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Emerging Infectious Diseases Journal
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Volume 6: No. 1, January 2009

ORIGINAL RESEARCH
Mapping Cancer for Community Engagement

The map shows the state of Iowa with county borders and the locations of the cities of Algona, Ames, Atlantic, Bettendorf, Boone, Burlington, Carroll, Cedar Falls, Cedar Rapids, Centerville, Charles City, Clinton, Council Bluffs, Creston, Davenport, Decorah, Des Moines, Dubuque, Fort Dodge, Fort Madison, Iowa City, Keokuk, Marshalltown, Mason City, Muscatine, Newton, Oskaloosa, Ottumwa, Red Oak, Sioux City, Spencer, Storm Lake, and Waterloo. Interstate highways 35, 29, 680, 235, 80, 380, and 280 are also shown.

The legend shows the scale of the ratio of observed to expected late-stage colorectal cancer cases. There are 15 categories: 0.666-0.823, 0.824-0.866, 0.867-0.905, 0.906-0.936, 0.937-0.961, 0.962-0.984, 0.985-1.004, 1.005-1.021, 1.022-1.037, 1.038-1.054, 1.055-1.074, 1.075-1.097, 1.098-1.125, 1.126-1.178, and 1.179-1.384. Starting from the bottom and moving upward, the first 5 categories are in increasingly lighter shades of blue, the next 5 are white, and the last 5 are in increasingly darker shades of red.

In general, areas in the northern part of the state have expected or higher than expected rates of late-stage diagnosis of colorectal cancer, while rates in the south are generally lower than expected.

The figure includes the following text:

Proportion of cases of colorectal cancer diagnosed in late state is indirectly standardized by age and sex and smoothed using adaptive filter density estimation. Each rate is based on the closest 50 expected cases on a 3-mile grid. Red areas indicate higher rates than expected and blue areas indicate lower rates than expected, given the statewide late stage rate.

Data sources: Cancer incidence data from the Iowa Cancer Registry; 1:100,000 digital raster graphic from the Iowa Geographic Image Map Server hosted by Iowa State University; incorporated area locations from the Natural Resources GIS Library hosted by the Iowa Department of Natural Resources and the US Geological Survey.

Created by: Kirsten Beyer, Dept. of Geography, University of Iowa, June 2006.

Figure 1. Example of map and explanatory information to illustrate the spatial pattern of the proportion of all colorectal cancer cases diagnosed in the late stage, mapped using adaptive spatial filtering, Iowa, 1998-2003. Data sources: Cancer incidence data from the Iowa Cancer Registry; 1:100,000 digital raster graphic from the Iowa Geographic Image Map Server hosted by Iowa State University; incorporated area locations from the Natural Resources GIS Library hosted by the Iowa Department of Natural Resources and the US Geological Survey.

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The map shows the state of Iowa with county borders and the locations of the cities of Algona, Ames, Atlantic, Bettendorf, Boone, Burlington, Carroll, Cedar Falls, Cedar Rapids, Centerville, Charles City, Clinton, Council Bluffs, Creston, Davenport, Decorah, Des Moines, Dubuque, Fort Dodge, Fort Madison, Iowa City, Keokuk, Marshalltown, Mason City, Muscatine, Newton, Oskaloosa, Ottumwa, Red Oak, Sioux City, Spencer, Storm Lake, and Waterloo. Interstate highways 35, 29, 680, 235, 80, 380, and 280 are also shown.

The legend shows the scale of the ratio of observed to expected colorectal cancer cases. There are 15 categories: 0.549-0.805, 0.806-0.856, 0.857-0.892, 0.893-0.925, 0.926-0.958, 0.959-0.983, 0.984-1.009, 1.010-1.034, 1.035-1.060, 1.061-1.082, 1.083-1.111, 1.112-1.144, 1.145-1.195, 1.196-1.257, and 1.258-1.480. Starting from the bottom and moving upward, the first 5 categories are in increasingly lighter shades of blue, the next 5 are white, and the last 5 are in increasingly darker shades of red.

