 18 170.5 Clay 14 199.2 Cleveland 99 163.1 Columbus 43 128.0 Craven 76 147.2 Cumberland 226 159.2 Currituck 12 104.2 Dare 31 145.6 Davidson 134 147.6 Davie 28 117.6 Duplin 38 130.0 Durham 184 157.2 Edgecombe 63 198.0 Forsyth 308 166.7 Franklin 51 178.5 Gaston 156 137.0 Gates 7 93.3 Graham 5 81.8 Granville 39 138.7 Greene 15 138.6 Guilford 371 149.0 Halifax 57 165.5 Harnett 71 147.1 Haywood 70 179.0 Henderson 95 133.1 Hertford 21 144.5 Hoke 20 119.7 Hyde 7 218.7 Iredell 105 132.0 Jackson 29 134.9 Rates are based on the bridged-race population estimates obtained from the National Center for Health Statistics (Vintage 2006, available online at http://www.cdc.gov/nchs/about/major/dvs/popbridge/popbridge.htm) Table 8: 2005 Female Breast Cancer Incidence Rates By County 1 Rates per 100,000 Population and are age-adjusted to the 2000 U.S. Census * Cases less than 5 are suppressed. Cancer Incidence in North Carolina 2005 State Center for Health Statistics N.C. Division of Public Health 20 County Cases Rate ¹ NORTH CAROLINA 7,098 147.5 Johnston 107 147.8 Jones 5 79.3 Lee 53 164.2 Lenoir 62 159.7 Lincoln 60 155.3 McDowell 41 148.4 Macon 25 95.7 Madison 18 128.7 Martin 27 170.2 Mecklenburg 596 157.0 Mitchell 11 94.1 Montgomery 17 113.2 Moore 96 170.7 Nash 75 137.4 New Hanover 137 134.3 Northampton 21 124.4 Onslow 92 161.7 Orange 95 163.2 Pamlico 16 168.5 Pasquotank 32 145.3 Pender 33 120.7 Perquimans 19 201.1 Person 35 153.6 Pitt 106 158.7 Polk 15 88.0 Randolph 91 116.9 Richmond 29 99.7 Robeson 77 118.5 Rockingham 79 130.9 Rowan 124 161.9 Rutherford 62 149.5 Sampson 46 136.6 Scotland 13 61.8 Stanly 58 164.1 Stokes 34 118.8 Surry 58 127.6 Swain 12 145.8 Transylvania 33 137.4 Tyrrell 6 257.1 Union 103 135.9 Vance 31 123.8 Wake 561 163.9 Warren 25 225.7 Washington 11 108.3 Watauga 28 131.4 Wayne 97 151.6 Wilkes 58 136.3 Wilson 59 128.6 Yadkin 23 99.1 Yancey 16 116.7 Rates are based on the bridged-race population estimates obtained from the National Center for Health Statistics (Vintage 2006, available online at http://www.cdc.gov/nchs/about/major/dvs/popbridge/popbridge.htm) Table 8 (continued) : 2005 Female Breast Cancer Incidence Rates By County 1 Rates per 100,000 Population and are age-adjusted to the 2000 U.S. Census * Cases less than 5 are suppressed. Cancer Incidence in North Carolina 2005 State Center for Health Statistics N.C. Division of Public Health 21 County Cases Rate ¹ NORTH CAROLINA 5,780 147.8 Alamance 94 148.3 Alexander 33 190.4 Alleghany 11 134.6 Anson 16 128.6 Ashe 33 201.1 Avery 16 157.7 Beaufort 43 153.2 Bertie 16 174.1 Bladen 23 127.4 Brunswick 46 76.0 Buncombe 147 125.7 Burke 56 121.9 Cabarrus 104 173.7 Caldwell 49 128.4 Camden 10 259.6 Carteret 69 166.3 Caswell 15 124.9 Catawba 122 168.5 Chatham 44 152.2 Cherokee 20 105.8 Chowan * * Clay 15 193.3 Cleveland 70 144.6 Columbus 53 187.5 Craven 82 173.7 Cumberland 140 132.0 Currituck 9 71.3 Dare 19 101.3 Davidson 101 128.1 Davie 24 111.1 Duplin 26 112.9 Durham 169 187.8 Edgecombe 40 180.3 Forsyth 202 140.8 Franklin 27 118.2 Gaston 151 167.9 Gates * * Graham * * Granville 42 168.1 Greene 16 179.7 Guilford 370 192.9 Halifax 45 160.3 Harnett 34 85.6 Haywood 62 167.9 Henderson 84 127.4 