Atlas of Cancer Mortality -

Atlas of Cancer Mortality

Results -- Geographic Patterns for Colon Cancer

In all four race/sex groups, striking geographic variation was evident, with mortality rates highest in the northeast quadrant of the United States, including parts of New England, and both the mid-Atlantic and the midwestern states. Rates across the South and West have remained relatively low. Colon cancer mortality has been elevated in the Northeast for at least four decades, partly due to increased risks for urban populations with high socioeconomic levels,⁴² although the regional variation has diminished somewhat over time as more areas in the South have displayed rising mortality rates than in the North.^3,4 While reasons for the geographic patterns are unclear, dietary and nutritional factors are likely to be involved.^43-45 A diet high in fat and calories was suggested, for example, by a case-control study of colon cancer in a high-risk area of Nebraska with a large concentration of residents of Czechoslovakian background.⁴⁶ Of particular note is the lack of high rates in southern retirement areas, suggesting a pattern opposite to the rapid increase in risk reported in population groups migrating from low- to high-risk countries.⁴⁷ Colon cancer incidence rates among whites during 1991-95 were relatively high in Connecticut, Detroit, and Iowa, and low in Utah and New Mexico,⁴⁸ consistent with the mortality patterns.

References

3. Pickle LW, Mason TJ, Howard N, Hoover R, Fraumeni JF Jr. Atlas of U.S. cancer mortality among whites: 1950-1980. Washington, DC: U.S. Gov. Printing Office; 1987. DHHS Publ. No. (NIH) 87-2900.

4. Pickle LW, Mason TJ, Howard N, Hoover R, Fraumeni JF Jr. Atlas of U.S. cancer mortality among nonwhites: 1950-1980. Washington, DC: U.S. Gov. Printing Office; 1990. DHHS Publ. No. (NIH) 90-1582.

42. Blot WJ, Fraumeni JF Jr, Stone BJ, McKay FW. Geographic patterns of large bowel cancer in the United States. J Natl Cancer Inst 1976;57:1225-31.

43. Potter JD, Slattery ML, Bostick RM, Gapstur SM. Colon cancer: a review of the epidemiology. Epidemiol Rev 1993;15:499-545.

44. Schatzkin A, Freedman LS, Lanza E, Tangrea J. Diet and colorectal cancer: still an open question. J Natl Cancer Inst 1995;87:1733-5.

45. Potter JD. Nutrition and colorectal cancer. Cancer Causes Control 1996;7:127-46.

46. Pickle LW, Greene MH, Ziegler RG, Toledo A, Hoover R, Lynch HT, Fraumeni JF Jr. Colorectal cancer in rural Nebraska. Cancer Res 1984;44:363-9.

47. Ziegler RG, Devesa SS, Fraumeni JF Jr. Epidemiologic patterns of colorectal cancer. In: DeVita VT, Hellman S, Rosenberg SA, editors. Important advances in oncology 1986. Philadelphia: JB Lippincott; 1986. p. 209-32.

48. Ries LAG, Kosary CL, Hankey BF, Miller BA, Edwards BK, editors. SEER cancer statistics review, 1973-1995. Bethesda, MD: National Cancer Institute; 1998. NIH Publ. No. 98-2789.

Suggested Citation

Devesa SS, Grauman DG, Blot WJ, Pennello G, Hoover RN, Fraumeni JF Jr. Atlas of cancer mortality in the United States, 1950-94. Washington, DC: US Govt Print Off; 1999 [NIH Publ No. (NIH) 99-4564].