State disparities in colorectal cancer rates: Contributions of risk factors, screening, and survival differences

作者：Iris Lansdorp‐Vogelaar, Simon Lucas Goede, Jiemin Ma, Wu Xiau‐Cheng, Karen S. Pawlish, Marjolein van Ballegooijen, Ahmedin Jemal · 发表于：Cancer · 年份：2015 · DOI：10.1002/cncr.29561 · 被引用次数：15 · 研究领域：Colorectal Cancer Screening and Detection、Global Cancer Incidence and Screening、Nutritional Studies and Diet

BACKGROUND: Northeastern states of the United States have shown more progress in reducing colorectal cancer (CRC) incidence and mortality rates than Southern states, and this has resulted in considerable disparities. This study quantified how the disparities in CRC rates between Louisiana (a Southern state) and New Jersey (a Northeastern state) would be affected if differences in risk factors, screening, and stage-specific CRC relative survival between the states were eliminated. METHODS: This study used the Microsimulation Screening Analysis Colon microsimulation model to estimate age-adjusted CRC incidence and mortality rates in Louisiana from 1995 to 2009 under the assumption that 1) Louisiana had the same smoking and obesity prevalence observed in New Jersey, 2) Louisiana had the same CRC screening uptake observed in New Jersey, 3) Louisiana had the same stage-specific CRC relative survival observed in New Jersey, or 4) all the preceding were true. RESULTS: In 2009, the observed CRC incidence and mortality rates in Louisiana were 141.4 cases and 61.9 deaths per 100,000 individuals, respectively. With the same risk factors and screening observed in New Jersey, the CRC incidence rate in Louisiana was reduced by 3.5% and 15.2%, respectively. New Jersey's risk factors, screening, and survival reduced the CRC mortality rate in Louisiana by 3.0%, 10.8%, and 17.4%, respectively. With all trends combined, the modeled rates per 100,000 individuals in Louisiana became lower than th...