- Collection:
- Georgia Government Publications
- Title:
- Georgia cancer data report
- Creator:
- Georgia. Division of Public Health
- Contributor to Resource:
- American Cancer Society
- Publisher:
- Atlanta, Ga. : Dept. of Human Resources, Division of Public Health, in association with the American Cancer Society, Southeast Division
- Date of Original:
- 2000
- Subject:
- Cancer--Georgia--Statistics
- Location:
- United States, Georgia, 32.75042, -83.50018
- Medium:
- state government records
- Type:
- Text
- Format:
- application/pdf
- Description:
- Title from cover
- External Identifiers:
- Call Number GA H800.P8 S1 C63 2000
- Metadata URL:
- https://dlg.galileo.usg.edu/id:dlg_ggpd_s-ga-bh800-pp8-bs1-bc63-b2000-belec-p-btext
- Digital Object URL:
- https://dlg.galileo.usg.edu/do:dlg_ggpd_s-ga-bh800-pp8-bs1-bc63-b2000-belec-p-btext
- Language:
- eng
- Holding Institution:
- University of Georgia. Map and Government Information Library
- Rights:
-
Mission Statement for Georgia Department of Human Resources Our mission is to promote and protect the health of people in Georgia wherever they live, work, and play.We unite with individuals, families, and communities to improve their health and enhance their quality of life.
Mission Statement for American Cancer Society The American Cancer Society is the nationwide community-based voluntary health organization dedicated to eliminating cancer as a major health problem by preventing cancer, saving lives and diminishing suffering from cancer, through research, education, advocacy, and service.
If you would like more information on cancer, visit our web site at www.ph.dhr.state.ga.us.
If you would like more information on cancer, call 1-800-ACS-2345 24 hours a day, seven days a week. Or visit our web site at www.cancer.org.
2000, American Cancer Society, Inc.
15-102
GEORGIA Cancer Data REPORT
2000
September 1, 2000
Dear Friends:
The Georgia Cancer Data Report 2000 describes the immense impact of cancer in our state. During this year an estimated 32,900 Georgians will develop cancer and 13,700 will die from the disease.This means that a citizen of our state will be diagnosed with cancer every 16 minutes and that a Georgian will die of cancer about every 38 minutes.
Here are some highlights from this report: Cancer is the second leading cause of death in this state, accounting for one in four
deaths each year. Twenty-seven percent more African-American Georgians will die of cancer than whites. Cancers of the lung, breast, prostate, and colorectum account for 54 percent of our state's
cancer deaths. Unless current trends are reversed, one in two Georgia men and one in three Georgia
women will develop cancer in their lifetime.
This important document will serve as a guide to help us develop a plan to reverse these trends. Promising new screening tests and research show clearly that we can intervene and prevent cancer from becoming deadly. In order to take advantage of these new opportunities, we must capitalize on our existing resources and new research opportunities.Working together, we can dramatically reduce the number of Georgians who are currently projected to die of cancer.
I commend the Georgia Department of Human Resources' Division of Public Health and the American Cancer Society, Southeast Division for their partnership in developing and releasing this document.Through their joint efforts we have a much better perspective of the burden of cancer in our state, identification of risk factors for the more prevalent types of cancers, and guidelines for early detection and screening.This information will help us better plan our efforts in cancer prevention, screening, education, research, and treatment to meet the current and future needs of Georgians.
Sincerely,
Roy E. Barnes
TABLE OF CONTENTS
E XECUTIVE SUMMARY ....................................................3 INTRODUCTION ........................................................4 GEORGIA DEMOGRAPHICS ........................................4 BASIC CANCER INFORMATION ......................................5 CANCER IN GEORGIA IN 2000 ......................................6 C A N C E R M O R T A L I T Y . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10 C A N C E R I N C I D E N C E . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18 B R E A S T C A N C E R .......................................................... 22 U T E R I N E C E R V I X C A N C E R . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24 C O L O N & R E C T U M C A N C E R . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26 L U N G & B R O N C H U S C A N C E R . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28 P R O S T A T E C A N C E R . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29 C A N C E R R I S K B E H A V I O R S I N G E O R G I A . . . . . . . . . . . . . . . . . . . . . . . . 30 C O N C L U S I O N . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34 T E C H N I C A L A P P E N D I X . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35 R E F E R E N C E S . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36 S T A T I S T I C A L A P P E N D I X . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37
ACKNOWLEDGEMENTS
American Cancer Society, Southeast Division . . . . . Jack Shipkoski, Chief Executive Officer Cancer Control Department . . . . . . . . . . . . . . . . . . . . . . Kristen Copes, M.S.W.,Vice President
Sarah H. Landis, M.P.H., Manager, Regional Planning Marketing and Communications Department . . . . . . . . . . . . . . . Laurie Stephens,Vice President Public Health Internship Program . . . . . . . . . . . . . . . . . . . . . . . . . . Janae Zolna, M.P.H., Intern
Georgia Department of Human Resources . . . . . . . . . . . . Audrey W. Horne, Commissioner Division of Public Health . . . . . . . . . . . . . . . . . . . . Kathleen E.Toomey, M.D., M.P.H., Director Chronic Disease Prevention and Health Promotion Branch . . . . . . . . . . . . James H. Brannon Jr.,
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .M.S., M.Ed., Director Cancer Control Section . . . . . . . . . . . . . . . . . . . . . . . . . Carol B. Steiner, M.N., R.N., Director Epidemiology Branch . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Paul A. Blake, M.D., M.P.H., Director Chronic Disease, Injury, and Environmental Epidemiology Section . . . . . . . . . . .Kenneth Powell,
M.D., M.P.H., Director
Suggested Citation--Landis SH, Steiner CB, Bayakly AR, McNamara C, Powell KE. Georgia Cancer Data Report, 2000. Georgia Department of Human Resources, Division of Public Health, Cancer Control Section, and the American Cancer Society, Southeast Division, May, 2000. Publication Number: DPH00.27HW.
03 G E O R G I A
Cancer Data Report
2000
EXECUTIVE SUMMARY
Cancer is a major health problem in Georgia More than 32,900 Georgians will develop
cancer in 2000, and 13,700 will die from this disease. Cancer was the second leading cause of death in Georgia in 1994-1998, accounting for 22% of all deaths. One in 2 males, and 1 in 3 females in the US will develop cancer in their lifetime. Cancer mortality rates in Georgia declined 6% between 1993-1998. Lung cancer is the leading cause of cancer death among Georgians and accounts for 30% of all cancer deaths. Lung cancer mortality rates among Georgia females have doubled since 1980. Blacks in Georgia are 27% more likely to die of cancer than whites.
Much of the burden of death and disability from cancer is preventable Tobacco use accounts for at least 30% of all
cancer deaths. Tobacco use is responsible for about 87% of
all lung cancers in Georgia.
Between 1992-1998, smoking rates in Georgia increased 5% per year among females and 4% per year among males.
In 1999, 55% of middle school students reported ever having used tobacco; 19% reported current use of tobacco.
About one-third of cancer deaths are related to diet, nutrition, and physical activity.
In 1998, only 21% of Georgia adults consumed 5 or more fruits and vegetables per day.
Less than one-third of Georgia adults are physically active on a regular basis.
Some cancers can be detected early when treatment is most effective For 1996-1998, 55% of Georgia females aged
50 and older had a mammogram and clinical breast examination within the previous year. For 1996-1998, 90% of Georgia females aged 18 and older had a Pap test in the past 3 years. In 1997, 52% of Georgia males and 45% of Georgia females had ever had a sigmoidoscopy.
Age-adjusted Rates and Standard Populations Age-adjusted rates allow for direct comparison of cancer incidence and mortality among populations with different age structures. Recently, the National Center for Health Statistics recommended that all rates calculated for deaths occurring during 1999 and thereafter be age-adjusted to the 2000 US standard population. Changing from previously used standards, such as the 1970 US standard, to the 2000 US standard will affect the magnitude of age-adjusted rates. Rates adjusted to the 2000 US standard will be higher in magnitude (see figure below).
In order to begin the transition to the new standard population, this report displays rates calculated to both the 1970 US standard (Tables 2, 3 and 4, pages 14-17, 19-21 and 24) and the 2000 US standard (Statistical Appendix Tables 2A, 3A and 4A, pages 37-45).The reader must use caution when comparing the rates presented in this report with rates from other data sources. It is important to note the standard population used for age-adjustment in order to make accurate comparison of rates from a variety of sources. Rates calculated using different standard populations are not directly comparable.
Rate per 100,000
250.0
Cancer Death Rates in Georgia, 1980-1998
200.0
150.0
100.0 1980 1982
2000 Standard
1970 Standard
1940 Standard
1986 1990 Year
1994
1998
04 G E O R G I A
Cancer Data Report
2000
INTRODUCTION
The Challenge Cancer is the second leading cause of death in Georgia, accounting for 22% of all deaths between 1994-1998 (Figure 1). In 2000, an estimated 13,700 Georgians will die of cancer and 32,920 Georgians are expected to be diagnosed with this disease.The most common forms of cancer, lung, colorectal, breast and prostate, will account for 55% of all cancer diagnoses and 54% of all cancer deaths.
Hope and Progress Currently, there is no universal cure for all types of cancer. However, there is hope in reducing the number of lives lost to this disease. New and better treatments for cancer continue to be developed and survival rates for cancer are
Figure 1. Figure 1. LeadinLgeCaadusiensgofCDeaauthsien sGeorfgiDa,e19a9t4h-1i9n98Georgia, 1994-1998
Heart disease 30%
Diabetes 2%
Pneumonia & influenza
4%
COPD 4%
Unintentional injury 5%
Stroke 7%
Cancer 22%
Lung & bronchus 30%
Colon & rectum 9% Breast 8% Prostate 7%
Other cancers 46%
Other 26%
improving. Many cancers can be detected early, increasing the chances of successful treatment and survival. More significantly, the risk of death from cancer can be reduced by adopting a healthy lifestyle. About 30% of all cancer deaths could be prevented by not smoking and another one-third could be prevented by adopting healthy diet and exercise practices.
Answers This report was written to assist health professionals, volunteers and staff of cancer control organizations, community groups and others who are working to reduce the burden of cancer throughout Georgia. Data provided at the state and local level can be used to measure outcomes and effectiveness of cancer control programs, develop plans for future programs, develop funding proposals, and coordinate effective collaborations.
This report describes the burden of cancer in Georgia and includes: 1) the 2000 estimated number of new cancer cases and deaths for Georgia and each county; 2) the number of cases and incidence rates for Georgia and each county; 3) the number of cancer deaths and mortality rates for Georgia and each county; 4) the prevalence of cancer screening in Georgia; and 5) the prevalence of cancer risk factors in Georgia.
GEORGIA DEMOGRAPHICS
During the 1990's, Georgia experienced substantial population growth. Between 19901998, the population of Georgia increased 18% compared to only 9% for the United States.1 Approximately half of Georgia's 7.6 million residents live in Metropolitan Atlanta.1, 2
In 1997, 70% of Georgians were white, 28% black, and 2% of other races; 3% of the population was of Hispanic origin.3 Between 2000-2015, the Hispanic population of Georgia is expected to increase by 48%. During these same years, the
black population is expected to increase by 29% and will comprise approximately one-third of the total population of Georgia.4
Like the United States, Georgia's population is aging. Between 2000-2015, the number of Georgians over the age of 65 will increase by 51% to 1.2 million.4 Since the risk of developing cancer increases with age, this aging of the population will increase the burden of cancer in Georgia.
05 G E O R G I A
Cancer Data Report
2000
BASIC CANCER INFORMATION
What Is Cancer? Cancer is a group of diseases characterized by uncontrolled growth and spread of abnormal cells. If the growth is not controlled, it can result in death. Cancer is caused by both internal and external factors. Many cancers can be prevented by lifestyle changes and many can be cured if detected and treated promptly.
How Many New Cases are Expected to Occur This Year? In 2000, about 32,920 Georgians will be diagnosed with cancer -- about 90 per day (Table 1, page 7). In the United States, 1.2 million cases of cancer are expected to occur in 2000. These estimates do not include non-melanoma skin cancer and carcinoma in situ for sites other than urinary bladder. Based on national estimates, more than 39,000 cases of non-melanoma skin cancer are expected to be diagnosed in Georgia this year.
How Many People are Expected to Die of Cancer This Year? In 2000, about 13,700 Georgians are expected to die from cancer (Table 1, page 7). Cancer is the second leading cause of death in Georgia, with approximately 1 out of every 4 deaths from cancer. In the United States, 552,200 cancer deaths are expected to occur in 2000.
Can Cancer Be Prevented? Many cancers can be prevented. Nearly two-thirds of cancer deaths can be linked to modifiable risk factors such as tobacco use, diet, obesity, and lack of exercise. In addition, many skin cancers could be prevented by protection from the sun's rays. Regular screening examinations by a health care provider can result in early detection of many cancers, when treatment is more likely to be successful.
Who Is at Risk of Developing Cancer? Everyone. Since the occurrence of cancer increases as individuals age, most cases affect adults who are middle-aged or older. Nearly 72% of all cancers in Georgia are diagnosed at ages 55 and older. In the United States, males have a 1 in 2 lifetime risk of developing cancer,
and for females the lifetime risk is 1 in 3. Lifetime risk refers to the probability that an individual, over the course of a lifetime, will develop cancer.
How is Cancer Treated? Cancer is commonly treated by surgery, radiation, chemotherapy, hormones, and immunotherapy (agents to stimulate the body's defenses) or a combination of two or more of these methods.
What Are the Costs of Cancer? The financial costs of cancer are great both to the individual and to society as a whole. Using estimates from the National Institutes of Health, the overall annual costs for cancer in Georgia is approximately $2.9 billion; $1.0 billion for direct medical costs (total of all health expenditures), $300 million for indirect morbidity costs (cost of lost productivity due to illness), and $1.6 billion for indirect mortality costs (cost of lost productivity due to premature death).Treatment of breast, lung, and prostate cancers account for over half of the direct medical costs.
Causes of Cancer in the United States
Estimated percentage of total cancer deaths attributable to established causes of cancer
Risk Factor
Percentage
Tobacco
30%
Adult diet/obesity
30%
Sedentary lifestyle
5%
Occupational factors
5%
Family history of cancer
5%
Viruses/other biologic agents
5%
Perinatal factors/growth
5%
Reproductive factors
3%
Alcohol
3%
Socioeconomic status
3%
Environmental pollution
2%
Ionizing/ultraviolet radiation
2%
Prescription drugs/medical procedures 1%
Salt/other food additives/contaminants 1%
Source: Cancer Causes & Control, Harvard Report on Cancer Prevention, 1996
06 G E O R G I A
Cancer Data Report
2000
CANCER IN GEORGIA IN 2000
Figure 2. Cancer Cases in Georgia, 2000 Estimates
Male
Female
Prostate 5,030
Lung & bronchus 3,480
Colon & rectum 1,640
Non-Hodgkin's lymphoma 930
Melanoma 810
Urinary bladder 720
Oral cavity 520
Kidney 450
Leukemia 440
Pancreas 290
ALL SITES* 17,760
Breast 4,650
Lung & bronchus 1,810
Colon & rectum 1,640
Uterine corpus 840
Ovary 780
Melanoma 670
Non-Hodgkin's lymphoma 580
Uterine cervix 550
Leukemia 350
Pancreas 270
ALL SITES* 15,160
* Excludes non-melanoma skin cancer and carcinoma in situ except urinary bladder.
Figure 3. Cancer Deaths in Georgia, 2000 Estimates
Male
Female
Lung & bronchus 2,770
Prostate 910
Colon & rectum 610
Pancreas 310
Leukemia 280
Non-Hodgkin's lymphoma 240
Esophagus 210
Stomach 190
Brain 170
Liver 150
ALL SITES* 7,490
Lung & bronchus 1,360
Breast 1,100
Colon & rectum 650
Pancreas 330
Ovary 330
Leukemia 220
Non-Hodgkin's lymphoma 220
Brain 140
Uterine cervix 130
Stomach 130
ALL SITES* 6,210
* Excludes non-melanoma skin cancer and carcinoma in situ except urinary bladder.