Hertford 18 138.8 Hoke 19 158.1 Hyde 7 245.8 Iredell 110 169.9 Jackson 21 114.9 Rates are based on the bridged-race population estimates obtained from the National Center for Health Statistics (Vintage 2006, available online at http://www.cdc.gov/nchs/about/major/dvs/popbridge/popbridge.htm) Table 9: 2005 Prostate Cancer Incidence Rates By County 1 Rates per 100,000 Population and are age-adjusted to the 2000 U.S. Census * Rates based on less than 10 cases are unstable and therefore suppressed. In situ cancers are excluded. Cancer Incidence in North Carolina 2005 State Center for Health Statistics N.C. Division of Public Health 22 County Cases Rate ¹ NORTH CAROLINA 5,780 147.8 Johnston 76 144.9 Jones 6 89.3 Lee 39 140.3 Lenoir 68 233.7 Lincoln 52 160.0 McDowell 33 140.0 Macon 21 83.6 Madison 22 189.7 Martin 21 171.1 Mecklenburg 423 143.9 Mitchell 11 114.4 Montgomery 12 85.6 Moore 99 173.5 Nash 69 152.4 New Hanover 92 101.5 Northampton 23 182.8 Onslow 66 146.1 Orange 82 170.6 Pamlico 17 182.7 Pasquotank 24 139.3 Pender 28 112.2 Perquimans 14 171.6 Person 26 148.5 Pitt 86 177.0 Polk 13 99.2 Randolph 97 150.1 Richmond 28 132.2 Robeson 95 188.8 Rockingham 64 130.3 Rowan 80 123.3 Rutherford 40 115.6 Sampson 21 72.7 Scotland 21 112.1 Stanly 44 148.0 Stokes 15 66.7 Surry 49 122.0 Swain 5 65.7 Transylvania 29 128.2 Tyrrell * * Union 80 136.7 Vance 25 135.2 Wake 420 162.0 Warren 21 181.1 Washington 12 160.5 Watauga 27 131.8 Wayne 53 106.3 Wilkes 78 205.4 Wilson 42 122.4 Yadkin 26 133.7 Yancey 10 84.2 Rates are based on the bridged-race population estimates obtained from the National Center for Health Statistics (Vintage 2006, available online at http://www.cdc.gov/nchs/about/major/dvs/popbridge/popbridge.htm) 1 Rates per 100,000 Population and are age-adjusted to the 2000 U.S. Census * Rates based on less than 10 cases are unstable and therefore suppressed. In situ cancers are excluded. Table 9 (continued) : 2005 Prostate Cancer Incidence Rates By County Cancer Incidence in North Carolina 2005 State Center for Health Statistics N.C. Division of Public Health 23 Table 10: Five Most Frequently Diagnosed Cancers By Age Group, 2005 The cancers listed are the five most frequently diagnosed cancers for each age group. Different age groups are at higher risks for different types of cancer. As age increases, the risk of cancer increases. Ages 0-14 Ages 15-19 Type Cases Rate* Type Cases Rate* Leukemia 81 4.5 Brain/CNS (includes benign brain/CNS) 29 4.9 Brain/CNS (includes benign brain/CNS) 77 4.3 Endocrine 23 3.9 Endocrine 23 1.3 Melanoma(Skin) 15 2.5 NH Lymphoma 16 0.9 Hodgkin's Disease 14 2.4 Kidney 16 0.9 Leukemia 12 2.0 Ages 20-24 Ages 25-29 Type Cases Rate* Type Cases Rate* Melanoma(Skin) 42 7.0 Endocrine 58 9.3 Endocrine 37 6.2 Melanoma(Skin) 35 5.6 Hodgkin's Disease 28 4.7 Testes 1 33 10.1 Testes 1 21 6.7 Brain/CNS (includes benign brain/CNS) 32 5.1 Brain/CNS (includes benign brain/CNS) 18 3.0 NH Lymphoma 28 4.5 Ages 30-34 Ages 35-39 Type Cases Rate* Type Cases Rate* Female Breast 1 100 32.4 Female Breast 1 239 75.6 Endocrine 85 13.5 Endocrine 90 14.1 Melanoma(Skin) 67 10.7 Melanoma(Skin) 85 13.3 Brain/CNS (includes benign brain/CNS) 56 8.9 Colon/Rectum 