Geographic Disparities in Cancer Incidence in the US Population Aged 20 to 49 Years, 2016–2020
GIS SNAPSHOTS — Volume 21 — May 9, 2024
PEER REVIEWED
Figure A is a lollipop chart displaying age-adjusted incidence rates (per 100,000 population) for 8 site groups.
Site | Rate |
---|---|
Breast | 75.1 |
Female genital system | 29.0 |
Corpus and uterus, NOS | 11.0 |
Cervix uteri | 10.4 |
Ovary | 5.7 |
Vulva | 1.1 |
Other female genital organs | 0.7 |
Vagina | 0.2 |
Male genital system | 17.4 |
Testis | 11.0 |
Prostate | 6.0 |
Penis | 0.3 |
Other male genital organs | 0.1 |
Digestive system | 22.7 |
Colon excluding rectum | 8.6 |
Rectum and rectosigmoid junction | 5.2 |
Stomach | 2.1 |
Pancreas | 2.1 |
Liver and intrahepatic bile duct | 1.3 |
Small intestine | 1.0 |
Anus, anal canal, and anorectum | 0.8 |
Esophagus | 0.7 |
Other biliary | 0.3 |
Gallbladder | 0.2 |
Retroperitoneum | 0.2 |
Other digestive organs | 0.2 |
Peritoneum, omentum, and mesentery | 0.1 |
Lymphohematopoietic | 16.9 |
Non-Hodgkin lymphoma | 6.8 |
Hodgkin lymphoma | 3.2 |
Myeloid and monocytic leukemia | 3.0 |
Lymphocytic leukemia | 1.7 |
Myeloma | 1.5 |
Kaposi sarcoma | 0.4 |
Other leukemia | 0.3 |
Endocrine system | 16.5 |
Thyroid | 16.1 |
Other endocrine including thymus | 0.5 |
Skin excluding basal and squamous | 12.3 |
Melanoma of the skin | 11.7 |
Other nonepithelial skin | 0.6 |
Urinary system | 8.2 |
Kidney and renal pelvis | 7.3 |
Urinary bladder | 0.8 |
Ureter | 0 |
Other urinary organs | 0 |
Figure B consists of a series of 8 maps that illustrate which states have higher incidence and/or advanced-stage incidence of cancer compared with the US overall. Each map corresponds to 1 of the 8 site groups.
Cancer site | Rate | Rising | Falling | Compared with US | ||
---|---|---|---|---|---|---|
High overall | High advanced-stage | Both high overall and advanced-stage | ||||
Breast | 23.3 | Georgia, Illinois, Wisconsin | None | Delaware, Illinois, Massachusetts, New Hampshire, Rhode Island | Florida, Georgia, Louisiana | Connecticut, Hawaii, Maryland, Minnesota, New Jersey, New York, North Carolina, Pennsylvania, Wisconsin |
Digestive | 14.4 | Illinois, Maryland, New York | None | Alabama, Oklahoma, Puerto Rico | Pennsylvania, South Carolina | Arkansas, Georgia, Hawaii, Indiana, Kentucky, Louisiana, Mississippi, Missouri, New York, North Carolina, Ohio, Tennessee, West Virginia |
Lymphohematopoietic | 11.0 | Alabama | Alaska, Connecticut, Florida, Georgia, Maine | Puerto Rico | Ohio | Connecticut, Florida, Georgia, Kentucky, Louisiana, Maryland, New Jersey, New York, Pennsylvania |
Endocrine | 10.7 | None | Arizona, Arkansas, Georgia, Indiana, Massachusetts, Mississippi, North Carolina, Pennsylvania, Tennessee | Delaware, Kansas, Kentucky, North Dakota, Ohio, Rhode Island, West Virginia, Wyoming | California, Colorado, Idaho, Illinois, Oregon | Connecticut, Iowa, Massachusetts, Nebraska, New Jersey, New Mexico, New York, Pennsylvania, Puerto Rico, South Dakota, Utah, Vermont |
Female genital | 9.1 | None | None | Alabama, Mississippi, Ohio, South Dakota | California, Georgia | Arkansas, Florida, Hawaii, Indiana, Kentucky, Missouri, Oklahoma, Puerto Rico, Texas, West Virginia |
Skin | 7.8 | None | Connecticut, Pennsylvania, New Hampshire | Alabama, Arizona, Arkansas, Georgia, Idaho, Illinois, Kansas, Maine, Montana, North Carolina, North Dakota, Oregon, South Dakota, Washington | Colorado, Delaware, Florida, Missouri, Pennsylvania, Tennessee | Indiana, Iowa, Kentucky, Michigan, Minnesota, Nebraska, New Hampshire, Ohio, Utah, Wisconsin |
Male genital | 5.8 | Louisiana, Texas | Hawaii | Connecticut, Iowa, Michigan, Minnesota, Montana, New Jersey, Puerto Rico, Tennessee, Utah, Wisconsin | Kentucky, Maryland, Mississippi, North Carolina | Georgia, Illinois, Louisiana, New York |
Urinary | 5.1 | New York, West Virginia | Pennsylvania | Alabama, Iowa, Kansas, New Mexico, Oklahoma, Pennsylvania, Tennessee | None | Arkansas, Illinois, Indiana, Kentucky, Louisiana, Mississippi, Missouri, Ohio, Texas, West Virginia |
Figure C is a stratified forest plot demonstrating how each state compares to the US regarding overall incidence and advanced-stage incidence for all early-onset cancers. States whose 95% CIs do not cross 1 are considered significantly different from the overall US in cancer incidence.
