Cancer Chapter 12: Cancer

Transcription

1 Cancer Chapter 12: Cancer 287

2 Health of Boston Cancer Cancer is a disease in which normal, healthy cells are damaged or changed, and begin to multiply abnormally. Since 1998, the incidence of cancer has slowly declined and stabilized in the U.S. (1), but some types have been more difficult to control than others. Nationally, the most commonly diagnosed cancers are prostate, lung, and colorectal cancers in men and breast, lung, and colorectal cancers in women (2). Cancer Prevention Many risk factors for cancer have been identified. About a third of cancer cases are estimated to be preventable (3). The largest contributor to preventable cancer is tobacco use and exposure (including exposure to cigarette smoke, cigarettes, and smokeless tobacco products), which cause about 22% of cancers every year (3). Alcohol consumption is another risk factor. Both alcohol and smoking damage DNA and block the use of many protective antioxidants and vitamins (4, 5). Many environmental chemicals and toxins encourage cancer formation, in addition to excessive exposure to sunlight or tanning beds, ionizing radiation, exposure to some viruses and bacteria, and certain hormones (7). Daily physical activity, regular intake of fruits and vegetables, and a healthy weight diminish risk for some of the most common cancers (6).Some risk factors are out of our control, like having a family history of cancer, or older age. Screening recommendations For those who are at the highest risk of developing cancer, evidence-based guidelines have been developed to ensure that any abnormal cells are caught early. For instance, those with a history of smoking are encouraged to be screened for lung cancer up to 15 years after they quit smoking. Cancer screening has been especially successful with detecting breast, cervix, rectum, and colon cancer, and consistent screening has contributed significantly to the decrease in cancer rates over the past twenty years. Although screening methods are not perfect, knowing your individual risk for developing cancer will help you and your doctor determine whether screening is right for you. 288

3 Cancer Boston 89.5% ( ) Age yrs 91.3% ( ) yrs 87.9% ( ) yrs 87.5% ( ) Race/Ethnicity Asian * Black 90.8% ( ) Latino 96.3% ( ) White 88.2% ( ) Educational Attainment Less than High 93.2% ( ) School High School 89.3% ( ) Degree/GED At Least Some College/ 88.5% ( ) Bachelor's or Higher Insurance Status Insured 90.1% ( ) In 2013, 90% of females ages had a mammogram within the past two years. A significantly higher percentage of Latino females reported having a mammogram within the past 2 years when compared to White females. Boston yrs yrs yrs Asian Black Latino White < HS HS/GED Some College + <$25,000 Income <$25, % ( ) $25,000- $49, % ( ) $50, % ( ) $25,000- $49,999 $50,000+ Insured Figure 12.1 Mammogram within the Past 2 Years by Selected Indicators, 2013 * Uninsured * 0% 25% 50% 75% 100% Percent of Females Ages *Insufficient sample size DATA SOURCE: Boston Behavioral Risk Factor Survey (2013), Boston Public Health Commission 289

4 Health of Boston Figure 12.2 Pap Test within the Past 3 Years by Selected Indicators, 2013 Boston yrs yrs yrs yrs Asian Black Latino White < HS HS/GED Some College + <$25,000 $25,000- $49,999 $50,000+ Insured Uninsured * 0% 25% 50% 75% 100% Percent of Females Ages Boston 86.1% ( ) Age yrs 79.5% ( ) yrs 94.8% ( ) yrs 85.6% ( ) yrs 75.7% ( ) Race/Ethnicity Asian 61.8% ( ) Black 85.8% ( ) Latino 84.4% ( ) White 92.3% ( ) Educational Attainment Less than High School 82.3% ( ) High School Degree/GED 85.2% ( ) At Least Some College/Bachelor's or Higher 86.9% ( ) Income <$25, % ( ) $25,000-$49, % ( ) $50, % ( ) Insurance Status Insured 86.7% ( ) Uninsured * *Insufficient sample size DATA SOURCE: Boston Behavioral Risk Factor Survey (2013), Boston Public Health Commission In 2013, 86% of Boston females ages had a pap test within the past three years. No statistical differences were found by level of educational attainment. Compared to females ages 30-44, a lower percentage of all age groups presented had a pap test within the past three years. By race, the percentage was lower for Asian residents compared to White residents, and by income level, the percentage was lower for residents with less than $25,000 annual income compared to residents with an income of $50,000 or more. 290

5 Cancer Boston 64.4% ( ) Age yrs 59.6% ( ) yrs 69.5% ( ) yrs 68.4% ( ) Race/Ethnicity Asian * Black 67.2% ( ) Latino 66.2% ( ) White 64% ( ) Educational Attainment Less than 56.2% ( ) High School High School Degree/GED 63.6% ( ) At Least Some College/ Bachelor's or 67.0% ( ) Higher Income <$25, % ( ) $25,000- $49, % ( ) $50, % ( ) Insurance Status Insured 64.9% ( ) Uninsured * In 2013, 64% of Boston adults ages reported receiving either a sigmoidoscopy or colonoscopy in the past 5 years. A significantly higher percentage of adults age had a sigmoidoscopy or colonoscopy in the past 5 years when compared to adults age No significant differences were found across race/ethnicity, educational attainment or annual income. Figure 12.3 Sigmoidoscopy or oscopy in the Past 5 Years, 2013 Boston yrs yrs yrs Asian Black Latino White < High School High School Graduate At Least Some College <$25,000 $25K-<$50K $50,000+ Insured Uninsured * * *Insufficient sample size 0% 25% 50% 75% 100% Percent of Adults Age DATA SOURCE: Boston Behavioral Risk Factor Survey (2013), Boston Public Health Commission 291