07
Table 1. Estimated New Cancer Cases and Cancer Deaths by County, Georgia, 2000
ESTIMATED NEW CASES
ESTIMATED DEATHS
County
All sites
Female breast
Colon & Lung & Prostate rectum bronchus
All sites
Female breast
Colon & Lung & rectum bronchus
Georgia
32,920
4,650
3,280
5,290
5,030
13,700
1,100
1,260
4,130
Appling
90
10
10
20
20
40
10
10
Atkinson
30
10
10
10
Bacon
60
10
10
10
10
30
10
Baker
20
10
10
Baldwin
190
30
20
30
30
80
10
10
20
Banks
50
10
10
10
20
10
Barrow
150
20
10
30
10
70
10
20
Bartow
320
40
40
60
50
140
10
10
50
Ben Hill
80
10
10
10
10
40
10
Berrien
80
10
10
20
10
30
10
Bibb
730
90
90
120
130
320
30
30
100
Bleckley
60
10
10
10
30
10
Brantley
70
20
30
10
Brooks
80
10
10
10
20
40
10
Bryan
70
10
10
10
10
30
10
Bulloch
190
30
20
30
40
80
10
10
20
Burke
100
20
10
10
10
40
10
10
Butts
90
10
10
10
10
40
10
Calhoun
30
20
10
Camden
100
10
10
20
20
40
10
Candler
50
10
10
20
10
Carroll
360
50
40
60
40
140
10
20
50
Catoosa
250
30
30
50
20
110
10
10
40
Charlton
50
10
10
10
10
20
10
Chatham
1,160
150
130
190
160
510
40
50
150
Chattahoochee
30
10
Chattooga
140
20
10
30
10
60
10
20
Cherokee
420
60
50
60
40
160
10
20
50
Clarke
290
50
30
50
70
130
10
10
40
Clay
20
10
Clayton
860
110
70
150
110
310
20
30
110
Clinch
30
10
10
10
Cobb
2,060
320
190
310
260
800
80
70
230
Coffee
150
20
10
20
60
10
10
20
Colquitt
190
20
20
30
50
90
10
10
30
Columbia
310
50
20
50
50
130
10
10
40
Cook
80
10
10
10
10
30
10
Coweta
270
40
20
50
50
120
10
10
40
Crawford
40
10
10
20
10
Crisp
140
20
10
30
20
60
10
20
Dade
60
10
10
10
30
10
Dawson
60
10
10
10
10
30
10
Decatur
130
20
20
20
20
70
10
20
DeKalb
2,580
480
260
350
460
1,040
100
100
280
Dodge
110
10
10
20
10
40
10
Dooly
60
10
10
10
10
30
Dougherty
440
60
50
80
80
200
20
20
60
Douglas
360
50
30
60
50
140
10
10
50
Early
70
10
10
10
10
30
10
Echols
10
10
Effingham
130
20
10
20
10
40
20
Elbert
120
20
10
20
30
50
10
10
20
Estimate is fewer than 5 cases or deaths. Cases or deaths between 5 and 9 were rounded to 10. Note: County estimates may not add to Georgia total due to rounding.
Prostate
910 10 10 20 10 10 10 10 30 10 10 20 40 10 10 10 10 70 10 10
08
Table 1. Estimated New Cancer Cases and Cancer Deaths by County, Georgia, 2000 (continued)
ESTIMATED NEW CASES
ESTIMATED DEATHS
County
All sites
Female breast
Colon & Lung & Prostate rectum bronchus
All sites
Female breast
Colon & Lung & Prostate rectum bronchus
Emanuel
120
10
20
20
20
50
10
10
10
Evans
50
10
10
10
20
10
Fannin
120
10
10
30
20
50
10
20
Fayette
350
50
50
50
30
150
20
10
40
10
Floyd
490
60
50
90
60
230
20
20
70
10
Forsyth
180
30
20
30
30
80
10
10
30
Franklin
100
10
10
20
10
50
10
Fulton
3,260
530
330
430
600
1,290
130
130
330
100
Gilmer
100
10
10
20
10
40
20
Glascock
10
10
Glynn
380
50
30
70
90
170
10
10
60
10
Gordon
200
20
20
40
20
90
10
10
30
10
Grady
120
20
10
20
30
50
20
Greene
70
10
10
10
20
30
10
Gwinnett
1,460
250
140
190
220
540
50
50
160
30
Habersham
150
20
20
30
10
60
10
10
20
Hall
480
70
50
80
80
210
20
20
60
10
Hancock
60
10
10
10
20
20
Haralson
130
20
10
30
20
50
10
20
Harris
110
10
10
20
30
50
10
10
Hart
110
20
10
20
20
50
10
20
10
Heard
40
10
10
10
20
10
Henry
310
50
30
50
30
120
10
10
40
10
Houston
430
70
40
80
70
180
20
20
60
10
Irwin
60
10
10
10
10
30
10
Jackson
160
20
20
30
20
70
10
10
20
10
Jasper
60
10
10
10
10
20
10
Jeff Davis
80
10
10
20
10
40
10
Jefferson
110
20
10
20
20
50
10
10
10
Jenkins
50
10
10
10
10
20
10
Johnson
50
10
10
20
10
Jones
100
20
10
20
20
40
20
Lamar
80
10
10
10
10
30
10
Lanier
30
10
10
10
Laurens
230
20
20
40
60
100
10
10
30
10
Lee
90
10
10
20
10
30
10
Liberty
160
30
10
20
40
60
10
20
10
Lincoln
50
10
10
10
10
20
10
Long
30
10
10
10
Lowndes
360
40
30
60
60
150
10
10
50
10
Lumpkin
80
10
10
20
10
30
10
McDuffie
110
20
10
20
10
40
10
McIntosh
80
10
10
10
20
30
10
Macon
70
10
10
10
20
30
10
Madison
120
20
10
20
10
50
20
Marion
20
10
10
10
10
Meriwether
120
10
10
20
20
50
10
10
Miller
30
10
10
20
Mitchell
110
10
10
20
20
50
20
Monroe
100
10
10
20
10
40
20
Montgomery
40
10
10
20
10
Morgan
70
10
10
10
10
30
10
Murray
130
10
10
30
10
50
20
Estimate is fewer than 5 cases or deaths. Cases or deaths between 5 and 9 were rounded to 10. Note: County estimates may not add to Georgia total due to rounding.
09
Table 1. Estimated New Cancer Cases and Cancer Deaths by County, Georgia, 2000 (continued)
ESTIMATED NEW CASES
ESTIMATED DEATHS
County
All sites
Female breast
Colon & Lung & Prostate rectum bronchus
All sites
Female breast
Colon & Lung & Prostate rectum bronchus
Muscogee
840
120
90
140
120
370
30
40
110
30
Newton
250
30
20
40
30
100
10
10
30
10
Oconee
80
10
10
10
10
30
10
Oglethorpe
50
10
10
10
20
10
Paulding
220
30
20
40
20
80
10
10
30
10
Peach
100
20
10
20
10
40
10
Pickens
90
10
10
20
20
40
20
Pierce
90
10
10
20
10
40
10
Pike
60
10
10
30
10
Polk
210
30
20
40
30
90
10
10
30
10
Pulaski
50
10
10
10
10
20
10
Putnam
100
10
20
30
40
10
Quitman
20
10
Rabun
90
10
10
10
10
40
10
Randolph
50
10
10
10
10
20
10
Richmond
1,010
130
100
160
120
420
30
40
120
20
Rockdale
280
50
30
50
30
110
10
10
30
Schley
30
10
10
10
Screven
80
10
10
10
20
30
10
Seminole
50
10
10
10
10
20
10
Spalding
260
40
20
40
30
120
10
10
40
10
Stephens
140
20
10
20
20
60
10
10
20
Stewart
40
10
10
20
10
10
Sumter
170
30
10
30
20
70
10
20
Talbot
40
10
10
10
20
Taliaferro
10
10
Tattnall
100
10
10
20
10
40
10
Taylor
40
10
10
20
10
Telfair
80
10
10
20
10
30
10
Terrell
70
10
10
10
30
10
Thomas
220
20
20
40
30
90
10
10
30
10
Tift
170
30
10
30
30
80
10
10
20
Toombs
150
10
10
30
10
60
10
20
Towns
60
10
10
10
10
30
10
Treutlen
40
10
10
Troup
320
40
30
60
60
140
10
10
40
10
Turner
40
10
10
20
Twiggs
50
10
10
10
10
20
10
Union
100
10
10
20
10
40
10
Upson
140
30
10
20
30
60
10
10
20
10
Walker
350
40
30
70
40
150
10
10
50
10
Walton
200
20
20
40
30
90
10
10
30
10
Ware
200
20
30
40
30
90
10
10
30
10
Warren
40
10
10
10
10
Washington
120
10
10
20
30
40
10
10
Wayne
120
20
10
20
10
50
20
Webster
20
10
Wheeler
30
10
10
10
10
White
70
10
10
10
10
30
10
Whitfield
370
50
30
70
60
170
10
10
60
10
Wilcox
40
10
10
20
Wilkes
80
10
10
10
20
30
10
Wilkinson
40
10
10
10
10
20
10
Worth
90
10
20
10
10
40
10
10
Estimate is fewer than 5 cases or deaths. Cases or deaths between 5 and 9 were rounded to 10. Note: County estimates may not add to Georgia total due to rounding.
10 G E O R G I A
Cancer Data Report
2000
CANCER MORTALITY
Cancer Mortality in Georgia Between 1994-1998, there was an average of 12,714 cancer deaths in Georgia per year; 6,818 among males and 5,896 among females (Table 2, page 14). Four cancer sites -- lung, colorectal, breast and prostate accounted for 54% of cancer deaths in Georgia.The burden of these cancers can be significantly reduced by broadening the use of mammography, colorectal screening, and other early detection examinations and by preventing or stopping tobacco use, improving diet, and increasing physical activity.
Figure 4. Counties with Significantly* High or Low Cancer Mortality Rates, 1994-1998
Males in Georgia are about 70% more likely to die of cancer than females. Lung cancer is the leading cause of cancer death among Georgia males and females and accounts for 30% of all cancer deaths each year. Among males, prostate and colorectal cancer are the second and third leading causes of cancer death; while breast and colorectal cancer rank second and third among females.
There are a large number of counties in rural south and east Georgia where mortality rates are significantly higher than the state average. All counties in the Metropolitan Atlanta area, with the exception of Fulton County, have significantly lower mortality rates than the state average.
Rome
Gainesville
Atlanta
Athens
Augusta
Columbus
Macon
Dublin
Albany
Valdosta
Waycross
* p < 0.05
Counties with rates significantly higher than state rate No significant difference Counties with rates significantly lower than state rate
Savannah
Brunswick
11 G E O R G I A
Cancer Data Report
2000
Cancer Mortality in Georgia and the United States Lung and prostate cancer mortality rates are higher among Georgia males compared to US males
by 20% and 19%, respectively (Figure 5). Pancreatic cancer and leukemia mortality rates are slightly lower or the same among Georgia
males compared to US males. Colorectal cancer mortality rates are 12% lower among Georgia males compared to US males and
10% lower among Georgia females compared to US females (Figures 5 and 6). Lung, breast, pancreatic and ovarian cancer mortality rates are slightly lower or the same among
Georgia females compared to US females (Figure 6).
Figure 5. Cancer Mortality Rates* in Georgia (1994-1998) and the United States (1993-1997), Males
100.0 80.0
83.0 69.4
Georgia United States
60.0
Rate per 100,000
40.0 29.3 24.7 18.4 21.0
20.0 9.3 9.7
0.0 Lung & bronchus
Prostate
Colon & rectum
Cancer Site
* Average annual rate per 100,000, age-adjusted to the 1970 US standard population.
Pancreas
8.2 8.3 Leukemia
Rate per 100,000
Figure 6. Cancer Mortality Rates* in Georgia (1994-1998) and the United States (1993-1997), Females
100.0
Georgia
80.0
United States
60.0
40.0 33.0 34.0 20.0
23.6 24.8
13.0 14.4
6.9 7.2
0.0 Lung & bronchus
Breast
Colon & rectum
Cancer Site
* Average annual rate per 100,000, age-adjusted to the 1970 US standard population.
Pancreas
7.3 7.5 Ovary
12 G E O R G I A
Cancer Data Report
2000
Rate per 100,000 Rate per 100,000
Trends in Cancer Mortality in Georgia Between 1991-1998, overall cancer mortality rates among Georgia males declined 9%. Lung cancer is the leading cause of cancer deaths among Georgia males; mortality rates are
2 times higher than rates of any other cancer. Since 1991, mortality rates from lung cancer have declined 14% (Figure 7). Prostate cancer is the second leading cause of cancer death among Georgia males. During 1980-1992, prostate cancer mortality rates in Georgia increased 29% followed by a 20% decline between 1992-1998. Colorectal cancer is the third leading cause of cancer death among Georgia males. During 1980-1990, colorectal cancer mortality rates increased 12% followed by a 20% decline between 1990-1998. Cancer of the pancreas and leukemia are the fourth and fifth leading causes of cancer death among Georgia males; mortality rates for these cancers have been relatively steady since 1980.
100.0 80.0
Figure 7. Trends in Cancer Mortality Rates* in Georgia, Males, 1980-1998
Lung & bronchus
100.0
Figure 8. Trends in Cancer Mortality Rates* in Georgia, Females, 1980-1998
80.0
60.0
60.0
40.0
20.0
0.0 1980
Prostate Colon & rectum Pancreas
1985
1990
Leukemia 1995 1998
Year
* Rate per 100,000, age-adjusted to the 1970 US standard population.
40.0 Breast
20.0
0.0 1980
Ovary 1985
Lung & bronchus
Colon & rectum Pancreas
1990
1995 1998
Year
* Rate per 100,000, age-adjusted to the 1970 US standard population.
Unlike males, overall cancer mortality rates among females have been steadily increasing over the past 2 decades; however, the increase appears to be slowing in recent years. Lung cancer is the leading cause of cancer death among Georgia females; the mortality rate has
doubled since 1980 (Figure 8). Since 1988, more females have died each year of lung cancer than breast cancer, which, for over 40 years, had been the major cause of cancer death among females. Breast cancer is the second leading cause of cancer death among Georgia females. During 19801987, breast cancer mortality rates in Georgia increased 25% followed by a 14% decline between 1987-1998. Colorectal cancer is the third leading cause of cancer death among Georgia females; since 1980, colorectal cancer mortality rates have declined 16%. Cancers of the pancreas and ovary are the fourth and fifth leading causes of cancer death among Georgia females; mortality rates for these cancers have been relatively steady since 1980.
13 G E O R G I A
Cancer Data Report
2000
Racial Differences in Cancer Mortality in Georgia Blacks in Georgia are 27% more likely to die of cancer than whites. During 1994-1998, overall cancer mortality rates were 205.1 per 100,000 among blacks and 161.1 per 100,000 among whites. Lung, prostate, colorectal, and pancreatic cancer mortality rates are higher (17%, 162%, 41%, and
50% respectively) among black males in Georgia compared to white males (Figure 9). Black males are more than twice as likely to die of prostate cancer than white males. Breast, colorectal, and pancreatic cancer mortality rates are higher (36%, 54%, and 48% respectively)
among black females in Georgia compared to white females (Figure 10). Lung and ovarian cancer mortality rates are lower (33% and 17% respectively) among black
females in Georgia compared to white females.
100.0 80.0 60.0
Figure 9. Cancer Mortality Rates* in Georgia by Race, Males, 1994-1998
96.0 82.0
Black White
59.8
Rate per 100,000
40.0
22.8
24.5
17.4
20.0
12.9
8.6
0.0 Lung & bronchus
Prostate
Colon & rectum
Cancer Site
* Average annual rate per 100,000, age-adjusted to the 1970 US standard population. Note: These rates are for non-Hispanic white and black males.
Pancreas
8.0 8.5 Leukemia
Rate per 100,000
100.0 80.0
Figure 10. Cancer Mortality Rates* in Georgia by Race, Females, 1994-1998 Black White
60.0
36.3 40.0
24.2 20.0
30.2 22.2
18.2 11.8
0.0 Lung & bronchus
Breast
Colon & rectum
Cancer Site
* Average annual rate per 100,000, age-adjusted to the 1970 US standard population. Note: These rates are for non-Hispanic white and black females.
