2008 Georgia program and data summary: cancer

2008 Georgia Program and Data Summary:
CANCER

Cancer is the second leading cause of death in Georgia.

Comprehensive Cancer Control Program (CCCP)
The Georgia Comprehensive Cancer Control Program (CCCP) is part of a national effort launched by the Centers for Disease Control and Prevention (CDC) aimed at reducing cancer related morbidity and mortality. The CCCP supports a collaborative process through which a community and its partners pool resources to promote cancer prevention, improve cancer detection, increase access to health and social services, and reduce the burden of cancer. These efforts will contribute to reducing cancer risk, detecting cancers earlier, improving treatments, and enhancing survivorship and quality of life for cancer patients.
Breast and Cervical Cancer Screening Program (BCCP)
The Georgia Breast and Cervical Cancer Screening Program (BCCP) was established in 1992 with funding from the Centers for Disease Control and Prevention (CDC) and the State of Georgia. It was an expansion of the Cervical Cancer Screening Program, which was established in 1965. The BCCP provides mammograms to low-income, uninsured women between the ages of 40-64 and Pap tests to women 18-64 years of age. Women with abormal results also receive diagnostic follow-up, case management services and referral to the Women's Health Medicaid Program if cancer is diagnosed.
The BCCP services are available in all 159 counties in Georgia and from selected non-public health providers in metro Atlanta. BCCP serves over 15,000 women each year.
Cancer State Aid (CSA)
The Cancer State Aid Program funds cancer treatment services for eligible low-income uninsured cancer patients in Georgia. Established in 1937 by the Georgia legislature at the request of Georgia physicians, the program is available through participating treatment facilities statewide. Participating facilities agree to treat approved patients at cost. Physicians that agree to participate donate their services.

Georgia Comprehensive Cancer Registry (GCCR)
The Georgia Comprehensive Cancer Registry (GCCR) is a statewide population-based cancer registry collecting data on all cancer cases diagnosed among Georgia residents since January 1, 1995. This information furthers our understanding of cancer and is used to develop strategies and policies for prevention, control, and treatment. The availability of this data at the state level allows health researchers to analyze geographic, racial, and other differences that point to cancer risk factors. It also helps to determine where early detection, educational, or other programs should be directed.
GCCR is a participant in the National Program for Cancer Registries (NPCR) that was established by the Centers for Disease Control and Prevention (CDC) in 1992 through the Federal Cancer Registry Amendment Act (Public Law 102515).
The goals of the GCCR are:
To collect information on all newly diagnosed cancer cases.
To calculate cancer incidence rates for the state of Georgia.
To make data available to the public and health care professionals.
To identify and evaluate cancer incidence and mortality trends on an ongoing basis.
To provide cancer incidence and mortality data to cancer control programs to assist in developing prevention strategies and evaluating their effectiveness.
To stimulate cancer control research.
Women's Health Medicaid Program (WHMP)
The Women's Health Medicaid Program (WHMP) is a partnership between the Georgia Department of Human Resources and the Georgia Department of Community Health to provide treatment for breast and cervical cancer and cervical pre-cancer to eligible women. WHMP was established in July 2001 by the National Breast and Cervical Cancer Prevention and Treatment Act of 2000 with matching funds appropriated through the Georgia Cancer Coalition.

Age-Adjusted Rates for Incidence and Mortality are presented for the five-year period 2001-2005. Georgia Department of Human Resources, Division of Public Health 2 Peachtree Street, NW Atlanta, GA 30303 (404) 657-3103 ga-gccr@dhr.state.ga.us http://health.state.ga.us

ALL TYPES OF CANCER

CANCER MORTALITY
Cancer is the second leading cause of death in Georgia.
Leading Causes of Death in Georgia, 2001-2005

Diabetes 2%
Pneumonia and Influenza 2%
Chronic Respiratory Disease 5%
Unintentional Injury 5%
Stroke 6%

Heart Disease 26%
Cancer 21%

Lung and Bronchus 30%
Colon and Rectum 9%
Breast 8%
Prostate 5%
Other Cancers 48%

Everyone. Since the occurrence of cancer increases as individuals age, most cancers affect adults who are middle-aged or older.
Age-adjusted Cancer Incidence Rates by County, Georgia, 2001-2005

Other 31%
Nearly two-thirds of cancer deaths can be linked to modifiable risk factors such as tobacco use, diet, obesity, and lack of physical activity.
The burden of cancer can be significantly reduced by appropriate use of mammography, colorectal screening, and by other early detection examinations and by preventing or stopping tobacco use, improving diet, and increasing physical activity.
CANCER INCIDENCE
During 2001-2005, an annual average of 35,537 cancer cases were diagnosed in Georgia.
Breast, lung and bronchus, and colon and rectum cancers account for 55% of all new cancer cases among females in Georgia.
Breast cancer is the leading cause of cancer incidence among females in Georgia.
Prostate, lung and bronchus, and colon and rectum cancers account for 56% of all new cancer cases among males in Georgia.
Prostate cancer is the leading cause of cancer incidence among males in Georgia.
WHO IS AT RISK FOR DEVELOPING CANCER?