No consistent pattern of cancer incidence by geography emerges.

The figure includes the following text:

Cancer incidence rate is indirectly standardized by age and sex and smoothed using adaptive filter density estimation. Each rate is based on the closest 50 expected cases on a 3-mile grid. Red areas indicate higher rates than expected and blue areas indicate lower rates than expected, given the statewide incidence rate.

Data sources: Cancer incidence data from the Iowa Cancer Registry; 1:100,000 digital raster graphic from the Iowa Geographic Image Map Server hosted by Iowa State University; incorporated area locations from the Natural Resources GIS Library hosted by the Iowa Department of Natural Resources and the US Geological Survey.

Created by: Kirsten Beyer, Dept. of Geography, University of Iowa, June 2006.

Figure 2. Example of map and explanatory information to illustrate the spatial pattern of colorectal cancer incidence, mapped using adaptive spatial filtering, Iowa, 1998-2003. Data sources: Cancer incidence data from the Iowa Cancer Registry; 1:100,000 digital raster graphic from the Iowa Geographic Image Map Server hosted by Iowa State University; incorporated area locations from the Natural Resources GIS Library hosted by the Iowa Department of Natural Resources and the US Geological Survey.

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The legend shows the scale of the ratio of observed to expected late-stage colorectal cancer cases. There are 15 categories: 0.493-0.823, 0.824-0.866, 0.867-0.905, 0.906-0.936, 0.937-0.961, 0.962-0.984, 0.985-1.004, 1.005-1.021, 1.022-1.037, 1.038-1.054, 1.055-1.074, 1.075-1.097, 1.098-1.125, 1.126-1.178, and 1.179-1.541. Starting from the bottom and moving upward, the first 5 categories are in increasingly lighter shades of blue, the next 5 gradually shift from blue to yellow, and the last 5 are in increasingly darker shades of red.

The main 2 images are of the same 9 counties, which include the cities of Spencer and Storm Lake. One image shows the adaptive spatial filtering rate based on the closest 50 expected cases on a 3-mile grid. Storm Lake and its county have the highest observed incidence, but many of the 3-mile blocks in surrounding counties that adjoin this county also show the highest incidence. The rates decrease with increasing distance from Storm Lake. There is also a separate small detail map showing the area immediately around Storm Lake, which shows some detail of the roads in that area. The second main image shows the rates using traditional mapping with only county boundaries, which are generally square. Storm Lake and the county to the east show the highest rates; the remainder of the surrounding counties show rates that range from the lowest to the middle of the scale.

Using the adaptive spatial filtering, the highest rate in the state is 1.384, and the lowest rate is 0.666. Using the traditional mapping, the highest rate in the state is 1.541, and the lowest rate is 0.493.

The figure includes the following text:

Data sources: Cancer incidence data from the Iowa Cancer Registry; 1:100,000 digital raster graphic from the Iowa Geographic Image Map Server hosted by Iowa State University; incorporated area locations from the Natural Resources GIS Library hosted by the Iowa Department of Natural Resources and the US Geological Survey.

Created by: Kirsten Beyer, Dept. of Geography, University of Iowa, June 2006.

Figure 3. Example of map and explanatory information to illustrate the comparison of adaptive spatial filtering and traditional mapping using county boundaries for 9 northwest Iowa counties to show all colorectal cancer cases diagnosed in the late stage, 1998-2003. Data sources: Cancer incidence data from the Iowa Cancer Registry; 1:100,000 digital raster graphic from the Iowa Geographic Image Map Server hosted by Iowa State University; incorporated area locations from the Natural Resources GIS Library hosted by the Iowa Department of Natural Resources and the US Geological Survey. 

