학술논문
Geographic Patterns in U.S. Lung Cancer Mortality and Cigarette Smoking.
Document Type
Academic Journal
Author
Shreves AH; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts.; Trans-Divisional Research Program, Division of Cancer Epidemiology and Genetics (DCEG), National Cancer Institute (NCI), National Institutes of Health (NIH), Bethesda, Maryland.; Buller ID; Occupational and Environmental Epidemiology Branch, DCEG, NCI, NIH Bethesda, Maryland.; Cancer Prevention Fellowship Program, Division of Cancer Prevention, NCI, NIH, Bethesda, Maryland.; Chase E; Biostatistics Branch, DCEG, NCI, NIH, Bethesda, Maryland.; Department of Biostatistics, University of Michigan School of Public Health, University of Michigan, Ann Arbor, Michigan.; Creutzfeldt H; Occupational and Environmental Epidemiology Branch, DCEG, NCI, NIH Bethesda, Maryland.; Fielding School of Public Health, University of California Los Angeles, Los Angeles, California.; Fisher JA; Occupational and Environmental Epidemiology Branch, DCEG, NCI, NIH Bethesda, Maryland.; Graubard BI; Biostatistics Branch, DCEG, NCI, NIH, Bethesda, Maryland.; Hoover RN; Office of the Director, DCEG, NCI, NIH, Bethesda, Maryland.; Silverman DT; Occupational and Environmental Epidemiology Branch, DCEG, NCI, NIH Bethesda, Maryland.; Devesa SS; Infections and Immunology Branch, DCEG, NCI, NIH, Bethesda, Maryland.; Jones RR
Source
Publisher: American Association for Cancer Research Country of Publication: United States NLM ID: 9200608 Publication Model: Print Cited Medium: Internet ISSN: 1538-7755 (Electronic) Linking ISSN: 10559965 NLM ISO Abbreviation: Cancer Epidemiol Biomarkers Prev Subsets: MEDLINE
Subject
Language
English
Abstract
Background: Despite the success of smoking cessation campaigns, lung cancer remains the leading cause of cancer death in the U.S. Variations in smoking behavior and lung cancer mortality are evident by sex and region.
Methods: Applying geospatial methods to lung cancer mortality data from the National Vital Statistics System and county-level estimates of smoking prevalences from the NCI's Small Area Estimates of Cancer-Related Measures, we evaluated patterns in lung cancer mortality rates (2005-2018) in relation to patterns in ever cigarette smoking prevalences (1997-2003).
Results: Overall, ever smoking spatial patterns were generally associated with lung cancer mortality rates, which were elevated in the Appalachian region and lower in the West for both sexes. However, we also observed geographic variation in mortality rates that is not explained by smoking. Using Lee's L statistic for assessing bivariate spatial association, we identified counties where the ever smoking prevalence was low and lung cancer rates were high. We observed a significant cluster of counties (n = 25; P values ranging from 0.001 to 0.04) with low ever smoking prevalence and high mortality rates among females around the Mississippi River region south of St. Louis, Missouri and a similar and smaller cluster among males in Western Mississippi (n = 12; P values ranging from 0.002 to 0.03) that has not been previously described.
Conclusions: Our analyses identified U.S. counties where factors other than smoking may be driving lung cancer mortality.
Impact: These novel findings highlight areas where investigation of environmental and other risk factors for lung cancer is needed.
(©2022 American Association for Cancer Research.)
Methods: Applying geospatial methods to lung cancer mortality data from the National Vital Statistics System and county-level estimates of smoking prevalences from the NCI's Small Area Estimates of Cancer-Related Measures, we evaluated patterns in lung cancer mortality rates (2005-2018) in relation to patterns in ever cigarette smoking prevalences (1997-2003).
Results: Overall, ever smoking spatial patterns were generally associated with lung cancer mortality rates, which were elevated in the Appalachian region and lower in the West for both sexes. However, we also observed geographic variation in mortality rates that is not explained by smoking. Using Lee's L statistic for assessing bivariate spatial association, we identified counties where the ever smoking prevalence was low and lung cancer rates were high. We observed a significant cluster of counties (n = 25; P values ranging from 0.001 to 0.04) with low ever smoking prevalence and high mortality rates among females around the Mississippi River region south of St. Louis, Missouri and a similar and smaller cluster among males in Western Mississippi (n = 12; P values ranging from 0.002 to 0.03) that has not been previously described.
Conclusions: Our analyses identified U.S. counties where factors other than smoking may be driving lung cancer mortality.
Impact: These novel findings highlight areas where investigation of environmental and other risk factors for lung cancer is needed.
(©2022 American Association for Cancer Research.)