The age-adjusted cancer incidence rate for Georgia is 466 per 100,000 population.
Age-adjusted Cancer Incidence Rates by Race and Sex, Georgia vs. United States, 2001-2005

Incidence per 100,000

Georgia

United States

800 653 636

600

567 557

375 390 411 423

400

200

0 Black Males

White Males

Black

White

Females Females

White females are 9% more likely to be diagnosed with cancer than black females.
Black males in Georgia are 15% more likely to be diagnosed with cancer than white males.
2008 ESTIMATES
In 2008, at least 35,600 new cancer cases will be diagnosed among Georgians: about 97 cases per day. More than 14,400 Georgians will die of cancer in 2008.

Age-Adjusted Rates for Incidence and Mortality are presented for the five-year period 2001-2005. Georgia Department of Human Resources, Division of Public Health 2 Peachtree Street, NW Atlanta, GA 30303 (404) 657-3103 ga-gccr@dhr.state.ga.us http://health.state.ga.us

LEADING CAUSES OF CANCER INCIDENCE IN GEORGIA

Age-adjusted Cancer Incidence Rates, Males, Georgia vs. United States 2001-2005

Age-adjusted Cancer Incidence Rates, Females, Georgia vs. United States, 2001-2005

ProstaPtreostate Lung anLduBngraonndcBhruonschus
ColoreCcotlaorlectal BladderBilandcdeIrninSclitIun Situ

MelanMoemlaanoma Non-HodgNkoinn-HLodygmkipn hLoymmpahoma Kidney anKdidnReeynanadl RPeenlavliPselvis

Georgia United States

Oral COarvalitCyavity LeukeLmeuikaemia PancrPeaanscreas

0 20 40 60 80 100 120 140 160 180
Rate Per 100,000

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ColonCaonldorRecetacltum UtUertienreinCeoCrpourspus

Melanoma
Melanoma
NNono-nH-oHdogkdignkLinymLypmhopmhoa ma OvOaryvary
ThyTrhoyidroid PanPcarnecasreas KiKdnideyneayndanRdenRael nPaellvPieslvis

Georgia United States

0 20 40 60 80 100 120 140 160 Rate Per 100,000

The age-adjusted cancer incidence rate for males in Georgia is 572 per 100,000.
Prostate cancer is the leading cause of cancer among Georgia males and accounts for 28% of all new cancer cases among males each year.
Prostate and lung and bronchus cancer incidence rates are higher among Georgia males than among U.S. males.
Bladder cancer incidence rate is lower among Georgia males than the U.S. males.
In Georgia, males are 45% more likely to be diagnosed with cancer than females.

The age-adjusted cancer incidence rate for
females in Georgia is 395 per 100,000.
Breast cancer is the leading cause of cancer
among Georgia females and accounts for 31% of all new cancer cases among females each year.
Breast, lung and bronchus, colorectal, and uterine
cancer incidence rates are lower among Georgia females than U.S. females.
ESTIMATED COSTS
In Georgia, cancer costs in 2004 were approximately $4.6 billion: $1.7 billion for direct medical costs, $406 million for indirect morbidity costs, and $2.5 billion for indirect mortality costs.
In the U.S., males have a 1 in 2 lifetime risk of developing cancer. Females have a 1 in 3 lifetime risk.

Age-Adjusted Rates for Incidence and Mortality are presented for the five-year period 2001-2005. Georgia Department of Human Resources, Division of Public Health 2 Peachtree Street, NW Atlanta, GA 30303 (404) 657-3103 ga-gccr@dhr.state.ga.us http://health.state.ga.us

BREAST CANCER
Breast cancer is the most commonly diagnosed cancer among Georgia females.