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County Rate
Adair 1.5409
Adams 0.9237a
Allamakee 1.1407
Appanoose 1.0708
Audubon 0.9484
Benton 0.8394
Black Hawk 1.0167
Boone 0.9926
Bremer 0.7052
Buchanan 1.0183
Buena Vista 1.5013
Butler 0.9873
Calhoun 1.0474
Carroll 0.9385
Cass 1.0577
Cedar 1.1913
Cerro Gordo 1.1084
Cherokee 1.0406
Chickasaw 1.2255
Clarke 1.1572
Clay 1.0186
Clayton 1.1583
Clinton 0.9485
Crawford 1.0889
Dallas 0.9910
Davis 1.2613
Decatur 0.8654
Delaware 1.0403
Des Moines 0.9165
Dickinson 1.1641
Dubuque 0.9832
Emmet 1.2251
Fayette 1.1792
Floyd 1.1782
Franklin 1.3161
Fremont 0.9842
Greene 0.9119
Grundy 0.9705
Guthrie 1.0057
Hamilton 1.2554
Hancock 1.0874
Hardin 1.0582
Harrison 1.1140
Henry 0.9135
Howard 1.0655
Humboldt 1.0626
Ida 0.8666
Iowa 0.8651
Jackson 1.0575
Jasper 1.0072
Jefferson 0.9707
Johnson 0.9254
Jones 0.9908
Keokuk 0.8797
Kossuth 1.2071
Lee 1.0034
Linn 0.9446
Louisa 1.3215
Lucas 0.4927
Lyon 0.6879
Madison 1.0810
Mahaska 0.7727
Marion 0.8480
Marshall 0.8953
Mills 1.0207
Mitchell 1.0450
Monona 0.9153
Monroe 1.1528a
Montgomery 0.9160
Muscatine 0.8486
O’Brien 1.0597
Osceola 0.9514a
Page 0.7954
Palo Alto 0.8530
Plymouth 0.9880
Pocahontas 1.3106
Polk 0.9731
Pottawattamie 0.9993
Poweshiek 1.0022
Ringgold 1.0304
Sac 1.0097
Scott 1.1125
Shelby 0.7405
Sioux 1.0616
Story 1.0462
Tama 1.1248
Taylor 1.2779
Union 1.1286
Van Buren 1.2321a
Wapello 0.8441
Warren 0.9598
Washington 0.8205
Wayne 1.0782
Webster 1.0159
Winnebago 0.8808
Winneshiek 0.9563
Woodbury 0.9613
Worth 0.8107
Wright 0.9282

a Fewer than 10 expected late-stage cases.

The map shows the state of Iowa with county borders and the locations of the cities of Cedar Rapids, Council Bluffs, Davenport, Des Moines, Dubuque, Fort Dodge, Iowa City, Ottumwa, Sioux City, Spencer, and Waterloo. Interstate highways 35, 29, 680, 235, 80, 380, and 280 are also shown.

The legend shows the scale of the ratio of observed to expected late stage colorectal cancer cases. There are 9 categories: 0.493-0.741, 0.742-0.881, 0.882-0.949, 0.950-0.993, 0.994-1.030, 1.031-1.089, 1.090-1.207, 1.208-1.322, and 1.323-1.541. Starting from the bottom and moving upward, the first 3 categories are in increasingly lighter shades of blue, the next 3 are white, and the last 3 are in increasingly darker shades of red.

The figure includes the following text:

Proportion of cases diagnosed in late stage is indirectly standardized by age and sex. Red areas indicate higher rates than expected and blue areas indicate lower rates than expected, given the statewide late stage rate.

Data sources: Cancer incidence data from the Iowa Cancer Registry; county border data from the Natural Resources GIS Library hosted by the Iowa Department of Natural Resources and the US Geological Survey.

Created by: Kirsten Beyer, Dept. of Geography, University of Iowa, June 2006.

Figure 4. Example of map and explanatory information to illustrate the spatial pattern of the proportion of all colorectal cancer cases diagnosed in the late stage, mapped using county boundaries, Iowa, 1998-2003. Data sources: Cancer incidence data from the Iowa Cancer Registry; county border data from the Natural Resources GIS Library hosted by the Iowa Department of Natural Resources and the US Geological Survey.

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The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.


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