9.3 6.3
Pancreas
6.4 7.7 Ovary
Table 2. Average Annual Number of Cancer Deaths and Mortality Rates by County, Georgia, 1994-1998
ALL SITES
BREAST
COLON & RECTUM
LUNG & BRONCHUS
PROSTATE
Male
Female
Female
Male
Female
Male
Female
Male
County
Deaths Rate* Deaths Rate* Deaths Rate* Deaths Rate* Deaths Rate* Deaths Rate* Deaths Rate* Deaths Rate*
Georgia
6,818 227.3 5,896 135.5 1,014 23.6
553 18.4
599 13.0 2,478 83.0 1,353 33.0
830 29.3
14
Appling
22 277.7
15 125.9
2 20.1
<2
3 21.5
9 118.9
3 23.4
4 51.5
Atkinson
6 196.7
7 175.3
<2
<2
<2
3 96.2
<2
<2
Bacon
13 259.1
12 168.1
<2
<2
<2
5 100.8
<2
<2
Baker
3 156.6
4 136.3
<2
<2
<2
<2
<2
<2
Baldwin
43 224.4
33 132.4
6 26.7
5 23.0
3 10.4
17 86.5
9 36.9
6 30.0
Banks
12 224.7
8 114.4
<2
<2
<2
5 84.5
2 33.4
<2
Barrow
34 229.8
26 122.9
4 16.7
2 15.2
<2
14 96.8
8 41.5
<2
Bartow
72 257.4
50 129.7
9 22.2
6 21.8
6 15.0
27 95.8
13 35.5
8 34.0
Ben Hill
19 223.3
16 116.8
2 20.1
2 27.7
<2
8 98.4
3 25.7
2 23.3
Berrien
17 220.0
15 137.6
2 21.5
<2
2 17.1
8 108.1
4 31.4
2 31.0
Bibb
178 248.2
150 130.6
24 21.9
16 23.0
17 13.6
67 93.1
38 34.1
23 31.4
Bleckley
15 274.1
11 122.1
<2
<2
<2
7 123.0
2 25.4
<2
Brantley
13 219.6
13 177.4
<2
<2
<2
6 110.3
4 61.3
<2
Brooks
20 229.9
15 114.0
<2
2 23.6
2 14.8
7 84.9
3 23.1
3 35.8
Bryan
18 240.6
14 148.3
<2
<2
<2
7 86.9
4 48.9
2 33.3
Bulloch
42 218.8
38 140.1
8 30.4
4 18.3
4 12.1
13 69.0
6 23.8
6 34.5
Burke
22 253.6
20 152.8
4 35.9
<2
2 15.3
6 67.2
4 29.0
4 41.2
Butts
17 211.7
16 156.2
2 26.0
<2
<2
6 72.8
4 40.1
<2
Calhoun
7 269.8
6 115.0
<2
<2
<2
<2
<2
<2
Camden
21 226.7
19 149.6
3 20.6
<2
<2
6 68.0
6 49.2
4 44.8
Candler
12 256.3
9 134.0
<2
<2
<2
3 75.7
2 33.9
<2
Carroll
75 228.0
65 139.8
11 22.6
8 24.1
7 15.6
30 90.2
14 33.9
7 23.5
Catoosa
52 219.1
41 127.8
6 19.7
5 22.3
3
9.0
22 91.4
13 42.0
3 15.6
Charlton
10 251.8
11 204.4
<2
<2
<2
3 79.2
2 37.2
<2
Chatham
248 224.8
229 142.0
36 23.7
21 19.3
26 15.5
88 80.3
55 35.3
32 28.9
Chattahoochee
4 388.2
3 176.0
<2
<2
<2
<2
<2
<2
Chattooga
31 240.8
30 156.1
4 25.8
2 15.2
3 11.6
14 107.9
8 42.8
3 19.8
Cherokee
83 215.3
64 121.3
11 19.2
8 19.6
7 12.7
26 71.2
14 29.2
7 22.0
Clarke
63 207.4
55 117.5
11 24.5
5 17.7
4
7.4
23 76.7
13 30.4
10 32.4
Clay
5 225.9
5 157.6
<2
<2
<2
<2
<2
<2
Clayton
136 222.5
126 148.2
18 20.4
11 18.6
10 10.7
53 86.2
37 46.1
12 24.3
Clinch
8 259.1
5 124.2
<2
<2
<2
2 78.9
<2
<2
Cobb
349 211.4
338 140.7
58 23.2
29 17.9
33 13.8
122 73.5
80 35.4
37 26.9
Coffee
31 222.0
25 127.4
4 22.4
3 22.4
<2
12 86.7
5 29.2
<2
Colquitt
45 222.1
40 136.9
5 17.5
3 14.4
6 17.5
17 85.0
7 26.8
9 41.4
Columbia
56 198.2
54 141.2
9 21.1
3 11.0
4 10.6
21 68.4
14 38.0
6 25.1
Cook
21 291.7
14 128.8
3 27.2
<2
<2
8 107.1
3 30.2
2 28.9
Coweta
66 231.8
52 125.6
10 21.9
6 21.7
3
7.1
23 79.1
13 33.2
10 40.4
Crawford
9 195.1
6 114.3
<2
<2
<2
3 68.0
<2
<2
* Average annual rate per 100,000, age-adjusted to the 1970 US standard population.
Rate not calculated for fewer than 2 average deaths.
Table 2. Average Annual Number of Cancer Deaths and Mortality Rates by County, Georgia, 1994-1998 (continued)
ALL SITES
BREAST
COLON & RECTUM
LUNG & BRONCHUS
PROSTATE
Male
Female
Female
Male
Female
Male
Female
Male
County
Deaths Rate* Deaths Rate* Deaths Rate* Deaths Rate* Deaths Rate* Deaths Rate* Deaths Rate* Deaths Rate*
Crisp
32 326.5
22 130.9
4 25.5
<2
<2
15 149.9
5 30.6
4 44.0
15
Dade
15 194.4
12 128.4
<2
<2
<2
6 79.6
3 38.0
3 36.8
Dawson
13 257.3
9 129.3
2 34.3
<2
<2
5 89.7
2 34.5
<2
Decatur
32 248.8
28 150.4
5 29.2
3 23.8
2
9.5
12 96.7
6 35.5
4 30.6
DeKalb
433 208.0
421 134.6
89 27.8
36 17.4
46 14.0
134 65.5
89 30.4
58 31.4
Dodge
26 273.1
21 153.1
3 25.5
2 23.4
2 16.8
10 107.3
4 27.9
3 27.9
Dooly
12 243.2
12 145.3
3 36.3
<2
<2
4 80.0
<2
<2
Dougherty
101 251.8
81 132.6
14 23.4
10 24.3
8 11.1
39 95.5
19 34.0
15 38.9
Douglas
68 228.6
55 138.5
10 24.1
4 13.3
4
9.6
24 83.6
14 38.1
6 22.7
Early
17 263.5
15 139.1
4 33.0
<2
2 14.0
6 87.4
3 25.0
3 41.4
Echols
3 243.1
<2
<2
<2
<2
<2
<2
<2
Effingham
28 222.2
22 132.4
3 21.0
<2
2 14.5
13 98.4
4 27.7
2 23.1
Elbert
29 266.1
23 142.4
4 26.5
2 21.1
3 15.1
10 95.9
5 32.0
2 22.7
Emanuel
33 302.0
20 120.2
3 21.1
3 31.2
2 10.7
10 94.1
5 28.7
3 29.1
Evans
12 249.4
9 129.2
<2
<2
<2
5 101.2
<2
2 41.2
Fannin
29 208.2
22 132.2
3 20.6
2 18.0
3 16.0
12 88.3
7 45.2
3 19.6
Fayette
55 188.5
54 132.0
8 19.2
6 19.9
6 14.0
18 60.3
13 31.9
7 28.5
Floyd
111 244.8
96 141.8
15 23.5
9 19.0
9 11.8
43 94.4
23 36.8
10 22.0
Forsyth
41 156.1
38 103.7
6 16.6
<2
5 15.0
16 58.2
8 22.7
5 22.3
Franklin
23 203.4
20 132.7
4 22.8
<2
2 13.8
8 71.3
3 20.9
3 27.3
Fulton
627 235.0
636 149.4
125 29.4
55 20.3
72 15.7
190 72.3
134 33.5
89 35.1
Gilmer
24 230.3
20 145.9
2 16.4
2 20.1
2 12.4
9 86.7
7 51.9
3 25.1
Glascock
4 207.8
<2
<2
<2
<2
<2
<2
<2
Glynn
78 205.9
73 142.4
11 23.7
5 13.2
7 12.6
27 70.8
21 41.1
9 25.3
Gordon
44 246.0
32 128.5
5 20.3
3 17.6
3 11.5
16 90.8
9 37.2
5 30.6
Grady
32 269.5
19 117.9
4 24.4
2 15.8
<2
13 115.7
3 22.0
5 38.8
Greene
16 242.6
12 133.4
3 34.7
<2
2 20.4
6 89.5
2 22.8
2 35.4
Gwinnett
233 186.3
227 129.9
44 23.2
22 17.8
23 13.5
72 59.3
52 31.4
23 22.4
Habersham
34 191.8
29 122.3
6 26.5
3 17.0
4 13.5
14 80.4
6 25.3
3 16.6
Hall
103 205.8
84 122.1
15 22.1
10 20.1
8 10.5
39 76.7
21 33.0
12 24.6
Hancock
13 292.6
11 154.0
2 33.2
<2
<2
3 77.5
<2
3 65.6
Haralson
29 238.1
24 133.3
3 19.5
<2
3 14.2
13 105.1
5 35.6
3 25.1
Harris
28 239.7
18 122.8
4 24.8
2 21.3
<2
8 64.3
4 27.4
5 41.2
Hart
27 209.8
20 107.9
4 25.7
2 17.6
2 11.2
10 78.9
3 17.2
4 31.7
Heard
8 178.7
6 111.2
<2
<2
<2
3 75.3
<2
<2
Henry
68 202.6
62 136.2
11 23.0
5 13.5
7 15.4
23 70.5
15 33.6
6 21.6
Houston
87 230.5
76 139.8
15 26.0
6 17.6
6 10.8
33 82.7
22 41.0
10 35.9
Irwin
14 297.9
10 136.7
<2
<2
<2
8 159.4
<2
2 36.0
Jackson
36 216.5
29 129.8
5 23.1
4 21.2
<2
16 93.6
7 34.6
3 21.3
Jasper
12 252.5
11 179.6
2 38.3
<2
<2
5 96.4
<2
<2
* Average annual rate per 100,000, age-adjusted to the 1970 US standard population.
Rate not calculated for fewer than 2 average deaths.
Table 2. Average Annual Number of Cancer Deaths and Mortality Rates by County, Georgia, 1994-1998 (continued)
ALL SITES
BREAST
COLON & RECTUM
LUNG & BRONCHUS
PROSTATE
Male
Female
Female
Male
Female
Male
Female
Male
County
Deaths Rate* Deaths Rate* Deaths Rate* Deaths Rate* Deaths Rate* Deaths Rate* Deaths Rate* Deaths Rate*
Jeff Davis
20 340.5
10 119.6
<2
<2
<2
9 156.3
2 32.2
2 44.8
16
Jefferson
24 283.1
22 153.6
5 45.0
<2
4 22.1
10 119.6
3 21.5
4 47.9
Jenkins
13 269.2
7 122.5
<2
<2
<2
5 115.9
2 35.5
2 43.4
Johnson
11 249.9
11 147.6
<2
<2
<2
4 97.8
<2
<2
Jones
21 231.8
18 134.9
3 22.7
<2
2 15.7
9 92.2
4 31.4
3 34.2
Lamar
19 261.4
15 149.6
2 22.7
<2
<2
8 106.7
3 36.6
3 43.1
Lanier
8 286.4
4 104.8
<2
<2
<2
3 110.5
<2
<2
Laurens
58 266.0
37 121.4
6 18.2
3 15.5
3 10.3
21 91.3
7 23.3
10 44.3
Lee
14 249.8
14 148.3
2 17.8
<2
<2
6 95.8
3 35.7
<2
Liberty
31 285.9
23 147.9
5 27.4
2 18.4
<2
9 86.1
7 48.5
5 56.5
Lincoln
12 276.6
8 137.6
<2
<2
<2
5 115.2
<2
2 44.5
Long
6 212.2
5 135.1
<2
<2
<2
2 68.0
<2
<2
Lowndes
78 241.6
66 141.1
8 17.5
4 13.3
7 14.7
31 96.0
18 40.6
11 35.6
Lumpkin
18 222.0
14 136.6
2 25.5
<2
<2
7 90.1
4 42.3
2 25.7
McDuffie
23 237.5
21 151.6
4 27.6
<2
2 12.4
11 110.4
5 37.2
<2
McIntosh
15 287.9
10 155.9
2 35.4
<2
<2
5 88.4
<2
3 49.3
Macon
16 280.0
13 148.1
<2
<2
<2
6 99.2
<2
3 52.3
Madison
25 232.6
22 147.9
4 27.3
<2
2 16.2
9 86.3
4 27.3
3 27.0
Marion
8 272.4
3 72.5
<2
<2
<2
4 128.7
<2
<2
Meriwether
27 236.8
24 141.2
3 17.6
<2
3 13.8
9 81.1
5 30.6
5 40.9
Miller
7 192.0
6 103.2
<2
<2
<2
2 53.4
<2
<2
Mitchell
26 275.0
21 144.3
2 17.2
<2
3 20.0
12 129.5
5 33.1
3 30.6
Monroe
25 292.7
18 141.8
3 20.5
<2
3 18.6
11 133.7
4 32.3
2 28.9
Montgomery
10 265.2
7 142.5
<2
<2
<2
4 95.8
<2
<2
Morgan
15 206.3
12 115.4
<2
2 31.4
<2
5 70.8
3 25.1
<2
Murray
25 211.4
22 137.0
3 20.4
2 19.0
2 11.9
12 101.7
6 40.1
2 21.0
Muscogee
190 242.7
166 136.7
28 23.7
16 21.4
16 12.5
70 87.8
39 33.5
27 35.7
Newton
49 224.8
45 141.6
6 21.1
4 16.7
4 12.6
20 95.0
8 27.3
6 28.3
Oconee
18 208.7
14 106.5
3 22.6
<2
<2
5 65.4
4 31.3
<2
Oglethorpe
12 237.7
9 124.4
<2
<2
<2
4 80.0
3 45.5
<2
Paulding
47 231.8
37 139.1
6 23.3
5 25.1
2
8.0
19 91.5
11 45.9
5 29.1
Peach
22 230.9
18 125.3
4 26.2
<2
<2
9 94.5
3 22.3
3 29.0
Pickens
21 223.6
13 98.0
3 26.6
<2
<2
9 92.1
3 21.2
<2
Pierce
21 279.9
12 130.5
2 26.5
<2
<2
9 121.9
<2
3 34.4
Pike
18 290.3
10 120.3
<2
<2
<2
7 112.2
3 39.9
2 36.8
Polk
51 276.2
41 148.2
7 26.5
4 23.2
4 12.2
21 112.1
11 41.6
5 26.7
Pulaski
11 230.2
10 132.0
2 38.7
<2
<2
3 56.6
2 27.2
2 45.3
Putnam
21 225.9
16 137.8
<2
<2
<2
8 86.8
4 36.2
3 34.7
Quitman
4 264.1
3 138.9
<2
<2
<2
<2
<2
<2
Rabun
22 220.3
17 137.1
3 25.1
2 21.2
2 14.9
7 76.4
2 18.1
3 23.6
* Average annual rate per 100,000, age-adjusted to the 1970 US standard population.
Rate not calculated for fewer than 2 average deaths.
Table 2. Average Annual Number of Cancer Deaths and Mortality Rates by County, Georgia, 1994-1998 (continued)
ALL SITES
BREAST
COLON & RECTUM
LUNG & BRONCHUS
PROSTATE
Male
Female
Female
Male
Female
Male
Female
Male
County
Deaths Rate* Deaths Rate* Deaths Rate* Deaths Rate* Deaths Rate* Deaths Rate* Deaths Rate* Deaths Rate*
Randolph
13 296.7
10 132.5
<2
<2
<2
4 90.5
<2
2 53.9
17
Richmond
210 267.1
175 149.4
28 23.7
15 19.8
18 14.8
73 93.8
43 37.4
19 26.1
Rockdale
49 191.8
52 147.2
10 27.1
4 17.6
5 13.3
19 72.7
13 38.1
4 19.1
Schley
5 311.2
5 195.7
<2
<2
<2
2 118.9
<2
<2
Screven
24 311.9
16 153.1
4 38.9
2 27.6
2 21.6
8 104.8
3 28.9
4 48.7
Seminole
11 225.6
9 121.5
<2
<2
<2
4 75.1
<2
<2
Spalding
58 231.8
52 133.4
9 24.8
4 16.5
4
9.5
20 79.7
12 36.1
7 27.5
Stephens
34 232.7
28 128.5
5 24.7
3 17.6
2 10.2
13 89.5
5 27.7
5 29.8
Stewart
8 248.1
7 143.9
<2
<2
<2
4 137.5
<2
3 73.8
Sumter
33 246.4
33 151.1
5 29.2
2 15.1
3 12.5
11 83.9
7 33.9
4 30.3
Talbot
9 254.6
7 142.5
<2
<2
<2
3 100.8
<2
<2
Taliaferro
3 281.1
<2
<2
<2
<2
<2
<2
<2
Tattnall
28 283.9
16 123.0
3 27.1
<2
<2
10 104.3
3 27.2
3 26.2
Taylor
8 195.5
8 128.6
<2
<2
<2
3 80.2
2 35.5
<2
Telfair
19 311.9
15 151.9
3 32.2
3 45.3
<2
8 132.0
3 38.3
<2
Terrell
17 320.5
11 139.4
<2
<2
<2
8 151.5
<2
2 41.8
Thomas
54 259.1
39 120.4
4 13.8
5 25.9
3
9.2
21 100.0
8 24.5
6 26.9
Tift
38 245.9
33 140.4
5 24.7
2 13.6
<2
15 99.5
8 34.4
5 30.1
Toombs
31 273.2
28 154.2
3 17.9
<2
<2
14 119.0
6 35.3
4 35.6
Towns
13 164.3
11 117.8
2 26.0
<2
<2
4 56.5
<2
<2
Treutlen
7 220.1
7 151.6
<2
<2
<2
3 87.4
<2
<2
Troup
71 254.9
61 138.8
7 19.2
5 19.3
8 14.5
29 106.3
14 35.2
9 32.5
Turner
12 256.0
8 118.1
<2
<2
<2
4 83.1
2 28.1
<2
Twiggs
13 263.4
7 120.0
<2
<2
<2
6 118.5
2 33.0
<2
Union
27 225.3
18 117.0
<2
2 17.4
2 13.2
11 92.2
5 36.4
2 17.2
Upson
28 192.2
31 138.6
7 33.7
2 13.2
3 14.8
9 63.3
6 27.9
5 35.2
Walker
81 241.2
62 134.0
9 21.8
6 18.8
6 12.0
36 106.4
16 35.3
6 18.9
Walton
49 225.3
36 120.4
4 12.2
4 17.4
4 13.8
18 83.3
9 34.0
5 25.9
Ware
50 250.8
36 121.7
4 13.7
4 21.1
5 13.7
22 110.0
8 27.6
6 28.2
Warren
8 239.1
7 130.6
<2
<2
<2
3 107.4
<2
<2
Washington
25 280.9
23 155.4
3 18.2
3 28.6
2 11.1
7 75.1
6 45.1
4 42.2
Wayne
28 228.4
22 140.9
4 23.4
<2
<2
13 104.3
6 36.7
3 23.4
Webster
4 275.7
3 169.5
<2
<2
<2
<2
<2
<2
Wheeler
7 255.1
4 121.1
<2
<2
<2
3 119.8
<2
<2
White
17 163.1
14 106.6
3 25.3
<2
<2
7 64.9
3 23.9
<2
Whitfield
76 219.7
67 136.2
12 25.3
6 18.1
6 10.7
33 96.1
16 36.5
9 26.9
Wilcox
10 227.1
7 114.2
<2
<2
<2
4 91.2
<2
<2
Wilkes
18 301.7
14 154.4
3 35.0
<2
<2
7 114.5
<2
2 42.3
Wilkinson
10 197.2
9 132.8
2 32.1
<2
<2
4 81.5
<2
<2
Worth
22 220.5
17 122.6
3 19.8
3 27.9
2 15.8
8 76.8
4 26.8
2 23.1
* Average annual rate per 100,000, age-adjusted to the 1970 US standard population.
