Gastrointestinal cancers in Mississippi

Objectives: According to a 2007 US Census Bureau report, Mississippi is the poorest state in the United States and is ranked last among all 50 states for overall quality of health. The objective of the study was to describe gastrointestinal (GI) cancers in Mississippi overall and the Mississippi Delta region in particular. Methods: The age-adjusted incidence rates for GI cancers for 2003-2007, compiled from the Mississippi Cancer Registry and the Centers for Disease Control and Prevention's National Program of Cancer Registries, were retrieved and compared among 18 Mississippi Delta counties, 64 non-Delta counties, the entire state of Mississippi, and the United States. Colorectal cancer incidence rates and national rankings were correlated with influencing factors of race, obesity, diabetes mellitus, education, unemployment rate, availability of health insurance and primary care physicians, physical activity, diet, and per capita income. Results: Compared with the United States as a whole, Mississippi had higher rates of colon and rectal cancers and a lower overall rate of gallbladder cancers in both whites and African Americans. Of all GI cancers, only liver, intrahepatic bile duct, and gallbladder cancers had lower age-adjusted incidence rates in the Mississippi Delta region. There was a large difference between African Americans and whites in the Delta region. Whites residing in the Delta counties had higher incidence rates than African Americans of all cancers except liver and intrahepatic bile duct cancers. Conclusions: The majority of GI cancers had higher incidence rates in the Mississippi Delta than non-Delta counties and in the entire state than the United States. These disparities observed on a regional and ethnic basis call for targeted prevention efforts to eliminate disparities in GI cancer incidence rates.