56 8.8 Testes 1 40 12.5 Brain/CNS (includes benign brain/CNS) 54 8.5 Ages 40-44 Ages 45-49 Type Cases Rate* Type Cases Rate* Female Breast 1 514 152.6 Female Breast 1 785 241.1 Colon/Rectum 147 22.1 Lung/Bronchus 273 42.9 Melanoma(Skin) 130 19.5 Colon/rectum 211 33.1 Endocrine 128 19.2 Prostate 1 160 51.5 Lung/Bronchus 105 15.8 Melanoma(Skin) 145 22.8 1 Sex specific populations are used to calculate rates for sex-specific cancers. In situ cancers except those of the urinary bladder and female breast are excluded. Report includes benign brain/CNS. Rates are based on the bridged-race population estimates obtained from the National Center for Health Statistics (Vintage 2006, available online at http://www.cdc.gov/nchs/about/major/dvs/popbridge/popbridge.htm) Cancer Incidence in North Carolina 2005 State Center for Health Statistics N.C. Division of Public Health 24 Table 10 (continued) : Five Most Frequently Diagnosed Cancers By Age Group, 2005 Ages 50-54 Ages 55-59 Type Cases Rate* Type Cases Rate Female Breast 1 805 273.7 Female Breast 1 979 371.4 Prostate 1 452 164.2 Prostate 1 796 324.6 Lung/Bronchus 432 75.9 Lung/Bronchus 723 142.1 Colon/Rectum 362 63.6 Colon/Rectum 443 87.1 Melanoma(Skin) 168 29.5 Kidney 220 43.2 Ages 60-64 Ages 65-69 Type Cases Rate* Type Cases Rate* Prostate 1 998 543.5 Prostate 1 1,100 780.1 Lung/Bronchus 944 243.9 Lung/Bronchus 1,023 333.1 Female Breast 1 879 432.0 Female Breast 1 751 452.2 Colon/Rectum 514 132.8 Colon/Rectum 535 174.2 Bladder 183 47.3 Bladder 237 77.2 Ages 70-74 Ages 75-79 Type Cases Rate* Type Cases Rate* Lung/Bronchus 1,077 417.3 Lung/Bronchus 1,015 483.6 Prostate 1 1,019 896.5 Prostate 1 664 768.2 Female Breast 1 688 476.3 Colon/Rectum 586 279.2 Colon/Rectum 547 211.9 Female Breast 1 568 460.1 Bladder 251 97.2 Bladder 281 133.9 Ages 80-84 Ages 85+ Type Cases Rate* Type Cases Rate* Lung/Bronchus 669 441.3 Lung/Bronchus 390 306.1 Female Breast 1 443 459.4 Colon/Rectum 386 302.9 Colon/Rectum 427 281.6 Female Breast 1 313 345.6 Prostate 1 324 587.1 Prostate 1 228 618.8 Bladder 230 151.7 Bladder 163 127.9 1 Sex specific populations are used to calculate rates for sex-specific cancers. In situ cancers except those of the urinary bladder and female breast are excluded. Report includes benign brain/CNS. Rates are based on the bridged-race population estimates obtained from the National Center for Health Statistics (Vintage 2006, available online at http://www.cdc.gov/nchs/about/major/dvs/popbridge/popbridge.htm) Cancer Incidence in North Carolina 2005 State Center for Health Statistics N.C. Division of Public Health 25 Table 11: 2001-2005 Cancer Incidence Rates by Race and Ethnicity, Per 100,000 Population Age-Adjusted to the US 2000 Census * Counts less than five are suppressed. Rates based on counts less than 16 are unstable. Use with caution. Sites Whites African Americans American Indians Hispanics Total Cases Rate Cases Rate Cases Rate Cases Rate Cases Rate ORAL CAVITY 3,679 10.8 1,001 12.7 30 6.8 54 6.7 4,774 11.2 ESOPHAGUS 1,554 4.6 453 6.1 13 3.0 14 2.5 2,038 4.8 STOMACH 1,678 5.0 736 10.4 21 5.2 59 8.0 2,495 6.0 COLON/RECTUM 15,853 46.9 4,053 56.3 125 33.2 173 29.5 20,246 48.6 LIVER 1,401 