Rate not calculated for fewer than 2 average deaths.
18 G E O R G I A
Cancer Data Report
2000
CANCER INCIDENCE
The Georgia Comprehensive Cancer Registry The Georgia Comprehensive Cancer Registry was established to be a tool for Georgia health professionals at the state and local level to better understand the state's cancer burden.The Cancer Registry collects statewide data on new cases of cancer and these data are used to estimate cancer incidence rates within Georgia, monitor cancer trends, evaluate possible clusters of cancer, respond to inquiries about cancer from the public, and conduct research. Data from the Cancer Registry also assist state and local agencies in focusing cancer control programs on early detection and the prevention of risk behaviors. The State's goal is to produce cancer incidence and mortality reports yearly for use by the public and health professionals.
Figure 11. Completeness of Case Reporting by Health District, Georgia, 1997
64%
42% 100% 100%
69% 48%
100% 97%
In order to accurately understand the burden of cancer in Georgia it is important to have at least 90% of the newly diagnosed cancer cases reported to the Cancer Registry annually. For 1995, the first year cancer incidence data were required to be reported by all health care providers, reporting is 93% complete; for 1996 it is 75% complete; for 1997 it is 72% complete; and for 1998 it is only 51% complete. The primary reason for incomplete data is that there are still hospitals, laboratories, and outpatient treatment and diagnostic facilities that are not reporting their cancer data to the Cancer Registry. Projections show that if all hospitals, laboratories, and outpatient treatment and diagnostic facilities reported their newly diagnosed cancer cases completely and accurately, Cancer Registry data would be more than 90% complete each year. The State's goal for 2000 is to have all health care providers reporting data to the Cancer Registry.
The reader must use caution when analyzing the incidence data on Table 3 as these data are only 93% complete and may be an underestimate of the true cancer burden in Georgia and Georgia counties.
100%
68%
57% 47%
Cancer Incidence in Georgia In 1995, there were more than 23,000 cancer cases diagnosed in Georgia (Table 3). Four cancer
sites account for over half of Georgia's cancer
50% 48%
burden -- lung, colorectal, breast and prostate 36% cancer. In 1995, these four cancer sites accounted
for 57% of new cancer cases in Georgia.
53%
59%
74% 36%
Males in Georgia are nearly 50% more likely to develop cancer than females. Prostate cancer is the most common cancer diagnosed among Georgia males, followed by lung and colorectal cancer. Among females, breast cancer is the most commonly diagnosed cancer, followed by lung and colorectal cancer.
19
Table 3. Reported Number of Cancer Cases and Incidence Rates by County, Georgia, 1995
ALL SITES
BREAST
COLON & RECTUM LUNG & BRONCHUS
PROSTATE
Total
Female
Total
Total
Male
County
Cases
Rate*
Cases
Rate*
Cases
Rate*
Cases
Rate*
Cases
Rate*
Georgia Appling Atkinson
23,669 49 18
331.1 276.3 247.1
3,558 14 5
87.8 144.5
2,464
34.1
<5
<5
3,884
56.4
<5
<5
3,490 <5 <5
121.6
Bacon
31
263.8
8
<5
<5
<5
Baker Baldwin
17
372.2
53
121.1
<5
5
<5
<5
<5
13
30.2
5
7
Banks
32
265.1
<5
<5
<5
8
Barrow Bartow Ben Hill Berrien Bibb Bleckley
119
348.5
140
216.7
49
254.7
36
202.9
384
220.8
26
211.1
23
116.3
23
65.6
7
5
40
41.3
<5
8
17
26.3
<5
<5
38
21.6
<5
20
61.4
28
44.0
11
59.7
10
58.8
90
51.4
5
19
144.1
11
40.2
10
112.7
5
73
104.1
<5
Brantley
41
309.9
<5
<5
7
<5
Brooks
39
194.8
<5
<5
11
52.6
6
Bryan
68
369.5
8
6
14
82.6
6
Bulloch Burke
151
344.0
58
265.2
30
113.4
13
88.1
12
25.2
9
23
51.5
7
19
102.4
<5
Butts
64
373.5
9
6
13
79.7
12
159.1
Calhoun Camden Candler Carroll Catoosa
25
434.3
64
286.5
22
196.8
99
127.3
13
23.4
5
9
<5
14
31.5
<5
<5
8
<5
<5
<5
<5
14
68.0
<5
20
26.9
<5
5
6
<5
15
50.6
<5
Charlton
15
170.8
<5
<5
<5
<5
Chatham
977
377.9
137
97.1
151
56.5
172
66.7
101
93.1
Chattahoochee
15
584.1
<5
<5
<5
<5
Chattooga
100
319.8
18
103.1
11
33.3
17
55.9
12
87.0
Cherokee
245
268.6
35
63.0
22
24.6
42
52.8
37
107.6
Clarke Clay
307
411.6
<5
49
106.4
<5
27
33.3
<5
32
46.8
<5
60
208.3
<5
Clayton
666
429.5
113
117.2
61
41.1
115
79.6
93
157.5
Clinch
21
300.1
5
<5
6
<5
Cobb
1,812
431.3
305
119.2
171
44.1
271
70.9
282
175.4
Coffee Colquitt
120
354.8
99
216.6
17
86.9
12
54.6
13
39.4
<5
16
47.5
22
47.7
19
140.1
20
102.6
Columbia Cook
274
411.0
50
309.9
28
68.0
8
29
45.5
6
60
97.3
9
37
144.1
7
Coweta Crawford
245
355.1
13
125.4
39
92.9
<5
32
47.0
<5
41
62.3
<5
30
108.3
<5
Crisp Dade
90
371.4
<5
10
65.8
<5
<5
<5
16
69.3
<5
18
192.2
<5
Dawson Decatur
42
366.4
60
204.9
8
11
68.0
<5
6
8
12
39.6
6
<5
DeKalb Dodge Dooly
2,180 45 35
407.6 205.6 289.1
365
116.6
6
6
221
42.0
6
8
286
56.5
15
72.0
<5
386
187.6
<5
<5
Dougherty
393
400.2
66
119.1
49
48.3
68
68.9
65
162.9
Douglas Early Echols
192
268.3
11
79.5
<5
24
63.5
<5
<5
23
31.2
<5
<5
28
43.8
<5
<5
21
68.5
<5
<5
Effingham Elbert
105
364.6
71
301.2
21
132.1
8
6
7
25
89.9
13
53.0
13
109.9
12
108.7
* Rate per 100,000, age-adjusted to the 1970 US standard population.
Rate not calculated for fewer than 10 cases. Cancer cases for this county may be underreported to the Cancer Registry. Please use caution when comparing these data with mortality data for the same county.
20
Table 3. Reported Number of Cancer Cases and Incidence Rates by County, Georgia, 1995 (continued)
ALL SITES
BREAST
COLON & RECTUM LUNG & BRONCHUS
PROSTATE
Total
Female
Total
Total
Male
County
Cases
Rate*
Cases
Rate*
Cases
Rate*
Cases
Rate*
Cases
Rate*
Emanuel
72
292.0
6
10
39.2
19
73.2
8
Evans Fannin
32
295.0
58
212.9
6
11
77.2
<5
<5
9
12
40.0
<5
13
106.2
Fayette
245
353.2
57
143.6
35
53.8
29
44.2
42
137.9
Floyd
339
311.6
54
87.1
40
32.8
70
66.1
28
62.9
Forsyth
140
234.7
21
61.3
17
29.5
25
42.2
20
77.5
Franklin
67
276.9
9
14
59.6
9
10
88.4
Fulton Gilmer
2,957 55
433.8 254.7
433
109.8
<5
294
42.2
6
376
58.6
11
48.3
478
192.6
10
95.9
Glascock
10
231.1
<5
<5
<5
<5
Glynn Gordon Grady
315
366.2
114
279.2
76
283.3
43
87.2
19
81.7
19
126.9
26
28.6
8
6
53
61.3
30
74.0
11
42.3
53
146.9
7
6
Greene
62
421.5
8
11
63.7
8
8
Gwinnett
1,254
404.3
208
109.7
131
47.2
174
62.9
187
169.3
Habersham
121
329.6
13
64.7
11
30.7
21
53.8
17
100.3
Hall
405
356.1
56
90.4
42
35.2
67
59.8
70
146.7
Hancock Haralson Harris Hart Heard
49
451.6
45
169.1
65
261.6
40
151.3
21
209.2
7
<5
8
7
<5
8
<5
6
<5
<5
10
94.0
13
48.4
14
57.6
11
42.9
<5
7
<5
7
<5
<5
Henry Houston
285
368.6
159
165.1
41
93.3
15
28.8
26
34.7
14
13.9
44
61.0
22
23.5
43
140.6
33
85.2
Irwin
17
173.4
<5
<5
<5
<5
Jackson
130
352.0
20
103.5
17
46.6
15
40.5
16
103.7
Jasper
48
444.4
7
7
6
<5
Jeff Davis
45
330.5
5
8
10
73.1
11
199.5
Jefferson
80
362.0
5
14
60.6
17
84.4
10
116.5
Jenkins Johnson Jones
36
327.5
25
249.5
26
115.5
<5
6
<5
<5
<5
<5
8
8
6
6
<5
<5
Lamar Lanier
60
355.4
17
278.1
7
<5
<5
<5
15
95.7
<5
11
144.0
<5
Laurens
107
208.7
8
11
20.7
26
53.0
16
71.1
Lee
51
349.8
7
<5
9
13
237.3
Liberty
103
364.6
14
73.2
13
49.3
17
74.7
12
123.8
Lincoln Long
39
390.1
12
175.4
5
<5
<5
<5
13
133.5
<5
<5
<5
Lowndes
300
391.9
46
106.5
30
35.5
48
64.9
59
192.4
Lumpkin
50
291.1
11
116.6
5
9
7
McDuffie
76
334.4
12
79.1
12
55.5
13
55.8
10
104.3
McIntosh Macon
45
393.6
33
219.3
<5
<5
5
<5
7
<5
6
7
Madison Marion
76
310.7
12
168.0
9
<5
9
<5
12
52.5
<5
<5
<5
Meriwether Miller
88
320.6
16
189.8
11
75.5
<5
14
44.2
<5
16
60.0
<5
13
120.5
<5
Mitchell Monroe Montgomery
84
371.8
33
164.9
16
224.8
12
94.0
<5
<5
8
<5
<5
18
79.1
9
<5
8
8
<5
Morgan
74
435.1
12
120.6
9
9
13
188.1
Murray
80
290.4
11
72.5
7
14
54.1
6
* Rate per 100,000, age-adjusted to the 1970 US standard population.
Rate not calculated for fewer than 10 cases. Cancer cases for this county may be underreported to the Cancer Registry. Please use caution when comparing these data with mortality data for the same county.
21
Table 3. Reported Number of Cancer Cases and Incidence Rates by County, Georgia, 1995 (continued)
ALL SITES
BREAST
COLON & RECTUM LUNG & BRONCHUS
PROSTATE
Total
Female
Total
Total
Male
County
Cases
Rate*
Cases
Rate*
Cases
Rate*
Cases
Rate*
Cases
Rate*
Muscogee
636
328.8
97
90.2
78
38.9
111
57.8
93
118.3
Newton
144
286.3
25
92.2
14
27.4
31
61.0
7
Oconee Oglethorpe Paulding Peach Pickens
80
422.1
30
257.4
97
212.7
52
234.8
50
259.3
16
137.6
<5
13
45.7
6
<5
6
<5
9
7
<5
8
<5
22
55.7
9
10
51.9
11
145.0
5
11
64.0
7
13
144.2
Pierce Pike
52
313.0
36
283.9
9
6
5
8
8
6
5
6
Polk Pulaski
152
345.9
17
164.3
32
129.8
<5
8
<5
31
70.5
5
17
94.6
<5
Putnam Quitman Rabun
83
406.9
<5
47
249.0
11
105.3
<5
6
8
<5
<5
16
77.7
<5
11
55.5
11
114.6
<5
5
Randolph
40
353.4
<5
10
81.6
7
8
Richmond
768
400.7
109
98.9
74
38.3
138
73.3
117
151.9
Rockdale
182
298.9
33
91.6
17
29.2
31
54.1
15
58.6
Schley
21
497.7
<5
7
<5
<5
Screven Seminole
62
349.0
8
9
<5
7
<5
15
83.5
<5
10
121.3
<5
Spalding
232
369.7
38
109.5
28
44.1
38
61.7
33
136.2
Stephens
109
325.5
20
104.1
9
15
44.1
20
140.5
Stewart
23
312.5
<5
<5
6
<5
Sumter
134
408.3
16
76.4
19
59.1
22
70.0
23
185.7
Talbot
44
518.1
8
7
6
<5
Taliaferro Tattnall
6
47
214.9
<5
9
<5
7
<5
9
<5
<5
Taylor Telfair
31
321.5
29
209.1
<5
<5
<5
7
7
5
8
<5
Terrell
53
419.1
6
<5
13
101.7
9
Thomas Tift Toombs
177
352.7
105
278.9
54
208.2
25
85.3
17
81.1
<5
20
38.9
11
29.5
<5
39
77.4
16
43.3
12
44.5
14
69.0
22
139.2
7
Towns Treutlen
44
345.2
12
177.8
<5
<5
<5
<5
10
68.1
<5
9
<5
Troup Turner Twiggs Union
223
330.2
25
245.0
18
165.1
48
209.8
33
84.7
<5
<5
5
27
38.3
<5
<5
<5
38
61.6
6
<5
9
36
133.0
<5
6
<5
Upson Walker Walton
96
272.1
13
17.5
92
189.5
15
77.2
<5
13
51.2
15
44.0
<5
5
10
27.9
<5
12
26.0
17
118.9
<5
15
71.1
Ware
148
315.8
24
96.6
22
43.1
14
30.1
23
117.5
Warren
33
419.7
5
<5
8
8
Washington Wayne Webster Wheeler
88
376.0
65
249.6
5
11
188.4
13
99.3
6
<5
<5
13
50.5
6
<5
<5
17
73.5
17
65.1
<5
<5
12
137.9
5
<5
<5
White
61
288.7
7
<5
10
46.3
13
133.4
Whitfield
335
411.5
58
127.6
31
38.4
75
95.4
35
107.5
Wilcox Wilkes Wilkinson
25
285.5
36
252.2
17
145.5
<5
<5
<5
<5
<5
<5
<5
10
68.5
<5
6
5
<5
Worth
64
292.6
6
9
15
68.4
9
* Rate per 100,000, age-adjusted to the 1970 US standard population.
Rate not calculated for fewer than 10 cases. Cancer cases for this county may be underreported to the Cancer Registry. Please use caution when comparing these data with mortality data for the same county.
22 G E O R G I A
Cancer Data Report
2000
BREAST CANCER
New Cases An estimated 4,650 new cases of breast cancer are expected to be diagnosed among Georgia females in 2000. Breast cancer is the most commonly diagnosed cancer among Georgia females and in 2000 will account for over 30% of all female cancer cases. One in 8 American females will develop breast cancer in her lifetime. Breast cancer can also occur in males, but is rare.
Figure 12. Health Districts with Significantly* High or Low Breast Cancer Mortality Rates, 1994-1998
1-2 2-0
1-1
3-1 3-4 10-0
3-2 3-5 3-3
6-0 4-0
5-2
7-0 5-1
9-1 9-3
8-2
8-1
9-2
* p < 0.05
Health districts with rates significantly higher than state rate No significant difference Health districts with rates significantly lower than state rate
Deaths An estimated 1,100 Georgia females are expected to die of breast cancer in 2000. Breast cancer is the second leading cause of cancer death in Georgia females and in 2000 will account for 18% of all cancer deaths in females. Breast cancer mortality rates increased 25% between 1980-1987 followed by a 14% decline between 1987-1998. This decrease is probably the result of earlier detection through mammography and improved treatment.
