Colorectal carcinoma mortality among Appalachian men and women, 1969-1999

Lori R. Armstrong, Trevor Thompson, H. Irene Hall, Steven Scott Coughlin, Brooke Steele, Joe D. Rogers

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

BACKGROUND. Colorectal carcinoma screening can reduce mortality, but residents of poor or medically underserved areas may face barriers to screening. The current study assessed colorectal carcinoma mortality in Appalachia, a historically underserved area, from 1969 to 1999. METHODS. All counties within the 13-state Appalachian region, which stretches from southern New York to northern Mississippi, were used to calculate annual death rates for the 31-year period. Joinpoint regression analysis was used to examine trends by age and race for the Appalachian region and the remainder of the United States. Five-year rates for 1995-1999 age-adjusted to the 2000 U.S. standard population were calculated by race and age group for the Appalachian region and elsewhere in the United States. RESULTS. Trend analysis showed that colorectal carcinoma death rates among both racial and gender groups studied had declined in recent years. Despite this, the rates for white males and white females were still significantly higher in Appalachia than in the rest of the country at the end of the study period, 1999. Five-year colorectal carcinoma death rates among white males (ages < 50, 50-59, and 70-79 years) and white females (ages < 50, 50-59, 70-79, ≥ 80 years) were significantly higher in Appalachia than elsewhere in the United States, whereas rates among black females 60-69 and 70-79 years old were significantly lower in Appalachia. CONCLUSIONS. The Appalachian region may benefit from targeted prevention efforts to eliminate disparities in the colorectal carcinoma death rates among subgroups. Further studies are needed to determine whether the higher death rates in specific Appalachian subgroups are related to a higher incidence of the disease, the cancer being at a later stage at diagnosis, poorer treatment, or other factors.

Original languageEnglish (US)
Pages (from-to)2851-2858
Number of pages8
JournalCancer
Volume101
Issue number12
DOIs
StatePublished - Dec 15 2004
Externally publishedYes

Fingerprint

Appalachian Region
Colorectal Neoplasms
Mortality
Medically Underserved Area
Mississippi
Age Groups
Regression Analysis

Keywords

  • Appalachian region
  • Colorectal carcinoma
  • Joinpoint
  • Mortality

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Armstrong, L. R., Thompson, T., Hall, H. I., Coughlin, S. S., Steele, B., & Rogers, J. D. (2004). Colorectal carcinoma mortality among Appalachian men and women, 1969-1999. Cancer, 101(12), 2851-2858. https://doi.org/10.1002/cncr.20667

Colorectal carcinoma mortality among Appalachian men and women, 1969-1999. / Armstrong, Lori R.; Thompson, Trevor; Hall, H. Irene; Coughlin, Steven Scott; Steele, Brooke; Rogers, Joe D.

In: Cancer, Vol. 101, No. 12, 15.12.2004, p. 2851-2858.

Research output: Contribution to journalArticle

Armstrong, LR, Thompson, T, Hall, HI, Coughlin, SS, Steele, B & Rogers, JD 2004, 'Colorectal carcinoma mortality among Appalachian men and women, 1969-1999', Cancer, vol. 101, no. 12, pp. 2851-2858. https://doi.org/10.1002/cncr.20667
Armstrong LR, Thompson T, Hall HI, Coughlin SS, Steele B, Rogers JD. Colorectal carcinoma mortality among Appalachian men and women, 1969-1999. Cancer. 2004 Dec 15;101(12):2851-2858. https://doi.org/10.1002/cncr.20667
Armstrong, Lori R. ; Thompson, Trevor ; Hall, H. Irene ; Coughlin, Steven Scott ; Steele, Brooke ; Rogers, Joe D. / Colorectal carcinoma mortality among Appalachian men and women, 1969-1999. In: Cancer. 2004 ; Vol. 101, No. 12. pp. 2851-2858.
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abstract = "BACKGROUND. Colorectal carcinoma screening can reduce mortality, but residents of poor or medically underserved areas may face barriers to screening. The current study assessed colorectal carcinoma mortality in Appalachia, a historically underserved area, from 1969 to 1999. METHODS. All counties within the 13-state Appalachian region, which stretches from southern New York to northern Mississippi, were used to calculate annual death rates for the 31-year period. Joinpoint regression analysis was used to examine trends by age and race for the Appalachian region and the remainder of the United States. Five-year rates for 1995-1999 age-adjusted to the 2000 U.S. standard population were calculated by race and age group for the Appalachian region and elsewhere in the United States. RESULTS. Trend analysis showed that colorectal carcinoma death rates among both racial and gender groups studied had declined in recent years. Despite this, the rates for white males and white females were still significantly higher in Appalachia than in the rest of the country at the end of the study period, 1999. Five-year colorectal carcinoma death rates among white males (ages < 50, 50-59, and 70-79 years) and white females (ages < 50, 50-59, 70-79, ≥ 80 years) were significantly higher in Appalachia than elsewhere in the United States, whereas rates among black females 60-69 and 70-79 years old were significantly lower in Appalachia. CONCLUSIONS. The Appalachian region may benefit from targeted prevention efforts to eliminate disparities in the colorectal carcinoma death rates among subgroups. Further studies are needed to determine whether the higher death rates in specific Appalachian subgroups are related to a higher incidence of the disease, the cancer being at a later stage at diagnosis, poorer treatment, or other factors.",
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AU - Thompson, Trevor