4.1 406 5.3 15 3.8 41 6.6 1,902 4.5 GALLBLADDER 265 0.8 104 1.5 * * * * 374 0.9 PANCREAS 3,499 10.4 1,013 14.5 15 4.3 45 8.5 4,570 11.0 LARYNX 1,467 4.3 495 6.6 8 1.9 16 2.4 1,986 4.7 LUNG/BRONCHUS 25,545 74.9 4,957 69.0 229 57.9 179 35.8 30,914 73.8 BONE 304 1.0 67 0.7 * * 21 0.7 384 0.9 SOFT TISSUE 913 2.8 247 3.0 13 2.8 36 2.1 1,191 2.8 MELANOMA (SKIN) 6,843 20.5 56 0.8 9 2.1 31 3.6 6,998 16.6 FEMALE BREAST 27,342 150.5 6,188 140.0 212 87.3 415 106.8 34,156 148.2 CERVIX UTERI 1,205 7.2 453 10.1 19 7.7 101 19.0 1,746 7.9 CORPUS UTERI 3854 20.9 872 20.6 37 17.0 68 20.7 4839 20.7 OVARY 2394 13.0 400 9.1 12 5.1 50 14.1 2,850 12.2 PROSTATE 21,053 138.2 7080 248.2 265 154.1 208 85.5 28,759 156.1 TESTES 905 5.6 61 1.4 9 3.4 71 3.4 1,003 4.7 BLADDER 7,198 21.3 756 11.0 33 10.5 45 10.8 8,044 19.4 KIDNEY 4,874 14.3 1,195 15.8 55 14.1 88 12.9 6,183 14.6 ENDOCRINE 2,803 8.5 583 7.0 18 3.8 119 7.9 3,516 8.3 MULTIPLE MYELOMA 1,611 4.8 754 10.6 15 3.7 25 4.0 2,404 5.8 LEUKEMIA 3,726 11.3 611 8.0 26 6.6 134 8.3 4,464 10.8 BRAIN/OTHER CNS (includes benign brain/CNS) 3,541 10.7 566 7.1 33 7.2 99 8.0 4,209 10.0 HODGKINS DISEASE 847 2.6 218 2.4 10 1.9 34 1.3 1,098 2.6 NON-HODGKINS LYMPHOMA 6,240 18.6 956 12.3 34 7.9 122 15.2 7,342 17.6 OTHER CANCERS 9,375 28.0 2,027 27.9 104 27.1 153 21.2 11,657 28.1 ALL CANCERS 159,969 472.5 36,308 492.7 1,365 337.8 2,403 314.7 200,142 475.9 Hispanic ethnicity is independent of race, so the counts will not sum to the total. Hispanic ethnicity is determined by self-report and the National Hispanic Identification Algorithm available online at Http:// www.naaccr.org/filesystem/pdf/NHIA%20v2%2009-21-05.pdf American Indian rate is known to be underreported. Previous analyses by the North Carolina Central Cancer Registry indicates approximately 17% of patients of American Indian race are reported as a different race. Incidence is assumed to be under-estimated as a result of misclassification. Incidence rates for 2001-2005 used the Bridged-race population estimates obtained from the National Center for Health Statistics (Vintage 2006, available online at http://www.cdc.gov/nchs/about/major/dvs/popbridge/popbridge.htm). Cancer Incidence in North Carolina 2005 State Center for Health Statistics N.C. Division of Public Health 26 Chart 1: Trends For The Four Major Cancers 1990-2005 * Rates per 100,000 Population Age-Adjusted to the 2000 U.S. Census Colon/Rectum Cancer 0 10 20 30 40 50 60 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 Rate* Incidence Mortality Lung/Bronchus Cancer 0 10 20 30 40 50 60 70 80 90 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 Rate* Incidence Mortality Cancer Incidence in North Carolina 2005 State Center for Health Statistics N.C. Division of Public Health 27 Includes in situ breast cancers. Chart 1 (continued) : Trends For The Four Major Cancers 1990-2005 * Rates per 100,000 Population Age-Adjusted to the 2000 U.S. Census Prostate Cancer 0 50 100 150 200 250 1990 1992 1994 1996 1998 2000 2002 2004 Rate* Incidence Mortality Female Breast Cancer 0 20 40 60 80 100 120 140 160 180 1990 1992 1994 1996 1998 2000 2002 2004 Rate* Incidence Mortality Cancer Incidence in North Carolina 2005 State