The Fulton (3-2), DeKalb (3-5), and Augusta (6-0) health districts have significantly higher mortality rates than the state average; while the Athens (10-0),Waycross (9-2), and Valdosta (8-1) health districts have significantly lower rates (Figure 12).
Risk Factors Risk increases with age A personal or family history of breast cancer Biopsy-confirmed atypical hyperplasia A long menstrual history (menstrual periods
that start early and end late in life) Recent use of oral contraceptives or post-
menopausal estrogens Never having children or having the first child
after age 30 Consuming 2 or more drinks of alcohol daily
Prevention There is no known way to prevent breast cancer. For now, the best strategy for women at average risk is to manage modifiable risk factors (above), such as alcohol and estrogen use. The use of anti-estrogen drugs, such as Tamoxifen, have been shown to reduce the risk of recurrence in localized breast cancer. Following the guidelines for early detection of breast cancer will not prevent breast cancer, but can find cancers when the likelihood of successful treatment is greatest.
23 G E O R G I A
Cancer Data Report
2000
Early Detection Early detection of breast cancer saves lives. Mammograms and clinical breast examinations are both important screening tools. A mammogram, or low-dose x-ray of the breast, is valuable because it can identify breast abnormalities before they can be felt by a women or her health care provider. Numerous studies have shown that early detection increases survival and treatment options.
Breast Cancer Screening in Georgia According to the 1998 Behavioral Risk Factor Surveillance System, only 44% of females aged 40-49 and 45% of females aged 65 and older reported having had a mammogram and clinical breast examination within the past year. Females aged 50-64 were more likely to have had an annual mammogram and clinical breast examination (57%) (Figure 13). Although the sample size in some health districts is small, there is apparent geographical variation in mammography and clinical breast examination among women aged 50 and older in Georgia. For the 3 year period 1996-1998, the prevalence ranged from 37% in the Clayton health district (3-3) to 70% in the Gwinnett health district (3-4); the state average was 55% (Figure 14).
American Cancer Society
Guidelines for Early Detection
of Breast Cancer
Females 40 and older: Annual mammogram, annual clinical breast examination by a health care professional, monthly breast self-examination.The clinical breast examination should be conducted close to the scheduled mammogram.
Females aged 20-39: Clinical breast examination by a health care professional every three years, monthly breast self-examination.
Health District
Percent (%)
Figure 13. Mammogram and Clinical Breast Examination*,
Females Aged 40 and Older, Georgia, 1998
60
57%
50 44%
45%
40
30
20
10
0
40-49
50-64
65+
Age Group
* Reported having had a mammogram and clinical breast examination within the past year.
Figure 14. Mammogram and Clinical Breast Examination* by Health District, Females Aged 50 and Older, Georgia, 1996-1998
Georgia = 55%
1-1 ^1-2
2-0 3-1 3-2 ^3-3 3-4 3-5 4-0 ^5-1 5-2 6-0 7-0 ^8-1 8-2 9-1 9-2 ^9-3 10-0
50% 61% 62%
54% 61%
37% 70%
64% 49%
63% 45%
58% 57% 44% 40%
67% 48%
65% 51%
0 10 20 30 40 50 60 70 80
Percent (%)
* Reported having had a mammogram and clinical breast examination within the past year. ^ Fewer than 50 respondents, data may be unstable. Note: 95% confidence interval for Georgia was 3% and intervals for the health districts ranged from 9% to 20%.
24 G E O R G I A
Cancer Data Report
2000
UTERINE CERVIX CANCER
New Cases An estimated 550 new cases of invasive cervical cancer are expected to be diagnosed among Georgia females in 2000.
Deaths An estimated 130 Georgia females are expected to die of cervical cancer in 2000. In Georgia, mortality rates from cervical cancer have declined nearly 35% during the past 20 years.
The Dublin (5-1),Valdosta (8-1), and Savannah (9-1) health districts have significantly higher mortality rates than the state average; while the Dalton (1-2), Cobb (3-1), Gwinnett (3-4) and DeKalb (3-5) health districts have significantly lower rates (Figure 15 and Table 4).
Figure 15. Health Districts with Significantly* High or Low Cervical Cancer Mortality Rates, 1994-1998
1-2 2-0
1-1
3-1 3-4 10-0
3-2 3-5 3-3
6-0 4-0
5-2
7-0 5-1
9-1 9-3
8-2
8-1
9-2
* p < 0.05
Health districts with rates significantly higher than state rate No significant difference Health districts with rates significantly lower than state rate
Risk Factors Risk is closely linked to sexual behavior and
to sexually transmitted infections with certain types of human papillomavirus First intercourse at an early age Multiple sexual partners, or partners who have had multiple sexual partners Cigarette smoking
Prevention The vast majority of invasive cervical cancers can be prevented. Preventing the development of precancers by decreasing the risk of exposure to sexually transmitted human papillomavirus, and early detection and treatment of precancers
Table 4. Invasive Cervical Cancer Incidence and Average Annual Mortality by Health District, Georgia
Incidence (1995)
Mortality (1994-1998)
Health District
Cases Rate* Deaths Rate*
Georgia 1-1
389 8.9 19 6.6
124 2.9 10 3.3
1-2 2-0 3-1
12 7.9 14 6.5 34 9.4
3 1.7 5 2.2 7 2.4
3-2
44 10.7
11 2.7
3-3
15 14.7
3 3.1
3-4
33 11.1
7 2.1
3-5
31 8.0
6 1.7
4-0 5-1 5-2 6-0 7-0 8-1
34 10.6
<5
12 4.6
20 8.4
20 9.4
10 7.7
11 3.4 4 4.7 7 2.6 8 3.2 8 3.6 7 5.5
8-2 9-1
25 12.1 14 8.2
8 3.7 7 4.3
9-2
18 9.4
5 2.7
9-3
14 12.9
4 3.6
10-0
17 10.0
4 2.3
* Incidence rate or average annual mortality rate per 100,000, age-adjusted to the 1970 US standard population.
Rate not calculated for fewer than 10 cases.
Cancer cases for these health districts may be underreported to the Cancer Registry. Please use caution when comparing these data with mortality data from the same health district.
25 G E O R G I A
Cancer Data Report
2000
are the best strategies for preventing invasive disease. Cervical cancer and precancers of the cervix can be prevented by managing modifiable risk factors, such as delaying onset of first sexual intercourse, and limiting the number of lifetime sexual partners.
Early Detection Deaths from cervical cancer were reduced dramatically with the advent of the Pap smear test developed in the 1940's.With regular Pap tests and appropriate follow-up care, death from cervical cancer is almost totally preventable.
Cervical Cancer Screening in Georgia According to the 1998 Behavioral Risk Factor Surveillance System, the rate of Pap test screening (within the past 3 years) was similar for all age groups except for females aged 65 and older, who had the lowest rate (66%) (Figure 16). Although the sample size in some health districts is small, there is apparent geographical variation in Pap test prevalence among women aged 18 and older in Georgia. For the 3 year period 19961998, the prevalence ranged from 76% in the Brunswick health district (9-3) to 96% in the Fulton health district (3-2); the state average was 90% (Figure 17).
American Cancer Society
Guidelines for Early Detection
of Cervical Cancer
Annual Pap test and pelvic examination in females who are or have been sexually active, or have reached age 18. After three or more consecutive annual exams with normal findings, the Pap test may be performed less frequently at the discretion of the physician.
Health District
Percent (%)
Figure 16. Pap Test, Females Aged 18 and Older*,
Georgia, 1998
100
91% 88% 90%
85%
80 66%
60
40
20
0 18-24 25-39 40-49 50-64 65+
Age Group
* Reported having had a Pap test within the past 3 years, women with intact uterine cervix.
Figure 17. Pap Test by Health District, Females Aged 18 and Older, Georgia, 1996-1998
Georgia = 90%
1-1 1-2 2-0 3-1 3-2 3-3 3-4 3-5 4-0 ^5-1 5-2 6-0 7-0 8-1 8-2 9-1 9-2 9-3 10-0
84% 88% 89% 92% 96%
85% 94% 94%
90% 92% 89% 94% 90% 80% 89% 93% 86% 76% 94%
0
20
40
60
80
100
Percent (%)
* Reported having had a Pap test within the past 3 years, women with intact uterine cervix. ^ Fewer than 50 respondents, data may be unstable. Note: 95% confidence interval for Georgia was 1% and intervals for the health districts ranged from 2% to 23%.
26 G E O R G I A
Cancer Data Report
2000
COLON & RECTUM CANCER
New Cases An estimated 3,280 new cases of colorectal cancer are expected to be diagnosed in Georgia in 2000; 1,640 males and 1,640 females. Colorectal cancer is the third most common cancer diagnosed among Georgia males and females.
Figure 18. Health Districts with Significantly* High or Low Colon and Rectum Cancer Mortality
Rates, 1994-1998
1-2 2-0
1-1
3-1 3-4 10-0
3-2 3-5 3-3
6-0 4-0
5-2
Deaths An estimated 1,260 Georgians are expected to die of colorectal cancer in 2000; 610 males and 650 females. Colorectal cancer is third leading cause of cancer death among Georgia males and females. Mortality rates for colorectal cancer declined 20% among males between 1990-1998 and declined 16% among females between 1980-1998.
The Augusta (6-0), Savannah (9-1) and Fulton (3-2) health districts have significantly higher mortality rates than the state average; while the Gainesville (2-0), Athens (10-0),Waycross (9-2) and Brunswick (9-3) health districts have significantly lower rates (Figure 18).
Risk Factors Personal or family history of colorectal cancer
or polyps, and inflammatory bowel disease Physical inactivity A high fat and/or low fiber diet Inadequate intake of fruits and vegetables
Prevention
7-0 5-1
The early detection and removal of precancerous
9-1
polyps can greatly reduce the risk of developing
or dying of invasive colorectal cancer. Other
9-3
strategies for prevention include managing
modifiable risk factors (above), such as diet and
8-2
8-1
9-2
physical activity.
* p < 0.05
Health districts with rates significantly higher than state rate No significant difference Health districts with rates significantly lower than state rate
27 G E O R G I A
Cancer Data Report
2000
Early Detection Early detection of colorectal cancer can save lives. Two effective tools available for screening for colorectal cancer are fecal occult blood tests, which detect blood in a person's stool sample, and sigmoidoscopy, an examination of the rectum and lower colon using a lighted flexible tube.
American Cancer Society Guidelines for Early Detection
of Colorectal Cancer
Beginning at age 50, males and females should follow one of the examination schedules below:
Fecal occult blood test every year and flexible sigmoidoscopy every five years.*
A colonoscopy every 10 years.*
A double-contrast barium enema every 5 to 10 years.*
People who are at moderate or high risk for colorectal cancer should talk with their doctor about an appropriate testing schedule.
* A digital rectal examination should be done at the same time as sigmoidoscopy, colonoscopy, or double-contrast barium enema.
Percent (%)
Colorectal Cancer Screening in Georgia According to the 1997 Behavioral Risk Factor Surveillance System, 52% of males and 45% of females aged 50 and older reported ever having had a sigmoidoscopic or proctoscopic examination (Figure 19).
Figure 19. Sigmoidoscopic/Proctoscopic Examination*, Persons Aged 50 and Older, Georgia, 1997
60 52%
50
45%
40
30
20
10
0 Male
Female
Gender
* Reported ever having had a sigmoidoscopic/proctoscopic examination.
28 G E O R G I A
Cancer Data Report
2000
LUNG & BRONCHUS CANCER
New Cases An estimated 5,290 new cases of lung cancer are expected to be diagnosed in Georgia in 2000; 3,480 males and 1,810 females. Lung cancer is the most common cancer diagnosed in Georgia and in 2000 will account for 16% of all cancer diagnoses.
Figure 20. Health Districts with Significantly* High or Low Lung and Bronchus Cancer Mortality
Rates, 1994-1998
Deaths An estimated 4,130 Georgians are expected to die of lung cancer in 2000; 2,770 males and 1,360 females. In 2000, lung cancer deaths will account for 30% of all cancer deaths in Georgia. In recent years, mortality rates from lung cancer have declined among males; however, among females, rates have doubled since 1980. Decreasing mortality rates among males are most likely a result of decreased smoking rates over the previous 30 years.
1-2 2-0
1-1
3-1 3-4 10-0
3-2 3-5 3-3
6-0 4-0
5-2
7-0 5-1
9-1 9-3
8-2
8-1
9-2
* p < 0.05
Health districts with rates significantly higher than state rate No significant difference Health districts with rates significantly lower than state rate
The northwest and southern health districts have significantly higher mortality rates than the state average; while most of the Metropolitan Atlanta, Gainesville (2-0), and LaGrange (4-0) health districts have significantly lower rates (Figure 20).
Risk Factors Tobacco use (accounts for almost 87% of all
lung cancer cases) Exposure to environmental (second-hand)
tobacco smoke Exposure to certain industrial substances, such
as arsenic; some organic chemicals; radon and asbestos, particularly for persons who smoke Radiation exposure from occupational, medical, and environmental sources Air pollution
Prevention The best strategy for preventing lung cancer is not to smoke and to avoid exposure to environmental or second hand smoke. In those who stop smoking, damaged lung tissue often returns to normal. People who work with potentially cancer causing chemicals should take appropriate protective measures to avoid harmful exposure.
Early Detection There is no known effective way to routinely screen for lung cancer. Because symptoms often do not appear until the disease is advanced, early detection is difficult.
29 G E O R G I A
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2000
PROSTATE CANCER
New Cases An estimated 5,030 new cases of prostate cancer are expected to be diagnosed among Georgia males in 2000. Prostate cancer is the most commonly diagnosed cancer among Georgia males and in 2000 will account for 28% of all male cancer cases.
Deaths An estimated 910 Georgia males are expected to die of prostate cancer in 2000. Prostate cancer is the second leading cause of cancer death among males. During 1980-1992, prostate cancer mortality rates in Georgia increased 29% followed by a 20% decline in rates from 1992-1998. Mortality rates among black males are more than twice as high as rates among white males.
Figure 21. Health Districts with Significantly* High or Low Prostate Cancer Mortality Rates, 1994-1998
1-2 2-0
1-1
3-1 3-4 10-0
3-2 3-5 3-3
6-0 4-0
5-2
The Fulton (3-2) and DeKalb (3-5) health districts as well as many of the southern and central Georgia health districts have significantly higher mortality rates than the state average, while the northern health districts have significantly lower rates (Figure 21).
Risk Factors Risk increases with age; 91% of cases are
diagnosed in males over age 55 Black race Family history; genetic predisposition (may
be responsible for 5%-10% of prostate cancers) A high fat diet
Prevention There is no known way to prevent prostate cancer. Many known risk factors such as age, race, and family history cannot be controlled; however managing diet may help to reduce prostate cancer risk.
Early Detection A blood test for prostate specific antigen (PSA) and digital rectal examination of the prostate gland are two tools commonly used to detect prostate cancer early. Neither the PSA nor the digital rectal examination have been proven to reduce mortality from prostate cancer. Currently, there are no commonly accepted recommendations regarding routine screening for prostate cancer. Men should discuss prostate cancer screening options with their health care professional.
7-0 5-1
9-1 9-3
8-2
8-1
9-2
* p < 0.05
Health districts with rates significantly higher than state rate No significant difference Health districts with rates significantly lower than state rate
American Cancer Society
Guidelines for Early Detection
of Prostate Cancer
Males aged 50 and older who have at least a 10-year life expectancy should talk with their health care professional about having a digital rectal examination of the prostate gland and a prostatespecific antigen (PSA) blood test every year. Males who are at high risk for prostate cancer (blacks or males who have a history of prostate cancer in close family members) should consider beginning these tests at an earlier age.
30 G E O R G I A
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2000
CANCER RISK BEHAVIORS IN GEORGIA
Tobacco Use Smoking is the most preventable cause of death in our society.Tobacco use accounts for at least 30% of all cancer deaths, about 87% of all lung cancer cases and is also associated with cancers of the mouth, pharynx, larynx, esophagus, pancreas, uterine cervix, kidney, and bladder. In 1996, tobacco use was responsible for 17% or one in six deaths in Georgia; and Georgians who die as a result of their smoking habit lose an average of 14.6 years of life.
The use of spit tobacco and cigars is on the rise. In 1986, the US Surgeon General concluded that the use of spit tobacco is not a safe substitute for smoking cigarettes. Spit tobacco causes cancer, a number of non-cancerous oral conditions and can lead to nicotine addiction and dependence.5 Cigars contain most of the same carcinogens and cancer-producing chemicals found in cigarettes and regular cigar smoking causes cancer of the lung, oral cavity, larynx, esophagus, and probably cancer of the pancreas.6
Tobacco Use Among Georgia Adults According to the 1998 Behavioral Risk
Factor Surveillance System, an estimated 24% of Georgia adults smoke. Males (28%) are more likely to smoke than females (20%) and whites (25%) are more likely to smoke than blacks (19%). The prevalence of smoking among both males and females in Georgia declined between 1984-1992. However, since 1992, the prevalence has increased 4.4% per year among males and 5.0% among females (Figure 22). Although the sample size in some health districts is small, there is apparent geographical variation in adult cigarette use. For the 3 year period 1996-1998, the prevalence ranged from 17% in the Fulton health district (3-2) to 30% in the Valdosta health district (8-1); the state average was 23% (Figure 23).
