Last week, for the first time, the U.S. government issued a state-by-state reporton cancer. With it, this country caught up with most of the rest of the industrialized world, where national cancer registries have long identified geographic variations in the occurrence of the disease.
Using age-adjusted data for cancer cases diagnosed in 1999 (the most recent year for which statistics are available), the report covers 37 states plus the District, as well as six large metropolitan areas. Maryland is included; Virginia, which did not meet minimum cancer data quality standards, is not.
The news locally is not good: The District had the highest overall rate of cancer incidence -- not surprisingly, when comparing a small urban area to the states. Arizona's was lowest.
The report's usefulness extends beyond geographical comparison, however. All data are also presented by race, and in some categories, the racial disparity is considerable. The report's overall findings: The leading cancer in men, regardless of race, is prostate cancer. But rates are 50 percent higher for blacks than for whites. For women, breast cancer tops the list. Rates are about 20 percent higher for whites than for blacks.
Locally, the differences were even greater. In the District, the prostate cancer rate for whites was 144 cases per 100,000 population. For blacks, however, the rate was 275 -- about 91 percent higher. The breast cancer rate for black women in Washington was 126.3, while for whites it was 162.8 -- about 29 percent higher.
White men in Washington were diagnosed with lung cancer at a rate of 63.7 per 100,000; the rate for black men was more than double that at 134.6.
The report makes for fascinating reading, in part for the questions it doesn't answer: Why, for example, was the rate of non-Hodgkin's lymphoma so much lower among men in Delaware than among those in Connecticut? And what accounted for leukemia rates, which were considerably above the national average for men in Minnesota and women in Alaska? Other differences were less surprising: Skin cancer rates in sunny Florida were about double those in North Dakota.
The report is available from the Centers for Disease Control and Prevention at www.cdc.gov/cancer/npcr/uscs/index.htm.
-- Kathleen Cahill, for Outlook