Center for Health Statistics N.C. Division of Public Health 28 * Rates per 100,000 Population Age-Adjusted to the 2000 U.S. Census Chart 2: White and Minority Trends For The Four Major Cancers 1990-2005 Lung/Bronchus Cancer 0 10 20 30 40 50 60 70 80 90 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 Rate* White Incidence Minority Incidence White Mortality Minority Mortality Colon/Rectum Cancer 0 10 20 30 40 50 60 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 Rate* White Incidence Minority Incidence White Mortality Minority Mortality Cancer Incidence in North Carolina 2005 State Center for Health Statistics N.C. Division of Public Health 29 Chart 2 (continued) : White and Minority Trends For The Four Major Cancers 1990-2005 * Rates per 100,000 Population Age-Adjusted to the 2000 U.S. Census Prostate Cancer 0 50 100 150 200 250 300 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 Rate* White Incidence Minority Incidence White Mortality Minority Mortality Female Breast Cancer 0 20 40 60 80 100 120 140 160 180 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 Rate* White Incidence Minority Incidence White Mortality Minortiy Mortality Cancer Incidence in North Carolina 2005 State Center for Health Statistics N.C. Division of Public Health 30 Cancer Incidence in North Carolina 2005 State Center for Health Statistics N.C. Division of Public Health 31 Appendix A Primary Site Definitions International Classification of Disease for Oncology (ICD-O-3) Codes for Newly Diagnosed Neoplasms1 Primary Site ICD-O-3 All Sites C000-C809 Oral Cavity and Pharynx: C000-C148 Lips C000-C009 Tongue C019-C029 Salivary Glands C079-C089 Floor of Mouth C040-C049 Nasopharynx C110-C119 Oropharynx C100-C109 Hypopharynx C129-C139 Other Mouth and Pharynx C030-C039, C050-C069, C090-C099, C140, C142-C148 Digestive System: C150-C269, C480-C488 Esophagus C150-C159 Stomach C160-C169 Small Intestine C170-C179 Colon and Rectum C180-C209, C260 Anus, Anal Cavity and Anorectum C210-C212, C218 Liver and Intrahepatic Bile Duct C220-C221 Gallbladder C239 Pancreas C250-C259 Other Digestive Organs C240-C249, C268-C269, C480-C488 Respiratory System: C300-C399 Larynx C320-C329 Lung and Bronchus C340-C349 Other Respiratory Organs C300-C319, C339, C381-C399 Bones and Joints C400-C419 Soft Tissues C380, C470-C479, C490-C499 Skin C440-C449 Melanoma of Skin C440-C449 (M8720-M8790) Other Skin C440-C449 (Other histology) Breast C500-C509 Invasive C500-C509 (Behavior=3) In Situ C500-C509 (Behavior=2) Female Genital Organs: C530-C589 Cervix Uteri C530-C539 Uterus (Corpus, NOS) C540-C559 Ovary C569 Other Female Genital Organs C510-C529, C570-C589 Cancer Incidence in North Carolina 2005 State Center for Health Statistics N.C. Division of Public Health 32 Appendix A (Continued) Primary Site Definitions International Classification of Disease for Oncology (ICD-O-3) Codes for Newly Diagnosed Neoplasms1 Male Genital Organs: C600-C639 Prostate C619 Testis C620-C629 Penis C600-C609 Other Male Genital Organs C630-C639 Urinary System: C649-C689 Bladder C670-C679 Kidney and Renal Pelvis C649, C659 Ureter C669 Other Urinary System C680-C689 Eye & Orbit: C690-C699 Brain & Central Nervous