BREAST CANCER
Breast cancer accounts for 31% of all new cancer cases among females.
Over 5,235 new cases of breast cancer will be diagnosed in Georgia in 2008.
One in eight American females will develop breast cancer in her lifetime.
White women are more likely to be diagnosed with breast cancer than black women; however, black women are more likely to die from the disease.
Breast Cancer Incidence Rates, Females, by County, Georgia, 2001-2005

Incidenceper 100,000Females

Age-adjusted Breast Cancer Incidence Rates, Females by Race, Georgia vs. United States, 2001-2005

150

114 113

126 129

100

Georgia United States

50

0 Black Females White Females

Breast Cancer Incidence by Stage at Diagnosis, White and Black Females, Georgia, 2001-2005

White Females

Black Females

The age-adjusted breast cancer incidence rate among Georgia females is 121 per 100,000.
Nineteen counties have significantly lower breast cancer incidence rates than the state average.
Eight counties have significantly higher breast cancer incidence rates than the state average.

RISK FACTORS
Personal or family history Age Race (White) Previous breast radiation
Menstrual history (onset of menstrual cycle before age 12 or menopause after 55 years of age)
Obesity Smoking Physical inactivity Alcohol consumption Never having children or having first child
after age 30 Recent use of oral contraceptives or
postmenopausal estrogens
PREVENTION
The best strategy is to avoid the modifiable risk factors: obesity, smoking, physical inactivity, and alcohol consumption.

Age-Adjusted Rates for Incidence and Mortality are presented for the five-year period 2001-2005. Georgia Department of Human Resources, Division of Public Health 2 Peachtree Street, NW Atlanta, GA 30303 (404) 657-3103 ga-gccr@dhr.state.ga.us http://health.state.ga.us

LUNG CANCER
Quitting smoking and avoiding secondhand smoke are the best strategies for preventing lung cancer.

LUNG AND BRONCHUS CANCER
Lung cancer is the most common cancer diagnosed in Georgia.
Over 5,500 new cases of lung cancer will be diagnosed in Georgia in 2008.
Lung cancer accounts for 15% of all cancers.
Age-adjusted Lung Cancer Incidence Rates, Females, by County, Georgia, 2001-2005

Age-adjusted Lung Cancer Incidence Rates, Males, by Counties, Georgia, 2001-2005

The age-adjusted lung cancer incidence rate among Georgia females is 53 per 100,000.
Nine counties have significantly higher lung cancer incidence rates than the state average for females.
Six counties have significantly lower lung cancer incidence rates than the state average for females.
RISK FACTORS
Tobacco use (accounts for about 87% of lung cancers) Exposure to secondhand smoke Exposure to certain industrial substances such as
arsenic, organic chemicals, radon, and asbestos Radiation exposure from occupational, medical, and
environmental sources Air pollution
PREVENTION
Quitting smoking and avoiding secondhand smoke are the best strategies for preventing lung cancer.

The age-adjusted lung cancer incidence rate among Georgia males is 104 per 100,000.
Twenty-seven counties have significantly higher lung cancer incidence rates than the state average for males.
Seven counties have significantly lower lung cancer incidence rates than the state average for males.

Age-adjusted Lung Cancer Incidence, by Race and Sex, Georgia vs. United States, 2001-2005

150
110 107
100

106 87

50

Georgia United States

51 42

58 57

Incidence per 100,000

0 Black Males

White Black White Blacks Females Females

RESOURCE
To get help to quit all forms of tobacco use call the Georgia Tobacco Quit Line at 1-877-270-STOP.

Age-Adjusted Rates for Incidence and Mortality are presented for the five-year period 2001-2005. Georgia Department of Human Resources, Division of Public Health 2 Peachtree Street, NW Atlanta, GA 30303 (404) 657-3103 ga-gccr@dhr.state.ga.us http://health.state.ga.us

PROSTATE CANCER
Prostate cancer is the most commonly diagnosed cancer among Georgia men.

PROSTATE CANCER
Over 5,300 new cases of prostate cancer will be diagnosed in Georgia in 2008.
Prostate cancer accounts for 28% of all new cancer cases among males.
The prostate cancer incidence rate among black males is 79% higher than among white males in Georgia.
One in six American males will develop prostate cancer in his lifetime.
Prostate Cancer Incidence Rates, by County, Georgia, 2001-2005

The age-adjusted prostate cancer incidence rate among Georgia males is 164 per 100,000.
Thirty-two counties have significantly lower prostate cancer incidence rates than the state average.

Sixteen counties have significantly higher prostate
cancer incidence rates than the state average.

Age-adjusted Prostate Cancer Incidence Rate, Georgia vs. United States, 2001-2005

Incidence per 100,000

300 258

250

236

200

150

100

50

0 Black Males

Georgia United States 144 150
White Males

RISK FACTORS
Increasing age (about 90% of cases are diagnosed in males over age 55)
Race (Black)
Family history
Obesity
PREVENTION
There is no known way to prevent prostate cancer. Studies are underway to determine if early detection of prostate cancer will lower the prostate cancer death rate. Until that information is available, whether a man should undergo prostate screening is a decision that should be made after discussing the risks and the benefits with his physician.

