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Temporal and Spatial Analysis of Cancer Rates in the United States

Han, Yueh-Ying (2007) Temporal and Spatial Analysis of Cancer Rates in the United States. Doctoral Dissertation, University of Pittsburgh. (Unpublished)

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Introduction: Spatial, temporal and racial patterns of cancer remain largely unexplained in the United States. Time trends of cancer incidence and mortality can be used to estimate the current cancer burden, anticipate clinical care needs, and suggest hypotheses regarding possible etiologic explanations for underlying trends. Methods: Using U.S. 1979-2003 cancer incidence and 1969-2003 cancer mortality data, age-period-cohort and Joinpoint regression models were fit to summarize gender- and race-specific temporal trends for three broad cancer categories that include tobacco-related cancer, screen-detectable cancer, and cancer unrelated to tobacco and screening. Demographic patterns and time trends of non-Hodgkin's lymphoma (NHL) incidence between Pennsylvania and the U.S. from 1985 to 2004 were compared. Using Idaho cancer incidence, 1990-2005, and arsenic levels in ground water, 1990-2005, spatial analysis was conducted to identify geographic patterns of cancer incidence and to evaluate the relationship between arsenic exposure in ground water and cancer incidence in Idaho. Results: Over the last three decades, tobacco-related cancer incidence declined among men and increased among women. Screen-detectable cancer incidence increased, more rapidly among men than women. For cancer unrelated to tobacco and screening, incidence increased in every gender-and-race group. Though not identical, NHL incidence patterns, with substantial increases, were similar in the U.S. and Pennsylvania. NHL incidence was higher in Pennsylvania counties with a greater percentage of urban residents. Although spatial clustering was demonstrated in Idaho cancer incidence, no relationship was found between arsenic exposure in ground water and Idaho cancer incidence. Conclusion: NHL and other cancers unrelated to smoking or screening have increased in the U.S. in the past two decades in white and black men and women. Etiologic research should attempt to identify modifiable risk factors, including environmental exposures, responsible for the increasing incidence of NHL and cancer unrelated to tobacco and screening. The ecologic association observed in Pennsylvania between NHL incidence and urban residence may be relevant to NHL risk in the entire United States. Additional environmental and demographic information should be evaluated in order to clarify the arsenic-related cancer risk in Idaho counties where ground water has been found to contain higher levels of arsenic. Public Health Significance: Age, period and cohort modeling of cancer incidence and mortality provides important indications of current and future health care needs and also suggests hypotheses for future research. The results of this analysis provide health professionals, researchers, and policy-makers with detailed information and an understandable overview of cancer patterns in the United States. Hypotheses should be generated about these unexplained patterns of cancer so that avoidable cancer risks can be identified that will decrease the cancer burden and associated requirements for health care.


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Item Type: University of Pittsburgh ETD
Status: Unpublished
CreatorsEmailPitt UsernameORCID
Han,, yuehying.han@gmail.comYUH13
ETD Committee:
TitleMemberEmail AddressPitt UsernameORCID
Committee ChairWeissfeld, Joel
Committee CoChairDavis, Devra
Committee MemberGoldstein, Bernard Dbgoldstein@eoh.pitt.eduBDGOLD
Committee MemberTalbott, Evelyn Oeot1@pitt.eduEOT1
Committee MemberDinse, Gregg
Date: 28 September 2007
Date Type: Completion
Defense Date: 17 July 2007
Approval Date: 28 September 2007
Submission Date: 1 August 2007
Access Restriction: 5 year -- Restrict access to University of Pittsburgh for a period of 5 years.
Institution: University of Pittsburgh
Schools and Programs: School of Public Health > Epidemiology
Degree: PhD - Doctor of Philosophy
Thesis Type: Doctoral Dissertation
Refereed: Yes
Uncontrolled Keywords: Cancer trend; Descriptive analysis; Epidemiology; Incidence/Mortality; SEER program; United States
Other ID:, etd-08012007-161547
Date Deposited: 10 Nov 2011 19:55
Last Modified: 15 Nov 2016 13:47


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