There are many benefits to smoking cessation. People who quit smoking, regardless of age, live longer than people who continue to smoke.
Percent (%)
Figure 22. Current Cigarette Use*, Persons Aged 18 and Older, Georgia, 1984-1998
40 Decreased 5.9%
35
per year
Increased 4.4% per year
30
Male
25
20
15
Female
10 Decreased 4.7%
5
per year
Increased 5.0% per year
0 1984
1986
1988
1990
1992
1994
Year
* Reported having smoked at least 100 cigarettes in their lifetime, and now are current smokers.
1996
1998
31 G E O R G I A
Cancer Data Report
2000
Quitting smoking decreases the risk of developing many cancers and other major diseases, including coronary heart disease and other cardiovascular diseases.7
According to the 1998 Behavioral Risk Factor Surveillance System, 46% of Georgia males and 49% of Georgia females who were current smokers reported that they had tried to quit smoking for at least one day during the past year.
Tobacco Use Among Georgia Youth According to the 1999 Georgia Youth
Tobacco Survey, the prevalence of middle school students who have ever used tobacco was 59% among males and 50% among females (Figure 24). During 1999, 21% of male and 16% of female middle school students reported current tobacco use (Figure 24). The prevalence of students in grades six, seven and eight who have ever used tobacco was 43%, 57% and 65%, respectively. Students in grade eight were significantly more likely to have ever used tobacco compared to students in grade six. The prevalence of Hispanic middle school students who have ever used tobacco was 68%, while 54% of white students and 53% of black students reported having ever used tobacco.
Health District
Figure 23. Current Cigarette Use* by Health Districts, Adults aged 18 and Older, Georgia, 1996-1998
Georgia = 23%
1-1 1-2 2-0 3-1 3-2 3-3 3-4 3-5 4-0 5-1 5-2 6-0 7-0 8-1 8-2 9-1 9-2 9-3 10-0
28% 21%
28% 21% 17% 18%
26% 18%
29% 27% 24% 23% 18%
30% 23% 24% 20% 18% 22%
0
20
40
60
80
100
Percent (%)
* Reported having smoked at least 100 cigarettes in their lifetime and now are current smokers. Note: 95% confidence interval for Georgia was 1% and intervals for the health districts ranged from 3% to 13%.
Percent (%) Percent (%)
Figure 24. Ever and Current Tobacco Use by Gender, Middle School Students, Georgia, 1999
59% 60
55%
60
50%
50
50
40
40
30
30
21% 19%
20
20
16%
10
10
0 Male
Female
Total
Ever Used Tobacco*
** Reported ever having used cigarettes, smokeless tobacco, ** or cigars.
0 Male
Female
Total
Current Tobacco Use**
** Reported cigarette, smokeless tobacco, or cigar use on 1 or more ** of the preceding 30 days.
32 G E O R G I A
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2000
Diet and Nutrition Existing scientific evidence suggests that about one-third of the cancer deaths that occur in the US each year are due to dietary factors.8 The introduction of healthful diet and exercise practices at any time from childhood to old age can promote health and probably reduces cancer risk. Many dietary factors can affect cancer risk: type of food, food preparation methods, portion
Figure 25. Fruit and Vegetable Intake, Persons Aged 18 and Older, Georgia, 1998
3-4 servings per day 37%
5 or more servings per day
21%
< 1 serving per day 5%
1-2 servings per day
37%
sizes, food variety, and overall caloric balance. Cancer risk can be reduced by an overall dietary pattern that includes a high proportion of plant foods (fruits, vegetables, grains and beans), limited amounts of meat, dairy, and other high-fat foods and a balance of caloric intake and physical activity.
The recommendations of the American Cancer Society Advisory Committee on Diet, Nutrition, and Cancer Prevention (see text boxes on pages 32 and 33) are consistent in principle with the 1992 US Department of Agriculture (USDA) Food Guide Pyramid, the 1995 Dietary Guidelines for Americans, and dietary recommendations of other agencies.Although no diet can guarantee full protection against any disease, these recommendations offer the best nutrition information currently available to help Americans reduce their risk of cancer.
Nutrition in Georgia According to the 1998 Behavioral Risk
Factor Surveillance System, only 21% of Georgia adults were eating the recommended 5 or more servings of fruits and vegetables per day; 37% reported eating 3-4 servings or 1-2 servings per day; and 5% reported eating less than 1 serving per day. (Figure 25).
Choose most of the foods you eat from plant sources. Eat five or more servings of fruits and vegetables each day; eat other foods from plant sources, such as breads, cereals, grain products, rice, pasta, or beans several times each day. Consumption of fruits and vegetables can reduce the risk of developing some cancers.The evidence is particularly strong for reducing the risk of colon cancer.
Limit the intake of high-fat foods, particularly from animal sources. Choose foods low in fat; limit consumption of meats, especially high-fat meats. High-fat diets have been associated with an increased
risk of cancers of the colon and rectum, prostate, and uterine corpus (endometrium).
Limit consumption of alcoholic beverages, if you drink at all. Alcohol consumption increases the risk of cancers of the mouth, esophagus, pharynx, larynx, and liver. Studies have also noted an association between alcohol consumption and an increased risk of breast cancer. The mechanism is unknown but may be due to alcohol-induced changes in hormones in the blood, or to a carcinogenic effect of alcohol or its metabolites on breast tissue.
33 G E O R G I A
Cancer Data Report
2000
Physical Activity Physical activity can help protect against some cancers, either by balancing caloric intake with energy expenditure or by some other unknown mechanisms.8 An imbalance of caloric intake and output can lead to being overweight or obese, and increases the risk of developing several cancers. Maintaining a healthy body weight can also reduce the risk of chronic diseases such as coronary heart disease and diabetes. Moderate physical activity may increase caloric needs and encourage consumption of healthful foods while maintaining a recommended body weight.
The physical activity recommendations of the American Cancer Society Advisory Committee on Diet, Nutrition, and Cancer Prevention (see text box below) are consistent in principle with the recommendations of the Centers for Disease Control and Prevention, the American College of Sports Medicine, a National Institutes of Health Consensus Conference, and the US Surgeon General.
Be physically active: achieve and maintain a healthy weight. Be at least moderately active for 30 minutes or more on most days of the week; stay within your healthy weight range.
Percent (%)
Physical Activity in Georgia According to the 1998 Behavioral Risk
Factor Surveillance System, only 25% of Georgia adults were participating in regular physical activity; while 30% reported no leisure time physical activity at all (Figure 26). Between 1984-1998, there was a gradual increase among those reporting no leisure time physical activity and a gradual decrease among those reporting regular physical activity.
Figure 26. Physical Activity, Persons Aged 18 and Older, Georgia, 1984-1998
60
50 No leisure-time physical activity
40
30
20
Regular physical activity* 10
0 1984 1986 1988 1990 1992 1994 1996 1998
Year
* Five+ times per week and 150+ minutes per week and at least 10 minutes per session OR 3+ times per week of vigorous intensity activity for at least 20 minutes per session.
34 G E O R G I A
Cancer Data Report
2000
CONCLUSION
This report summarizes the most recent information available on cancer incidence, mortality, and risk in Georgia. Cancer is a significant health problem in Georgia; accounting for 1 in 4 deaths each year. Black Georgians suffer an increased burden of cancer; they are 27% more likely to die of cancer than whites. Although overall mortality rates have declined slightly in recent years, there is still much progress to be made.
The practical implications of the findings in this report are clear. Nearly two-thirds of cancer deaths could be prevented by adopting a healthy lifestyle including not smoking, eating a healthy diet and engaging in regular physical activity. Additionally, the risk of cancer death can be reduced by following recommended guidelines for early detection of cancer.
There is hope that Georgia can reduce its burden from cancer; prevention, early detection, and prompt treatment can make a difference. Greater effort needs to be made by all Georgians to reduce the prevalence of risk factors for cancer and to participate in cancer early detection
examinations. Sustained behavior change is difficult to make, even for highly motivated individuals.Therefore, it is essential to engage a variety of state and local governments, nonprofit organizations and private groups in a process to encourage policy and environmental changes that make it easier for people to change their behavior.
Much of the death and disability from cancer in Georgia is preventable. If we focus our attention on realistic ways to reduce risk and encourage early detection, we can increase the decline in cancer death rates and reduce the number of Georgians who receive a diagnosis of cancer. Georgians can work together to reduce the number of individuals who suffer and die from cancer.
Kathleen E. Toomey, M.D., M.P.H.
Director, Division of Public Health Georgia Department of Human Resources
Jack Shipkoski
Chief Executive Officer, American Cancer Society, Southeast Division
35 G E O R G I A
Cancer Data Report
2000
TECHNICAL APPENDIX
Definitions: Age-adjusted rate: A rate calculated in a manner that allows for the comparison of rates derived from populations with different age structures.
Cancer incidence rate: The number of new cancer cases occurring in a population during a specified period of time. Often expressed per 100,000 population.
Cancer mortality rate: The number of cancer deaths occurring in a population during a specified period of time. Often expressed per 100,000 population.
Confidence interval: A range of probable values for a prevalence estimate. A 95% confidence interval is one that will contain the true prevalence in 95 out of 100 samples surveyed.
Prevalence: The number of people with a disease or risk factor out of the total number of persons in a population. Often expressed as a percent.
Risk factor: A behavior, characteristic or finding on clinical examination that is consistently associated with increased probability of a disease or complications from the disease.
Data Sources: The number of deaths and death rates by county and for the state of Georgia were obtained from the Georgia Department of Human Resources, Division of Public Health,Vital Records Branch. Deaths and death rates for the United States were obtained from the National Center for Health Statistics, Centers for Disease Control and Prevention (CDC). For Figure 1, the ICD-9 codes for the disease categories were 1) cancer: 140-208; 2) heart disease: 390-398, 402, 404-429; 3) chronic obstructive pulmonary disease: 490-496; 4) diabetes: 250; 5) pneumonia and influenza: 480-487; 6) stroke: 430438; 7) unintentional injuries: E800-E949; and 8) other: all disease codes not already categorized.
For Tables 2 and 4, Figures 1, 4-10, 12, 15, 18 and 20-21, the ICD-9 codes used to define cancer sites were: 1) all cancers: 140.0-208.9; 2) breast: 174.0174.9; 3) colon & rectum: 153.0-153.9, 154.0-154.1, 159.0; 4) leukemia: 202.4, 203.1, 204.0-207.2, 207.8, 208.0-208.9; 5) lung & bronchus: 162.2162.9; 6) pancreas: 157.0-157.9; 7) prostate: 185; 8) uterine cervix: 180.0-180.9.
The number of cases and incidence rates by county and for the state of Georgia were obtained from the Georgia Department of Human Resources, Division of Public Health, Georgia Comprehensive Cancer Registry. For Tables 3 and 4, the ICD-O2 codes used for disease categories were: 1) breast: C500:C509; 2) colon & rectum: C180:C189, C260, C199, C209; 3) lung & bronchus: C340:C349; 4) prostate: C619; 5) uterine cervix: C530:C539.
Population projections for 2000 were obtained from the Office of Planning and Budgeting for the state of Georgia. Population estimates for 1994-1998 and the 2000 US standard population were obtained from the US Bureau of the Census.
Risk factor and screening behavior data were obtained from the Behavioral Risk Factor Surveillance System, a state-based surveillance system administered by the Georgia Department of Human Resources, Division of Public Health, in collaboration with the CDC.The objective of the Behavioral Risk Factor Surveillance System is to collect uniform, statespecific data on preventative health practices and risk behaviors that are linked to chronic diseases, injuries and preventable infectious diseases in the adult population. Limitations of Behavioral Risk Factor Surveillance System data include bias that may result from self-reporting of behaviors and sampling error as a result of surveying a sample rather than taking a complete population enumeration. As well, these data do not include Georgians without a telephone in the household.
Data on youth tobacco use were obtained from the Georgia Youth Tobacco Survey (GYTS).The GYTS is a random sample of students in public schools grades 6, 7 or 8 and grades 9-12. The purpose of this survey is to collect information on cigarette, smokeless tobacco, and cigar use; knowledge and attitudes; media and advertising; minors access; school curriculum; environmental tobacco smoke; and cessation.The survey was jointly developed by the Division of Public Health's Tobacco Prevention Program and the CDC.The results of the survey of high school students are not included in this report because the overall participation rate of high schools is too low for statewide generalization.
36 G E O R G I A
Cancer Data Report
2000
Methods: Mortality rates were calculated per 100,000 population and age-adjusted by the direct method to the 1970 and 2000 US standards. Except where calculated to show trends, the mortality rates are five-year average annual rates for the period 1994 through 1998. Incidence rates were calculated per 100,000 population and age-adjusted by the direct method to the 1970 and 2000 US standards. Rates were calculated for only 1995 as this is the only year in which Cancer Registry data are greater than 90% complete.
The estimated number of cases for 2000 was calculated by multiplying age-specific state incidence to mortality rate ratios by the county mortality rate. The results were then multiplied by county agespecific population estimates for 2000 and summed to obtain a county estimate. County values were summed to obtain a state total.This was done for each cancer site individually. For Cobb, Clayton,
DeKalb, Fulton and Gwinnett counties, the Metro Atlanta SEER incidence to mortality rate ratio was used in place of the state ratio.
The estimated numbers of deaths for 2000 were calculated by multiplying age-specific county population estimates for 2000 by gender- and agespecific county mortality rates for 1994-1998 and summing the resultant values. County values were summed to obtain a state total.This was done for each cancer site individually.
For Figures 2 and 3, the top ten sites chosen for cases and deaths were selected by ranking cancer incidence and mortality rates. Consequently, estimates for those sites were calculated.
For Figure 11, the percent of data completeness by health district was calculated by dividing the observed cases for 1997 by the expected cases for 1997 and multiplying by 100.
REFERENCES
1. US Bureau of the Census. ST-99-3 State Population Estimates: Annual Time Series, July 1, 1990 to July 1, 1999.
2. US Bureau of the Census. MA-98-3b Population Estimates for Metropolitan Areas and Components, Annual Time Series April 1, 1990 to July 1, 1998.
3. The Georgia County Guide, 1999. Boatright SR, Bachtel DC, Editors. Center for Agribusiness and Economic Development,The University of Georgia, Athens, GA, 1999.
4. US Bureau of the Census. PPL-47 Population Projections for States by Age, Sex, Race and Hispanic Origin: 1995 to 2025.
5. US Department of Health and Human Services. The Health Consequences of Using Smokeless Tobacco: A Report of the Advisory Committee to the Surgeon General. US Department of Health and Human Services, Public Health Service, National Institutes of Health, National Cancer Institute. DHHS Pub. No. (NIH) 86-2874, 1986.
6. Shanks TG, Burns DM. Disease Consequences of Cigar Smoking (Chapter 4). In: Cigars: Health Effects and Trends, Monograph No 9. Burns D, Cummings KM, Hoffman D, Editors, Bethesda, MD, US Department of Health and Human Services, National Institutes of Health, NIH Pub. No. 98-4302, 1998.
7. US Department of Health and Human Services. The Health Benefits of Smoking Cessation. US Department of Health and Human Services, Public Health Service, Centers for Disease Control and Prevention, Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health. DHHS Publication No. (CDC) 90-8416, 1990.
8. American Cancer Society. Guidelines on Diet, Nutrition, and Cancer Prevention: Reducing the Risk of Cancer with Healthy Food Choices and Physical Activity. Originally published in: CA-A Cancer Journal for Clinicians 46:325341;1996. Revised: March, 1999.