Age-Adjusted Rates for Incidence and Mortality are presented for the five-year period 2001-2005. Georgia Department of Human Resources, Division of Public Health 2 Peachtree Street, NW Atlanta, GA 30303 (404) 657-3103 ga-gccr@dhr.state.ga.us http://health.state.ga.us

COLORECTAL CANCER
In Georgia, colorectal cancer is the third most common cancer diagnosed among males and females.

COLORECTAL CANCER
Over 3,720 new cases of colorectal cancer will be diagnosed in Georgia in 2008.
Age-adjusted Colorectal Cancer Incidence Rates, Females, by County, Georgia, 2001-2005

Age-adjusted Colorectal Cancer Incidence Rates, Males, by County, Georgia, 2001-2005

The age-adjusted colorectal cancer incidence rate among Georgia females is 43 per 100,000.
Eight counties have a significantly higher colorectal cancer incidence rate than the state average for females.
Four counties have a significantly lower colorectal cancer incidence rate than the state average for females.
RISK FACTORS
Age Personal/family history of colorectal cancer or polyps Physical inactivity High-fat and/or low-fiber diet Inadequate intake of fruits and vegetables Obesity

The age-adjusted colorectal cancer incidence rate among Georgia males is 60 per 100,000.
Five counties have significantly higher colorectal cancer incidence rates than the state average for males.
Seven counties have significantly lower colorectal cancer incidence rates than the state average for males.
Age-adjusted Colorectal Cancer Incidence Rate, by Race and Sex, Georgia vs. United States, 2001-2005

Incidence per 100,000

100 80 70 69 60

Georgia 59 61

40

20

0 Black White Males Males

United States

53 52

40 44

Black White Females Females

PREVENTION
Colorectal cancer can be prevented by managing modifiable risk factors such as diet and physical activity, and by screening to enable detection and removal of precancerous polyps.

Age-Adjusted Rates for Incidence and Mortality are presented for the five-year period 2001-2005. Georgia Department of Human Resources, Division of Public Health 2 Peachtree Street, NW Atlanta, GA 30303 (404) 657-3103 ga-gccr@dhr.state.ga.us http://health.state.ga.us

Cancer is the second leading cause of death in Georgia.
However, 30% to 35% of cancer deaths can be prevented by eating a healthy diet and being physically active. In 2005, the Georgia Department of Human Resources, in partnership with the Office of the Governor, launched the Live Healthy Georgia campaign. The purpose of this comprehensive statewide communications campaign is to raise awareness about the risk factors for most chronic diseases, including cancer, poor nutrition, lack of regular physical activity, and use of tobacco products. Using five key messages, the campaign focuses on how to reduce those risk factors: eat healthy, be active, be smoke free, get checked, and be positive.
Eat healthy.
A healthy eating plan is one that emphasizes fruits, vegetables, whole grains, fat-free or lowfat milk and milk products; and includes lean meats, poultry, fish, beans, eggs, and nuts; and
is low in saturated fats, trans fats, cholesterol, salt (sodium), and added sugars.
Be active.
Participating in regular physical activity can help to reduce many risk factors for chronic diseases, including obesity and high blood pressure.
Be smoke free.
Tobacco use is a leading, preventable risk factor for many chronic diseases. Approximately 11,000 Georgians die each year from tobacco-related illnesses.
Get checked.
Undergoing routine physical check-ups and screenings can prevent some chronic diseases and detect other chronic diseases earlier when treatment may be more effective.
Be positive.
A positive attitude contributes to your overall well-being. If Georgians follow these guidelines, they can greatly reduce their chances of developing a chronic
disease, leading to an improved quality of life and reduced healthcare costs. Everyone benefits!
For more information about the Live Healthy Georgia campaign:
Phone: 404-657-6602 Website: http://www.livehealthygeorgia.com E-mail: livehealthygeorgia@dhr.state.ga.us
Data source: Georgia Comprehensive Cancer Registry (2001-2005) Visit: http://www.health.state.ga.us/programs/gccr/index.asp for more information about cancer in Georgia. Date updated: August 2008 Publication number: DPH08.332HW
Age-Adjusted Rates for Incidence and Mortality are presented for the five-year period 2001-2005. Georgia Department of Human Resources, Division of Public Health 2 Peachtree Street, NW Atlanta, GA 30303 (404) 657-3103 ga-gccr@dhr.state.ga.us http://health.state.ga.us