Abstract
Background: Lung cancer is the second most commonly diagnosed cancer in men and women and the leading cause of cancer related death in the United States. Racial disparities in lung cancer incidence, treatment, mortality and survival have been documented. Advances in cancer surveillance, such as expansions in geographic coverage, allow for a more complete description of lung cancer incidence. This population‐based study examines racial and ethnic disparities in incidence of lung cancer for the United States by demographic, geographic, and tumor characteristics.
Methods: We analyzed lung cancer incidence data obtained from cancer registries affiliated with Center for Disease Control's National Program of Cancer Registries and the National Cancer Institute's Surveillance, Epidemiology, and End Results program. The combined data collected on new cases diagnosed during 1998–2005 cover approximately 81% of the U.S. population. We calculated age‐adjusted (2000 US standard) incidence rates, rate ratios, and 95% confidence intervals by demographic and tumor characteristics such as age, sex, race, ethnicity, U.S. Census Region, tumor grade, stage and histology.
Results: A total of 1,296,933 lung and bronchial cancer cases were diagnosed in the U.S. from 1998 until 2005. The overall incidence rate was (69.2/100,000 persons). Rates were higher among men (88.5) than women (55.1). Among men, incidence rates were highest for blacks (111.1) followed by whites (87.7), Asian/Pacific Islanders (API) (53.4) and American Indians/Alaska Natives (AI/AN) (53.3). Among women, whites (56.3) had the highest incidence rates followed by blacks (53.1), API (37.4), and AI/AN (27.3). Compared to non‐Hispanics (71.8), Hispanics (37.5) had lower lung cancer incidence rates. More blacks were diagnosed at younger ages (40–59 years) compared to all other groups. At time of diagnosis, blacks have a higher percentage of distant disease (17%), and a higher percentage of poorly differentiated tumors (14%) compared to whites. Incidence rates differed amongst U.S. Census regions by race. Among whites, the highest lung cancer incidence rate was in the South (76.8) whereas rates among blacks (88.6), American Indians/Alaska Natives (61.5) & Hispanics (41.1) were highest in the Midwest.
Conclusion: This report updates previous findings from population‐based studies describing U.S. disparities in lung cancer incidence. Differences in stage at diagnosis by race were also noted. We describe regional differences in incidence rates for certain racial and ethnic groups. These differences may reflect differences in tobacco use behaviors, early detection, treatment, or other unknown factors. Further investigation into the source of differences is warranted.
Citation Information: Cancer Prev Res 2010;3(1 Suppl):A128.
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