37 G E O R G I A
Cancer Data Report 2000
STATISTICAL APPENDIX
INCIDENCE AND MORTALITY RATE TABLES AGE-ADJUSTED TO THE 2000 US STANDARD POPULATION
Table 2A: Average Annual Number of Cancer Deaths and Mortality Rates by County, Georgia 1994-1998 (Age-adjusted to 2000 US Standard)
Table 3A: Reported Number of Cancer Cases and Incidence Rates by County, Georgia, 1995 (Age-adjusted to 2000 US Standard)
Table 4A: Invasive Cervical Cancer Incidence and Average Annual Mortality by Health District, Georgia (Age-adjusted to 2000 US Standard)
Table 2A. Average Annual Number of Cancer Deaths and Mortality Rates by County, Georgia, 1994-1998 (Age-adjusted to 2000 US Standard)
ALL SITES
BREAST
COLON & RECTUM
LUNG & BRONCHUS
PROSTATE
Male
Female
Female
Male
Female
Male
Female
Male
County
Deaths Rate* Deaths Rate* Deaths Rate* Deaths Rate* Deaths Rate* Deaths Rate* Deaths Rate* Deaths Rate*
Georgia
6,818 288.2 5,896 167.8 1,014 28.8
553 23.7
599 17.0 2,478 100.6 1,353 38.8
830 43.4
38
Appling
22 353.6
15 166.4
2 26.2
<2
3 29.7
9 140.1
3 27.8
4 77.0
Atkinson
6 231.2
7 206.9
<2
<2
<2
3 111.5
<2
<2
Bacon
13 323.0
12 203.3
<2
<2
<2
5 122.5
<2
<2
Baker
3 215.7
4 174.7
<2
<2
<2
<2
<2
<2
Baldwin
43 288.0
33 161.5
6 31.2
5 30.0
3 13.6
17 107.1
9 42.6
6 43.1
Banks
12 308.1
8 137.2
<2
<2
<2
5 111.8
2 36.4
<2
Barrow
34 277.1
26 144.8
4 19.9
2 19.6
<2
14 117.2
8 47.5
<2
Bartow
72 326.5
50 157.9
9 27.2
6 26.8
6 18.8
27 112.7
13 40.6
8 52.7
Ben Hill
19 295.6
16 149.7
2 24.1
2 34.8
<2
8 130.1
3 28.3
2 33.5
Berrien
17 278.3
15 173.3
2 25.2
<2
2 22.7
8 128.6
4 40.2
2 46.3
Bibb
178 312.4
150 161.5
24 26.5
16 30.4
17 17.8
67 112.2
38 40.8
23 45.3
Bleckley
15 336.3
11 154.9
<2
<2
<2
7 143.8
2 29.2
<2
Brantley
13 272.7
13 218.7
<2
<2
<2
6 133.8
4 70.8
<2
Brooks
20 298.4
15 145.5
<2
2 30.0
2 19.4
7 108.9
3 28.2
3 56.0
Bryan
18 318.7
14 178.6
<2
<2
<2
7 108.5
4 53.5
2 59.7
Bulloch
42 272.0
38 172.3
8 36.8
4 23.4
4 17.4
13 82.5
6 28.0
6 49.7
Burke
22 312.6
20 182.9
4 39.3
<2
2 19.9
6 87.6
4 36.2
4 58.8
Butts
17 255.0
16 185.8
2 29.9
<2
<2
6 86.9
4 44.9
<2
Calhoun
7 336.8
6 142.9
<2
<2
<2
<2
<2
<2
Camden
21 294.7
19 189.1
3 27.7
<2
<2
6 81.1
6 56.6
4 66.7
Candler
12 307.3
9 167.3
<2
<2
<2
3 81.1
2 40.2
<2
Carroll
75 282.1
65 169.9
11 28.2
8 30.2
7 18.8
30 108.2
14 37.5
7 34.0
Catoosa
52 271.4
41 157.0
6 23.7
5 28.2
3 12.9
22 109.4
13 47.8
3 22.3
Charlton
10 310.1
11 238.4
<2
<2
<2
3 88.2
2 44.7
<2
Chatham
248 287.6
229 177.2
36 28.7
21 25.1
26 19.6
88 97.9
55 42.0
32 43.4
Chattahoochee
4 509.2
3 215.0
<2
<2
<2
<2
<2
<2
Chattooga
31 302.6
30 199.0
4 31.4
2 20.0
3 17.2
14 126.8
8 50.6
3 31.0
Cherokee
83 273.0
64 150.6
11 23.9
8 24.3
7 17.2
26 88.7
14 33.1
7 32.4
Clarke
63 265.6
55 143.1
11 29.2
5 22.7
4 10.4
23 92.4
13 35.0
10 48.9
Clay
5 312.4
5 189.1
<2
<2
<2
<2
<2
<2
Clayton
136 277.4
126 181.2
18 23.8
11 22.2
10 14.6
53 103.6
37 53.2
12 37.0
Clinch
8 330.9
5 140.0
<2
<2
<2
2 102.0
<2
<2
Cobb
349 275.4
338 175.9
58 28.2
29 24.0
33 17.6
122 91.0
80 42.2
37 41.1
Coffee
31 281.3
25 157.9
4 26.9
3 29.8
<2
12 97.2
5 33.2
<2
Colquitt
45 291.0
40 170.5
5 21.5
3 19.6
6 24.1
17 107.2
7 31.4
9 62.1
Columbia
56 254.8
54 179.5
9 26.5
3 14.0
4 12.8
21 80.0
14 47.9
6 37.5
Cook
21 376.8
14 158.2
3 32.2
<2
<2
8 134.3
3 32.1
2 49.1
Coweta
66 307.8
52 153.3
10 27.3
6 28.8
3
8.6
23 101.5
13 38.2
10 62.6
Crawford
9 222.0
6 133.7
<2
<2
<2
3 75.8
<2
<2
* Average annual rate per 100,000, age-adjusted to the 2000 US standard population.
Rate not calculated for fewer than 2 average deaths.
Table 2A. Average Annual Number of Cancer Deaths and Mortality Rates by County, Georgia, 1994-1998 (Age-adjusted to 2000 US Standard) (continued)
ALL SITES
BREAST
COLON & RECTUM
LUNG & BRONCHUS
PROSTATE
Male
Female
Female
Male
Female
Male
Female
Male
County
Deaths Rate* Deaths Rate* Deaths Rate* Deaths Rate* Deaths Rate* Deaths Rate* Deaths Rate* Deaths Rate*
Crisp
32 414.2
22 164.3
4 33.4
<2
<2
15 190.8
5 38.1
4 65.8
39
Dade
15 249.4
12 158.6
<2
<2
<2
6 96.2
3 45.8
3 59.1
Dawson
13 341.6
9 160.1
2 43.4
<2
<2
5 116.5
2 36.9
<2
Decatur
32 307.2
28 193.3
5 34.9
3 27.1
2 14.0
12 107.9
6 43.7
4 49.9
DeKalb
433 268.2
421 166.8
89 33.7
36 22.5
46 18.2
134 81.5
89 36.1
58 46.1
Dodge
26 338.1
21 183.4
3 29.0
2 28.7
2 19.3
10 131.6
4 31.6
3 46.6
Dooly
12 316.4
12 185.4
3 48.0
<2
<2
4 103.8
<2
<2
Dougherty
101 324.2
81 162.2
14 27.9
10 31.4
8 15.3
39 117.6
19 38.8
15 60.3
Douglas
68 279.1
55 170.3
10 28.9
4 14.8
4 12.6
24 101.1
14 43.1
6 31.5
Early
17 333.6
15 180.9
4 42.8
<2
2 20.5
6 101.7
3 32.0
3 64.0
Echols
3 279.5
<2
<2
<2
<2
<2
<2
<2
Effingham
28 276.5
22 165.5
3 25.0
<2
2 19.1
13 116.7
4 33.1
2 36.9
Elbert
29 330.4
23 177.9
4 34.0
2 28.6
3 19.5
10 115.5
5 37.5
2 29.8
Emanuel
33 372.3
20 156.7
3 24.7
3 41.7
2 16.1
10 109.3
5 38.6
3 41.7
Evans
12 315.6
9 157.5
<2
<2
<2
5 115.4
<2
2 52.9
Fannin
29 265.9
22 163.4
3 25.1
2 20.0
3 20.1
12 106.5
7 52.8
3 31.4
Fayette
55 245.2
54 169.1
8 24.2
6 25.8
6 19.3
18 75.8
13 40.1
7 44.2
Floyd
111 308.9
96 173.0
15 28.5
9 25.5
9 15.8
43 113.2
23 41.5
10 30.4
Forsyth
41 209.3
38 131.8
6 21.0
<2
5 19.5
16 73.6
8 28.7
5 33.8
Franklin
23 261.5
20 161.1
4 28.4
<2
2 18.3
8 85.7
3 25.2
3 40.9
Fulton
627 297.3
636 185.8
125 36.1
55 26.1
72 20.7
190 87.8
134 40.3
89 50.2
Gilmer
24 294.1
20 178.5
2 19.8
2 25.6
2 17.1
9 105.9
7 59.8
3 45.0
Glascock
4 278.1
<2
<2
<2
<2
<2
<2
<2
Glynn
78 258.2
73 179.0
11 28.5
5 17.0
7 16.8
27 86.3
21 49.6
9 33.9
Gordon
44 307.1
32 159.6
5 24.9
3 22.2
3 16.1
16 111.7
9 43.0
5 47.2
Grady
32 340.6
19 147.6
4 30.4
2 21.8
<2
13 141.4
3 26.6
5 54.0
Greene
16 303.0
12 154.5
3 38.1
<2
2 26.1
6 103.4
2 27.0
2 45.5
Gwinnett
233 240.6
227 162.3
44 28.0
22 23.6
23 18.1
72 72.5
52 38.3
23 34.2
Habersham
34 243.8
29 154.6
6 31.5
3 22.4
4 18.9
14 97.6
6 30.6
3 25.4
Hall
103 256.8
84 150.9
15 26.4
10 25.8
8 14.5
39 91.4
21 37.1
12 36.0
Hancock
13 372.3
11 189.1
2 39.7
<2
<2
3 86.1
<2
3 92.6
Haralson
29 292.1
24 163.0
3 24.6
<2
3 18.5
13 120.5
5 38.6
3 40.5
Harris
28 309.4
18 151.2
4 31.2
2 30.5
<2
8 82.4
4 30.9
5 58.3
Hart
27 278.2
20 136.0
4 30.5
2 22.9
2 14.9
10 99.9
3 22.2
4 48.5
Heard
8 213.8
6 126.3
<2
<2
<2
3 84.4
<2
<2
Henry
68 252.0
62 166.8
11 27.6
5 17.1
7 19.2
23 85.6
15 39.0
6 32.3
Houston
87 299.4
76 175.3
15 33.1
6 24.2
6 14.6
33 101.4
22 50.1
10 55.8
Irwin
14 361.3
10 169.7
<2
<2
<2
8 197.0
<2
2 51.9
Jackson
36 277.3
29 160.3
5 27.6
4 24.9
<2
16 116.0
7 41.0
3 33.4
Jasper
12 316.6
11 213.0
2 43.8
<2
<2
5 112.2
<2
<2
* Average annual rate per 100,000, age-adjusted to the 2000 US standard population.
Rate not calculated for fewer than 2 average deaths.
Table 2A. Average Annual Number of Cancer Deaths and Mortality Rates by County, Georgia, 1994-1998 (Age-adjusted to 2000 US Standard) (continued)
ALL SITES
BREAST
COLON & RECTUM
LUNG & BRONCHUS
PROSTATE
Male
Female
Female
Male
Female
Male
Female
Male
County
Deaths Rate* Deaths Rate* Deaths Rate* Deaths Rate* Deaths Rate* Deaths Rate* Deaths Rate* Deaths Rate*
Jeff Davis
20 419.1
10 146.8
<2
<2
<2
9 188.9
2 36.2
2 67.8
40
Jefferson
24 358.8
22 191.8
5 53.0
<2
4 30.1
10 147.1
3 25.7
4 66.6
Jenkins
13 348.3
7 149.5
<2
<2
<2
5 142.2
2 41.4
2 64.4
Johnson
11 317.3
11 186.3
<2
<2
<2
4 111.8
<2
<2
Jones
21 294.9
18 173.8
3 27.6
<2
2 22.3
9 112.4
4 39.3
3 46.4
Lamar
19 341.3
15 179.5
2 27.0
<2
<2
8 136.1
3 40.6
3 65.5
Lanier
8 380.5
4 127.9
<2
<2
<2
3 146.0
<2
<2
Laurens
58 334.6
37 151.7
6 23.0
3 17.9
3 13.9
21 110.2
7 28.4
10 63.7
Lee
14 311.8
14 199.3
2 25.2
<2
<2
6 107.9
3 40.4
<2
Liberty
31 376.5
23 185.3
5 35.5
2 26.9
<2
9 109.5
7 57.2
5 86.6
Lincoln
12 348.6
8 172.2
<2
<2
<2
5 150.3
<2
2 62.8
Long
6 236.2
5 161.2
<2
<2
<2
2 73.3
<2
<2
Lowndes
78 300.7
66 176.2
8 22.3
4 16.0
7 18.4
31 116.7
18 49.4
11 50.4
Lumpkin
18 278.8
14 165.3
2 29.5
<2
<2
7 112.5
4 46.2
2 37.6
McDuffie
23 306.7
21 183.8
4 33.9
<2
2 16.8
11 133.5
5 41.2
<2
McIntosh
15 354.8
10 184.7
2 39.1
<2
<2
5 99.1
<2
3 66.4
Macon
16 344.8
13 177.8
<2
<2
<2
6 121.9
<2
3 75.5
Madison
25 294.5
22 178.9
4 31.5
<2
2 19.3
9 105.5
4 32.4
3 39.2
Marion
8 353.9
3 88.8
<2
<2
<2
4 152.1
<2
<2
Meriwether
27 293.9
24 170.8
3 20.6
<2
3 18.1
9 97.5
5 35.9
5 60.9
Miller
7 231.6
6 134.0
<2
<2
<2
2 66.4
<2
<2
Mitchell
26 338.1
21 176.8
2 20.3
<2
3 23.6
12 151.5
5 39.5
3 43.4
Monroe
25 348.4
18 175.4
3 25.5
<2
3 25.8
11 150.4
4 37.3
2 39.1
Montgomery
10 346.1
7 183.9
<2
<2
<2
4 132.4
<2
<2
Morgan
15 271.5
12 145.6
<2
2 34.8
<2
5 96.0
3 32.9
<2
Murray
25 251.7
22 168.5
3 23.9
2 24.2
2 16.5
12 112.9
6 45.4
2 30.7
Muscogee
190 309.2
166 166.9
28 28.6
16 27.6
16 16.1
70 105.7
39 38.7
27 53.0
Newton
49 284.1
45 173.7
6 24.3
4 20.2
4 16.1
20 117.0
8 31.1
6 42.2
Oconee
18 266.7
14 134.2
3 27.7
<2
<2
5 79.1
4 36.9
<2
Oglethorpe
12 294.1
9 153.0
<2
<2
<2
4 88.5
3 53.3
<2
Paulding
47 287.1
37 175.0
6 27.4
5 29.3
2 11.9
19 102.6
11 54.4
5 47.2
Peach
22 283.7
18 159.2
4 33.2
<2
<2
9 114.3
3 27.4
3 43.7
Pickens
21 265.4
13 124.5
3 33.1
<2
<2
9 111.2
3 26.1
<2
Pierce
21 341.4
12 156.1
2 28.3
<2
<2
9 139.8
<2
3 52.2
Pike
18 375.8
10 149.5
<2
<2
<2
7 133.5
3 45.7
2 55.4
Polk
51 344.8
41 182.8
7 31.9
4 30.1
4 18.2
21 132.3
11 47.4
5 35.5
Pulaski
11 291.2
10 170.0
2 46.4
<2
<2
3 73.0
2 33.8
2 66.2
Putnam
21 285.5
16 168.9
<2
<2
<2
8 112.2
4 42.7
3 48.1
Quitman
4 352.1
3 202.1
<2
<2
<2
<2
<2
<2
Rabun
22 270.7
17 170.7
3 29.1
2 25.8
2 20.6
7 85.8
2 22.6
3 35.0
* Average annual rate per 100,000, age-adjusted to the 2000 US standard population.
Rate not calculated for fewer than 2 average deaths.