System (CNS): C700-C729 Endocrine System: C379, C739-C759 Thyroid C739 Other Endocrine and Thymus C379, C740-C759 Lymphomas: M9590-M9717 Hodgkin’s Disease M9650-M9667 Non-Hodgkin’s M9590-M9596, M9670-M9671, M9673,M9675,M9678-M9680,M9684,M9687,M9689-M9691,M9695,M9698- M9702,M9705,M9708-M9709,M9714-M9719,M9727-M9729,M9823,M9827 Multiple Myeloma: M9731-M9732,M9734 Leukemia: M9800-M9948 Acute Lymphocytic M9826, M9835-M9837 Chronic Lymphocytic M9823 Acute Myeloid M9840, M9861, M9866, M9867, M9871-M9874, M9895-M9897,M9910,M9920 Chronic Myeloid M9863,M9875,M9876, M9945,M9946 Other Leukemia M9733, M9742,M9800-M9801,M9805, M9827,M9831, M9870, M9931, M9948, M9963-M9964 Ill-Defined & Unspecified M9740-M9741,M9750-M9758,M9760- M9769,M9950-M9960-M9962,M9970,M9975,M9980,M9982-M9978,M9989 1 Based on the SEER Incidence Site ICD-O-3 Recode, 1/27/2003 http://seer.cancer.gov/siterecode/ Note: Except for lymphoma, multiple myeloma, and leukemia, all categorized sites exclude M9590-M9989 unless otherwise stated. Cancer Incidence in North Carolina 2005 State Center for Health Statistics N.C. Division of Public Health 33 Appendix B Formulae Mathematical definitions: 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-specific rate: ri = (ci/ri)*100,000 where ri is the age-specific rate for age group (i), ci is the count of cases for that age group (i) and ri is the count of persons at risk (i.e., the population) for that age group (i); rates in all tables are presented per 100,000 population. Observed: ♦ Male Observed = Number of new cases of cancer among males �� Female Observed = Number of new cases of cancer among females 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-specific rate for age group. Appendix C: Population By County And Race/Gender North Carolina, 2005 County White Males White Females Minority Males Minority Females NORTH CAROLINA 3,208,831 3,265,515 1,040,559 1,157,554 Alamance 54,036 56,859 13,618 15,714 Alexander 16,652 16,397 1,596 1,170 Alleghany 5,262 5,376 136 90 Anson 6,459 6,261 6,701 6,268 Ashe 12,297 12,635 196 165 Avery 8,635 8,059 898 108 Beaufort 15,870 16,904 5,963 7,141 Bertie 3,429 3,631 5,594 6,677 Bladen 9,849 10,096 6,016 6,924 Brunswick 37,754 38,891 5,894 6,569 Buncombe 95,445 102,945 9,517 10,473 Burke 39,335 40,180 5,586 4,371 Cabarrus 62,068 63,305 11,556 12,656 Caldwell 36,498 37,703 2,544 2,589 Camden 3,697 3,815 689 769 Carteret 28,102 29,323 2,650 2,774 Caswell 7,672 7,487 4,233 4,098 Catawba 65,891 67,108 8,904 9,442 Chatham 24,005 24,248 4,630 5,206 Cherokee 11,900 12,798 521 504 Chowan 4,404 4,707 2,398 2,975 Clay 4,657 4,942 69 87 Cleveland 36,962 39,439 10,022 11,576 Columbus 17,274 18,229 8,790 10,106 Craven 34,018 34,366 12,051 13,394 Cumberland 84,566 85,216 60,077 69,168 Currituck 10,499 10,647 931 1,039 Dare 16,249 16,137 690 644 Davidson 67,806 69,730 7,986 9,011 Davie 17,759 18,202 1,518 1,536 Duplin 19,131 18,150 6,681 7,876 Durham 69,439 68,025 48,694 56,196 Edgecombe 11,006 11,536 14,150 17,309 Forsyth 114,349 120,002 42,055 49,320 Franklin 19,471 19,275 7,542 8,332 Gaston 79,895 84,022 15,071 17,249 Gates 3,467 3,468 2,048 2,197 Graham 3,548 3,758 345 353 Granville 17,990 16,194 10,646 8,594 