Order | State | Overall incidence rate ratio (95% CI) | Advanced-stage incidence rate ratio (95% CI) |
---|---|---|---|
1 | Kentucky | 1.19 (1.17–1.21) | 1.19 (1.16–1.22) |
2 | West Virginia | 1.19 (1.16–1.22) | 1.14 (1.10–1.19) |
3 | New York | 1.12 (1.11–1.13) | 1.11 (1.09–1.12) |
4 | Florida | 1.05 (1.05–1.06) | 1.16 (1.14–1.17) |
5 | Iowa | 1.11 (1.09–1.13) | 1.07 (1.04–1.11) |
6 | Pennsylvania | 1.08 (1.07–1.09) | 1.08 (1.03–1.10) |
7 | Louisiana | 1.07 (1.05–1.09) | 1.08 (1.06–1.11) |
8 | Ohio | 1.07 (1.06–1.09) | 1.07 (1.05–1.08) |
9 | Vermont | 1.09 (1.04–1.14) | 1.04 (0.96–1.11) |
10 | Maine | 1.06 (1.03–1.10) | 1.06 (1.01–1.11) |
11 | New Jersey | 1.08 (1.06–1.09) | 1.04 (1.02–1.06) |
12 | Delaware | 1.06 (1.02–1.10) | 1.04 (0.98–1.10) |
13 | Missouri | 1.02 (1.01–1.04) | 1.06 (1.04–1.08) |
14 | Nebraska | 1.09 (1.06–1.12) | 0.99 (0.95–1.04) |
15 | Arkansas | 1.04 (1.02–1.07) | 1.03 (1.00–1.07) |
16 | Georgia | 1.02 (1.00–1.03) | 1.06 (1.04–1.08) |
17 | Connecticut | 1.04 (1.02–1.06) | 1.04 (1.01–1.07) |
18 | North Carolina | 1.02 (1.01–1.04) | 1.05 (1.03–1.07) |
19 | Mississippi | 1.02 (0.99–1.03) | 1.04 (1.01–1.08) |
20 | Hawaii | 1.04 (1.01–1.07) | 1.01 (0.97–1.06) |
21 | Minnesota | 1.09 (1.07–1.10) | 0.97 (0.94–0.99) |
22 | Rhode Island | 1.02 (0.98–1.05) | 1.03 (0.97–1.09) |
23 | Indiana | 1.02 (1.0–1.03) | 1.03 (1.01–1.05) |
24 | South Dakota | 1.04 (1.00–1.0) | 1.00 (0.94–1.07) |
25 | Michigan | 1.01 (1.00–1.02) | 1.02 (1.00–1.04) |
26 | Wisconsin | 1.02 (1.00–1.04) | 1.01 (0.98–1.03) |
27 | Puerto Rico | 1.12 (1.10–1.14) | 0.92 (0.89–0.95) |
28 | Kansas | 1.05 (1.03–1.08) | 0.97 (0.94–1.00) |
29 | Illinois | 1.02 (1.01–1.03) | 1.00 (0.99–1.02) |
30 | Maryland | 1.01 (1.00–1.03) | 1.01 (1.00–1.03) |
31 | New Hampshire | 1.04 (1.01–1.08) | 0.97 (0.93–1.02) |
32 | Tennessee | 1.01 (1.00–1.02) | 1.00 (0.98–1.03) |
33 | North Dakota | 1.03 (0.98–1.07) | 0.98 (0.91–1.05) |
34 | Montana | 1.03 (1.00–1.07) | 0.96 (0.91–1.02) |
35 | Alabama | 1.05 (1.03–1.06) | 0.94 (0.92–0.97) |
36 | South Carolina | 0.97 (0.96–0.99) | 1.00 (0.97–1.02) |
37 | Idaho | 0.98 (0.95–1.01) | 0.98 (0.94–1.02) |
38 | Oklahoma | 0.99 (0.97–1.01) | 0.96 (0.93–0.99) |
39 | Utah | 1.01 (0.99–1.03) | 0.93 (0.90–0.96) |
40 | Massachusetts | 0.99 (0.97–1.00) | 0.94 (0.92–0.96) |
41 | Alaska | 0.95 (0.91–0.99) | 0.95 (0.89–1.02) |
42 | Washington | 0.95 (0.94–0.96) | 0.95 (0.93–0.97) |
43 | Oregon | 0.93 (0.92–0.95) | 0.93 (0.90–0.95) |
44 | Texas | 0.92 (0.91–0.93) | 0.92 (0.91–0.93) |
45 | California | 0.90 (0.89–0.90) | 0.92 (0.92–0.93) |
46 | District of Columbia | 0.92 (0.88–0.96) | 0.90 (0.84–0.97) |
47 | Virginia | 0.92 (0.90–0.93) | 0.89 (0.88–0.91) |
48 | Wyoming | 0.93 (0.89–0.98) | 0.85 (0.78–0.92) |
49 | Colorado | 0.89 (0.88–0.90) | 0.88 (0.86–0.90) |
50 | New Mexico | 0.90 (0.87–0.92) | 0.86 (0.83–0.90) |
51 | Arizona | 0.87 (0.86–0.88) | 0.80 (0.78–0.82) |
52 | Nevada | 0.85 (0.83–0.88) | 0.80 (0.77–0.83) |
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