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AU - Steele, Brooke

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N2 - BACKGROUND. Colorectal carcinoma screening can reduce mortality, but residents of poor or medically underserved areas may face barriers to screening. The current study assessed colorectal carcinoma mortality in Appalachia, a historically underserved area, from 1969 to 1999. METHODS. All counties within the 13-state Appalachian region, which stretches from southern New York to northern Mississippi, were used to calculate annual death rates for the 31-year period. Joinpoint regression analysis was used to examine trends by age and race for the Appalachian region and the remainder of the United States. Five-year rates for 1995-1999 age-adjusted to the 2000 U.S. standard population were calculated by race and age group for the Appalachian region and elsewhere in the United States. RESULTS. Trend analysis showed that colorectal carcinoma death rates among both racial and gender groups studied had declined in recent years. Despite this, the rates for white males and white females were still significantly higher in Appalachia than in the rest of the country at the end of the study period, 1999. Five-year colorectal carcinoma death rates among white males (ages < 50, 50-59, and 70-79 years) and white females (ages < 50, 50-59, 70-79, ≥ 80 years) were significantly higher in Appalachia than elsewhere in the United States, whereas rates among black females 60-69 and 70-79 years old were significantly lower in Appalachia. CONCLUSIONS. The Appalachian region may benefit from targeted prevention efforts to eliminate disparities in the colorectal carcinoma death rates among subgroups. Further studies are needed to determine whether the higher death rates in specific Appalachian subgroups are related to a higher incidence of the disease, the cancer being at a later stage at diagnosis, poorer treatment, or other factors.

AB - BACKGROUND. Colorectal carcinoma screening can reduce mortality, but residents of poor or medically underserved areas may face barriers to screening. The current study assessed colorectal carcinoma mortality in Appalachia, a historically underserved area, from 1969 to 1999. METHODS. All counties within the 13-state Appalachian region, which stretches from southern New York to northern Mississippi, were used to calculate annual death rates for the 31-year period. Joinpoint regression analysis was used to examine trends by age and race for the Appalachian region and the remainder of the United States. Five-year rates for 1995-1999 age-adjusted to the 2000 U.S. standard population were calculated by race and age group for the Appalachian region and elsewhere in the United States. RESULTS. Trend analysis showed that colorectal carcinoma death rates among both racial and gender groups studied had declined in recent years. Despite this, the rates for white males and white females were still significantly higher in Appalachia than in the rest of the country at the end of the study period, 1999. Five-year colorectal carcinoma death rates among white males (ages < 50, 50-59, and 70-79 years) and white females (ages < 50, 50-59, 70-79, ≥ 80 years) were significantly higher in Appalachia than elsewhere in the United States, whereas rates among black females 60-69 and 70-79 years old were significantly lower in Appalachia. CONCLUSIONS. The Appalachian region may benefit from targeted prevention efforts to eliminate disparities in the colorectal carcinoma death rates among subgroups. Further studies are needed to determine whether the higher death rates in specific Appalachian subgroups are related to a higher incidence of the disease, the cancer being at a later stage at diagnosis, poorer treatment, or other factors.

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KW - Mortality

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