Greene 6,148 5,717 4,215 3,994 Guilford 140,663 147,516 72,582 82,778 Halifax 11,144 12,162 15,285 17,036 Harnett 38,646 39,371 12,275 13,473 Haywood 26,268 28,372 692 752 Henderson 45,020 47,939 2,063 2,153 Hertford 4,063 4,317 7,295 7,861 Hoke 10,593 10,289 9,585 10,208 Hyde 1,762 1,638 1,171 871 Iredell 59,159 60,310 9,839 11,154 Jackson 14,749 15,639 2,455 2,381 Johnston 60,879 60,142 12,177 13,126 Jones 3,293 3,382 1,675 1,950 2005 North Carolina bridged-race population estimates obtained from the National Center for Health Statistics (Vintage 2006, available online at http://www.cdc.gov/nchs/about/major/dvs/popbridge/popbridge.htm). Cancer Incidence in North Carolina 2005 State Center for Health Statistics N.C. Public Division of Public Health 34 Appendix C (continued) : Population By County And Race/Gender North Carolina, 2005 County White Males White Females Minority Males Minority Females NORTH CAROLINA 3,208,831 3,265,515 1,040,559 1,157,554 Lee 21,787 21,754 5,695 6,511 Lenoir 16,423 17,197 11,057 13,201 Lincoln 32,208 32,435 2,459 2,646 McDowell 20,157 20,604 1,411 1,023 Macon 14,790 16,246 494 403 Madison 9,720 10,118 231 142 Martin 6,367 6,953 4,973 6,176 Mecklenburg 262,984 258,552 129,125 145,708 Mitchell 7,643 7,918 103 98 Montgomery 10,636 10,536 3,164 3,020 Moore 32,858 34,961 6,241 7,282 Nash 27,497 29,178 16,179 18,339 New Hanover 71,527 74,674 15,057 17,785 Northampton 4,224 4,397 5,985 6,795 Onslow 64,628 51,873 17,396 16,611 Orange 45,450 48,981 11,095 13,010 Pamlico 4,834 4,840 1,630 1,475 Pasquotank 11,009 11,414 7,598 8,239 Pender 18,215 18,060 4,997 5,185 Perquimans 4,328 4,576 1,420 1,722 Person 12,941 13,361 5,074 5,825 Pitt 44,223 46,236 23,600 28,226 Polk 8,438 9,379 601 644 Randolph 63,369 64,809 4,837 5,161 Richmond 15,316 15,474 7,759 8,157 Robeson 23,568 22,949 38,923 42,312 Rockingham 35,800 37,791 8,864 10,049 Rowan 55,177 56,450 11,227 11,928 Rutherford 26,865 28,965 3,783 4,041 Sampson 21,467 21,285 9,681 10,423 Scotland 9,123 9,745 8,822 9,386 Stanly 25,180 25,687 4,160 4,004 Stokes 21,168 22,151 1,200 1,271 Surry 33,615 35,214 1,748 1,845 Swain 4,426 4,789 2,010 2,024 Transylvania 13,386 14,486 843 917 Tyrrell 1,268 1,153 1,031 694 Union 70,758 70,351 10,850 11,524 Vance 10,376 10,938 10,263 11,969 Wake 280,398 274,886 92,961 102,620 Warren 3,940 3,897 5,914 6,009 Washington 3,209 3,360 3,096 3,618 Watauga 20,421 20,637 684 692 Wayne 37,092 36,981 18,833 20,921 Wilkes 31,422 32,091 1,818 1,797 Wilson 22,277 22,904 14,228 16,766 Yadkin 17,739 18,359 774 817 Yancey 8,851 9,060 150 136 2005 North Carolina bridged-race population estimates obtained from the National Center for Health Statistics (Vintage 2006, available online at http://www.cdc.gov/nchs/about/major/dvs/popbridge/popbridge.htm). Cancer Incidence in North Carolina 2005 State Center for Health Statistics N.C. Public Division of Public Health 35 Cancer Incidence in North Carolina 2005 State Center for Health Statistics N.C. Division of Public Health 36 Appendix D: U.S. Standard Million Population 2000 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 Source: U.S. Bureau of the Census, Census of Population: 2000. |
OCLC number | 28912294 |