6 Deaths per 100,000 Residents Health of Boston Figure 12.4 Cancer Deaths by Race/Ethnicity and Year* Boston Asian Black Latino White *Age-adjusted rates DATA SOURCE: Boston Resident Deaths, Massachusetts Department of Public Health From 2008 to 2012, there was no significant change in the cancer death rate for Boston overall. In 2012, the cancer death rate for Boston was Both Asian and Latino residents had lower cancer death rates compared with White residents, although the cancer death rate for Latino residents has increased since

7 Cancer Figure 12.5 Leading Types of Cancer Deaths by Year* (45.1) 236 (45.7) 224 (43.2) 214 (42.1) 238 (45.2) 105 (20.6) 83 (15.8) 92 (17.6) 82 (15.4) 91 (16.8) 69 (13.6) 66 (22.1) 48 (26.5) 67 (21.6) 63 (12.0) 48 (9.0) 63 (21.2) 53 (27.3) 53 (9.5) Counts (Rate per 100,000 residents) 55 (9.8) 53 (17.4) 49 (24.8) 69 (13.2) 56 (27.4) 52 (17.7) *Age-adjusted rates NOTE: Rank is based on number of deaths. Both counts and rates are presented. DATA SOURCE: Boston Resident Deaths, Massachusetts Department of Public Health From 2008 to 2012, lung cancer was the most common cause of cancer deaths in Boston accounting for more than 40% of all leading types of cancer deaths for the years presented. The next most common cause of cancer death was colon cancer for the years presented. 293

8 Health of Boston Asian Residents, Counts (Rate per 100,000 residents) 1 16 (38.6) 12 (27.2) 19 (43.7) 11 (24.2) 20 (42.1) 2 9 (22.2) 9 (22.1) 11 (24.5) 7 (15.6) 11 (22.3) 3 8 (17.9) 5 (11.5) 6 (13.0) 9 (18.2) 4 Non-Hodgkin Lymphoma 5 (11.7) Figure 12.6 Leading Types of Cancer Deaths by Race/Ethnicity and Year* 5 (10.7) 5 Black Residents, Counts (Rate per 100,000 residents) 1 50 (41.9) 46 (36.7) 55 (41.9) 59 (48.8) 51 (37.8) (25.4) 24 (20.8) 24 (32.3) 19 (55.3) 27 (21.7) 25 (33.7) 17 (13.3) 13 (32.3) 26 (21.8) 25 (66.7) 21 (17.0) 19 (24.9) 36 (29.5) 23 (29.1) 19 (52.2) 15 (11.5) 25 (58.9) 21 (16.6) 20 (13.5) 17 (14.3) Latino Residents, Counts (Rate per 100,000 residents) 1 7 (13.5) 14 (31.4) 12 (23.1) 11 (19.9) 14 (22.2) 2 6 (11.7) 6 (12.4) 7 (13.1) 6 (14.1) 7 (13.2) 3 5 (11.5) 5 (12.1) 7 (45.6) 5 (23.7) 7 (12.7) 4 Brain 5 (6.1) 5 (7.9) Stomach 7 (8.3) 5 Continued on next page. Leukemia 5 (7.3) Non-Hodgkin Lymphoma 6 (10.2) 294

9 Cancer White Residents, Counts (Rate per 100,000 residents) (53.7) 164 (57.0) 137 (48.3) 132 (47.8) 151 (54.3) 2 62 (21.0) 46 (15.5) 53 (17.8) 35 (11.8) 51 (16.9) (12.9) 37 (22.7) 26 (22.7) *Age-adjusted rates Not calculated, n<5 37 (12.7) 34 (19.0) 30 (26.1) 39 (26.2) 28 (9.5) 25 (9.0) DATA SOURCE: Boston Resident Deaths, Massachusetts Department of Public Health 29 (9.5) 28 (17.7) 25 (9.0) 42 (14.9) 35 (22.3) 23 (20.1) From 2008 to 2012, lung cancer was the most common cause of cancer deaths in Boston for Black, Latino and White residents. This was also true for Asian residents except in

10 Health of Boston References 1. National Cancer Institute. Report Highlights. The Cancer Trends Progress Report-2011/2012 Update. [Online] [Cited: February 13, 2014.] 2. Centers for Disease Control and Prevention. Other Ways to Reduce Cancer Risk. Cancer Prevention and Control. [Online] [Cited: February 13, 2014.] 3. World Health Organization. Cancer Prevention. Cancer. [Online] [Cited: February 2, 2014.] 4. National Cancer Institute. Alcohol and Cancer Risk. [Online] [Cited: February 13, 2014.] 5. Cigarette smoking cessation increases plasma levels of several antioxidant micronutrients and improves resistance towards oxidative challenge. Polidori, M. C., et al. 1, s.l. : British Journal of Nutrition, 2003, Vol National Cancer Institute. Risk Factors. [Online] [Cited: February 13, 2014.] 7. American Cancer Society. American Cancer Society Guidelines on Nutrition and Physical Activity for Cancer Prevention. [Online] [Cited: February 13, 2014.] rprevention/acs-guidelines-on-nutrition-and-physical-activity-for-cancer-prevention-diet-cancerquestions. 296