Table 2A. Average Annual Number of Cancer Deaths and Mortality Rates by County, Georgia, 1994-1998 (Age-adjusted to 2000 US Standard) (continued)
ALL SITES
BREAST
COLON & RECTUM
LUNG & BRONCHUS
PROSTATE
Male
Female
Female
Male
Female
Male
Female
Male
County
Deaths Rate* Deaths Rate* Deaths Rate* Deaths Rate* Deaths Rate* Deaths Rate* Deaths Rate* Deaths Rate*
Randolph
13 378.7
10 169.6
<2
<2
<2
4 123.3
<2
2 65.4
41
Richmond
210 334.2
175 184.8
28 29.2
15 26.1
18 18.8
73 113.6
43 45.0
19 37.1
Rockdale
49 254.3
52 181.9
10 34.0
4 26.3
5 19.0
19 89.0
13 44.0
4 29.8
Schley
5 378.9
5 234.8
<2
<2
<2
2 144.9
<2
<2
Screven
24 397.5
16 176.7
4 44.9
2 35.8
2 23.8
8 130.7
3 32.0
4 68.3
Seminole
11 287.5
9 149.0
<2
<2
<2
4 90.4
<2
<2
Spalding
58 293.5
52 163.7
9 30.2
4 20.5
4 13.0
20 99.3
12 40.3
7 42.1
Stephens
34 303.0
28 161.1
5 30.9
3 21.4
2 13.1
13 110.3
5 31.4
5 48.1
Stewart
8 308.6
7 184.4
<2
<2
<2
4 156.6
<2
3 100.0
Sumter
33 307.9
33 178.7
5 34.0
2 20.0
3 15.6
11 97.7
7 38.0
4 46.2
Talbot
9 326.0
7 164.5
<2
<2
<2
3 122.0
<2
<2
Taliaferro
3 381.8
<2
<2
<2
<2
<2
<2
<2
Tattnall
28 351.6
16 154.7
3 32.5
<2
<2
10 119.1
3 30.2
3 38.8
Taylor
8 251.0
8 163.0
<2
<2
<2
3 101.4
2 43.2
<2
Telfair
19 389.1
15 191.6
3 41.9
3 63.8
<2
8 155.1
3 45.6
<2
Terrell
17 400.9
11 160.7
<2
<2
<2
8 172.1
<2
2 68.3
Thomas
54 334.8
39 153.1
4 17.8
5 31.0
3 12.9
21 121.6
8 30.1
6 42.6
Tift
38 306.7
33 171.8
5 29.8
2 18.9
<2
15 116.2
8 41.2
5 42.5
Toombs
31 348.0
28 192.9
3 23.3
<2
<2
14 144.5
6 41.5
4 56.8
Towns
13 202.3
11 155.9
2 35.1
<2
<2
4 64.8
<2
<2
Treutlen
7 284.1
7 184.3
<2
<2
<2
3 103.5
<2
<2
Troup
71 321.8
61 170.7
7 23.1
5 25.1
8 20.2
29 125.2
14 40.7
9 46.1
Turner
12 303.2
8 150.5
<2
<2
<2
4 99.3
2 33.7
<2
Twiggs
13 329.0
7 148.3
<2
<2
<2
6 151.6
2 38.0
<2
Union
27 265.2
18 153.6
<2
2 21.0
2 18.3
11 103.1
5 45.1
2 24.5
Upson
28 240.8
31 173.4
7 40.8
2 16.4
3 18.6
9 75.8
6 34.4
5 49.4
Walker
81 300.9
62 167.1
9 26.2
6 23.5
6 15.3
36 128.6
16 42.0
6 27.0
Walton
49 285.7
36 145.8
4 16.2
4 22.6
4 17.2
18 103.4
9 38.2
5 38.3
Ware
50 311.7
36 150.8
4 18.5
4 26.6
5 18.6
22 132.1
8 32.2
6 39.3
Warren
8 305.2
7 164.6
<2
<2
<2
3 130.6
<2
<2
Washington
25 344.5
23 190.4
3 22.9
3 36.5
2 15.8
7 86.0
6 51.4
4 64.4
Wayne
28 277.2
22 169.9
4 28.3
<2
<2
13 122.5
6 43.0
3 34.6
Webster
4 337.6
3 225.0
<2
<2
<2
<2
<2
<2
Wheeler
7 313.3
4 135.5
<2
<2
<2
3 138.1
<2
<2
White
17 200.3
14 127.4
3 29.7
<2
<2
7 72.1
3 25.9
<2
Whitfield
76 277.8
67 168.7
12 30.3
6 24.9
6 15.9
33 114.3
16 41.1
9 40.2
Wilcox
10 285.3
7 140.4
<2
<2
<2
4 117.2
<2
<2
Wilkes
18 382.5
14 188.3
3 43.3
<2
<2
7 141.3
<2
2 63.2
Wilkinson
10 252.3
9 160.8
2 39.2
<2
<2
4 104.0
<2
<2
Worth
22 285.3
17 158.7
3 25.8
3 33.0
2 19.6
8 100.5
4 34.3
2 36.6
* Average annual rate per 100,000, age-adjusted to the 2000 US standard population.
Rate not calculated for fewer than 2 average deaths.
42
Table 3A. Reported Number of Cancer Cases and Incidence Rates by County, Georgia, 1995 (Age-adjusted to 2000 US Standard)
ALL SITES
BREAST
COLON & RECTUM LUNG & BRONCHUS
PROSTATE
Total
Female
Total
Total
Male
County
Cases
Rate*
Cases
Rate*
Cases
Rate*
Cases
Rate*
Cases
Rate*
Georgia Appling Atkinson Bacon
23,669 49 18 31
388.1 306.3 286.5 327.3
3,558 14 5 8
103.4 170.1
2,464
41.8
<5
<5
<5
3,884
64.9
<5
<5
<5
3,490 <5 <5 <5
141.9
Baker Baldwin
17
443.9
53
139.2
<5
5
<5
<5
<5
13
35.0
5
7
Banks
32
291.3
<5
<5
<5
8
Barrow Bartow Ben Hill Berrien Bibb Bleckley
119
396.8
140
251.2
49
287.8
36
243.0
384
253.9
26
233.0
23
136.2
23
75.0
7
5
40
48.3
<5
8
17
30.8
<5
<5
38
25.6
<5
20
69.2
28
52.1
11
64.8
10
67.7
90
59.1
5
19
163.9
11
43.2
10
136.8
5
73
121.9
<5
Brantley Brooks
41
372.3
39
229.4
<5
<5
<5
<5
7
11
64.1
<5
6
Bryan
68
458.1
8
6
14
99.8
6
Bulloch Burke
151
398.6
58
314.5
30
141.5
13
117.2
12
32.8
9
23
61.8
7
19
114.2
<5
Butts
64
425.8
9
6
13
86.3
12
182.8
Calhoun Camden Candler Carroll Catoosa Charlton
25
472.9
64
356.0
22
233.7
99
144.3
13
26.9
15
186.2
5
9
<5
14
38.3
<5
<5
<5
8
<5
<5
<5
<5
<5
14
72.6
<5
20
30.5
<5
<5
5
6
<5
15
56.0
<5
<5
Chatham
977
444.6
137
112.0
151
70.5
172
76.1
101
105.3
Chattahoochee
15
661.2
<5
<5
<5
<5
Chattooga
100
387.3
18
121.1
11
40.4
17
67.0
12
119.2
Cherokee
245
302.2
35
74.6
22
27.2
42
57.8
37
112.4
Clarke Clay
307
480.3
<5
49
130.0
<5
27
40.3
<5
32
51.3
<5
60
239.1
<5
Clayton
666
501.3
113
136.9
61
52.3
115
89.8
93
183.5
Clinch
21
343.5
5
<5
6
<5
Cobb
1,812
509.9
305
140.4
171
56.0
271
82.8
282
211.4
Coffee Colquitt
120
429.1
99
260.8
17
109.5
12
61.4
13
49.8
<5
16
54.7
22
57.1
19
157.5
20
128.7
Columbia Cook
274
479.8
50
353.0
28
75.1
8
29
60.3
6
60
113.8
9
37
171.4
7
Coweta Crawford
245
430.1
13
151.7
39
113.4
<5
32
59.3
<5
41
75.7
<5
30
125.9
<5
Crisp Dade
90
425.3
<5
10
82.1
<5
<5
<5
16
77.0
<5
18
234.9
<5
Dawson Decatur
42
430.2
60
237.6
8
11
78.3
<5
6
8
12
47.2
6
<5
DeKalb Dodge Dooly
2,180 45 35
483.1 236.1 334.5
365
137.7
6
6
221
52.2
6
8
286
66.4
15
78.2
<5
386
216.4
<5
<5
Dougherty
393
464.8
66
138.3
49
57.6
68
82.0
65
192.2
Douglas Early Echols
192
304.8
11
84.2
<5
24
71.5
<5
<5
23
37.7
<5
<5
28
50.0
<5
<5
21
73.5
<5
<5
Effingham Elbert
105
437.2
71
345.6
21
152.5
8
6
7
25
109.0
13
62.0
13
135.3
12
120.6
* Rate per 100,000, age-adjusted to the 2000 US standard population.
Rate not calculated for fewer than 10 cases. Cancer cases for this county may be underreported to the Cancer Registry. Please use caution when comparing these data with mortality data for the same county.
43
Table 3A. Reported Number of Cancer Cases and Incidence Rates by County, Georgia, 1995 (Age-adjusted to 2000 US Standard) (continued)
ALL SITES
BREAST
COLON & RECTUM LUNG & BRONCHUS
PROSTATE
Total
Female
Total
Total
Male
County Emanuel
Cases 72
Rate* 327.4
Cases 6
Rate*
Cases 10
Rate* 47.6
Cases 19
Rate* 80.8
Cases 8
Rate*
Evans Fannin
32
344.1
58
250.1
6
11
97.3
<5
<5
9
12
51.4
<5
13
112.2
Fayette
245
402.7
57
164.1
35
67.7
29
51.7
42
149.3
Floyd
339
372.4
54
104.8
40
43.1
70
75.7
28
73.8
Forsyth
140
264.2
21
71.5
17
31.9
25
48.5
20
80.6
Franklin
67
315.6
9
14
69.5
9
10
92.9
Fulton Gilmer
2,957 55
515.7 296.4
433
129.5
<5
294
52.8
6
376
68.4
11
59.2
478
224.2
10
109.9
Glascock
10
317.8
<5
<5
<5
<5
Glynn Gordon Grady
315
441.6
114
320.6
76
342.3
43
108.7
19
94.8
19
154.7
26
37.6
8
6
53
71.4
30
83.9
11
48.3
53
186.6
7
6
Greene
62
477.8
8
11
82.1
8
8
Gwinnett
1,254
477.7
208
129.8
131
59.0
174
73.2
187
202.5
Habersham
121
376.4
13
72.9
11
35.3
21
62.9
17
110.0
Hall
405
405.5
56
102.6
42
43.5
67
67.5
70
163.0
Hancock Haralson Harris Hart Heard
49
541.1
45
188.0
65
310.8
40
172.0
21
239.5
7
<5
8
7
<5
8
<5
6
<5
<5
10
112.8
13
52.4
14
69.8
11
44.5
<5
7
<5
7
<5
<5
Henry Houston Irwin
285
438.0
159
184.2
17
180.9
41
109.4
15
30.5
<5
26
42.2
14
16.5
<5
44
70.5
22
27.1
<5
43
174.6
33
101.4
<5
Jackson
130
409.5
20
118.1
17
54.4
15
46.2
16
115.7
Jasper
48
529.0
7
7
6
<5
Jeff Davis
45
389.3
5
8
10
87.0
11
256.6
Jefferson
80
442.4
5
14
73.2
17
100.3
10
150.4
Jenkins Johnson Jones
36
430.4
25
271.6
26
133.5
<5
6
<5
<5
<5
<5
8
8
6
6
<5
<5
Lamar Lanier Laurens
60
418.7
17
309.5
107
247.3
7
<5
8
<5
<5
11
25.5
15
104.6
<5
26
58.9
11
177.3
<5
16
83.5
Lee
51
413.2
7
<5
9
13
290.7
Liberty
103
424.7
14
95.5
13
54.9
17
85.6
12
155.8
Lincoln Long
39
441.4
12
189.0
5
<5
<5
<5
13
142.8
<5
<5
<5
Lowndes
300
465.5
46
125.0
30
48.8
48
75.7
59
229.4
Lumpkin
50
341.8
11
146.9
5
9
7
McDuffie
76
382.5
12
107.5
12
62.2
13
60.5
10
109.4
McIntosh Macon
45
479.0
33
255.5
<5
<5
5
<5
7
<5
6
7
Madison Marion
76
350.8
12
221.9
9
<5
9
<5
12
56.0
<5
<5
<5
Meriwether Miller
88
388.2
16
240.3
11
86.6
<5
14
60.5
<5
16
69.5
<5
13
156.6
<5
Mitchell Monroe Montgomery
84
431.8
33
191.5
16
232.9
12
116.3
<5
<5
8
<5
<5
18
90.8
9
<5
8
8
<5
Morgan
74
535.7
12
157.3
9
9
13
226.9
Murray
80
335.6
11
79.6
7
14
57.6
6
* Rate per 100,000, age-adjusted to the 2000 US standard population.
Rate not calculated for fewer than 10 cases. Cancer cases for this county may be underreported to the Cancer Registry. Please use caution when comparing these data with mortality data for the same county.
44
Table 3A. Reported Number of Cancer Cases and Incidence Rates by County, Georgia, 1995 (Age-adjusted to 2000 US Standard) (continued)
ALL SITES
BREAST
COLON & RECTUM LUNG & BRONCHUS
PROSTATE
Total
Female
Total
Total
Male
County
Cases
Rate*
Cases
Rate*
Cases
Rate*
Cases
Rate*
Cases
Rate*
Muscogee
636
381.8
97
106.9
78
47.8
111
65.5
93
137.5
Newton
144
329.3
25
101.1
14
32.9
31
72.4
7
Oconee Oglethorpe Paulding Peach Pickens
80
467.1
30
288.4
97
252.9
52
252.1
50
282.2
16
161.0
<5
13
55.5
6
<5
6
<5
9
7
<5
8
<5
22
60.6
9
10
60.2
11
166.8
5
11
73.0
7
13
151.1
Pierce Pike
52
370.0
36
316.9
9
6
5
8
8
6
5
6
Polk Pulaski
152
417.9
17
192.2
32
159.0
<5
8
<5
31
82.3
5
17
105.7
<5
Putnam Quitman Rabun
83
501.6
<5
47
277.2
11
125.3
<5
6
8
<5
<5
16
101.3
<5
11
56.8
11
119.9
<5
5
Randolph
40
431.6
<5
10
106.2
7
8
Richmond
768
468.9
109
115.7
74
46.7
138
84.9
117
172.7
Rockdale
182
357.4
33
110.8
17
36.5
31
65.4
15
64.8
Schley
21
585.0
<5
7
<5
<5
Screven Seminole
62
411.8
8
9
<5
7
<5
15
96.1
<5
10
170.0
<5
Spalding
232
445.9
38
124.9
28
53.8
38
72.5
33
160.9
Stephens
109
382.2
20
129.4
9
15
51.2
20
160.9
Stewart
23
370.6
<5
<5
6
<5
Sumter
134
472.5
16
95.5
19
67.3
22
76.8
23
212.8
Talbot
44
609.4
8
7
6
<5
Taliaferro Tattnall
6
47
250.2
<5
9
<5
7
<5
9
<5
<5
Taylor Telfair
31
371.7
29
228.9
<5
<5
<5
7
7
5
8
<5
Terrell
53
468.0
6
<5
13
112.1
9
Thomas Tift Toombs
177
421.4
105
317.0
54
227.2
25
103.8
17
91.9
<5
20
46.7
11
34.0
<5
39
92.7
16
47.5
12
50.7
14
84.4
22
167.9
7
Towns Treutlen
44
385.7
12
202.9
<5
<5
<5
<5
10
73.8
<5
9
<5
Troup Turner Twiggs Union
223
388.3
25
274.5
18
197.1
48
240.9
33
100.2
<5
<5
5
27
46.9
<5
<5
<5
38
65.9
6
<5
9
36
152.6
<5
6
<5
Upson Walker Walton
96
320.5
13
20.3
92
217.4
15
91.0
<5
13
56.4
15
49.7
<5
5
10
32.6
<5
12
29.5
17
149.2
<5
15
89.5
Ware
148
373.2
24
112.0
22
55.2
14
32.5
23
143.4
Warren
33
489.7
5
<5
8
8
Washington Wayne Webster Wheeler
88
453.2
65
279.6
5
11
216.8
13
121.4
6
<5
<5
13
64.4
6
<5
<5
17
88.2
17
71.8
<5
<5
12
183.2
5
<5
<5
White
61
328.5
7
<5
10
51.4
13
159.1
Whitfield
335
486.0
58
149.1
31
46.0
75
108.2
35
131.1
Wilcox Wilkes Wilkinson
25
315.9
36
294.0
17
171.2
<5
<5
<5
<5
<5
<5
<5
10
77.0
<5
6
5
<5
Worth
64
328.5
6
9
15
80.8
9
* Rate per 100,000, age-adjusted to the 2000 US standard population.
Rate not calculated for fewer than 10 cases. Cancer cases for this county may be underreported to the Cancer Registry. Please use caution when comparing these data with mortality data for the same county.
45
Table 4. Invasive Cervical Cancer Incidence and Average Annual Mortality by Health District, Georgia
(Age-adjusted to 2000 US Standard)
Incidence (1995)
Mortality (1994-1998)
Health District
Cases Rate* Deaths Rate*
Georgia 1-1
389 10.6 19 8.4
124 3.4 10 4.0
1-2 2-0
12 9.2 14 7.5
3 2.2 5 2.7
3-1
34 11.0
7 2.9
3-2
44 12.2
11 3.1
3-3
15 16.7
3 3.4
3-4
33 13.1
7 2.6
3-5
31 9.9
6 2.0
4-0 5-1 5-2 6-0 7-0 8-1
34 12.5
<5
12 5.3
20 9.6
20 11.4
10 9.0
11 4.0 4 5.5 7 3.2 8 3.8 8 4.4 7 6.4
8-2 9-1
25 14.5 14 10.2
8 4.4 7 5.1
9-2
18 12.1
5 3.2
9-3
14 16.2
4 4.3
10-0
17 11.6
4 2.7
* Incidence rate or average annual mortality rate per 100,000, age-adjusted to the 2000 US standard population.
Rate not calculated for fewer than 10 cases.
Cancer cases for these health districts may be underreported to the Cancer Registry. Please use caution when comparing these data with mortality data from the same health district.
For further information about this report or the two organizations contact:
Department of Human Resources Division of Public Health Cancer Control Section 2 Peachtree Street 16th Floor Atlanta, GA 30303 (404) 657-6611 http://www.ph.dhr.state.ga.us
American Cancer Society, Southeast Division 2200 Lake Boulevard Atlanta, GA 30319 (404) 816-7800 or 1-800-ACS-2345 http://www.cancer.org.