title: Geographic pattern of cancers related to tobacco and alcohol in Connecticut: implications for cancer control.
abstract: The purpose of this study was to examine the geographic distribution of standardized incidence ratios (SIRs) for Connecticut's 169 towns for 18,382 cancers diagnosed in 1995-2000 at sites most strongly associated with tobacco and/or alcohol (i.e, lung, oral cavity-pharynx, and esophagus), with consideration of census-derived indicators of socioeconomic status (SES) at the town level. For males, the state's four largest towns, all in the highest poverty-rate quartile, had statistically significantly elevated SIRs for both lung cancer and oral cavity-pharynx cancers, and also had elevated SIRs for esophageal cancer. Two of these four towns also had statistically significantly elevated SIRs for oral cavity-pharynx cancer for females. SIRs for both males and females were lowest for the lowest poverty quartile and highest for the highest poverty quartile, for each cancer-site group. Among 15,271 patients diagnosed with their first cancer at any of the selected sites in 1995-2000, risk of diagnosis of a second primary cancer at any of these sites (139 patients) was highest in the highest poverty-rate quartile. These surveillance methods should be useful for targeting cancer control efforts aimed at prevention or cessation of tobacco and/or heavy alcohol use, and early detection or chemoprevention of these cancers, including second primary cancers.
authors.affiliation: Department of Public Health, Connecticut Tumor Registry, 410 Capitol Avenue, PO Box 340308, Hartford 06134-0308, USA. anthony.polednak@po.state.ct.us
authors.forename: Anthony P
authors.initials: AP
authors.lastname: Polednak
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000428:Alcohol Drinking / Q000009:adverse effects*; D002648:Child; D002675:Child, Preschool; D003237:Connecticut / Q000453:epidemiology; D016021:Epidemiologic Studies; D004938:Esophageal Neoplasms / Q000453:epidemiology* / Q000209:etiology* / Q000517:prevention & control; D005260:Female; D005843:Geography; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008175:Lung Neoplasms / Q000453:epidemiology* / Q000209:etiology* / Q000517:prevention & control; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000453:epidemiology* / Q000209:etiology* / Q000517:prevention & control; D010610:Pharyngeal Neoplasms / Q000453:epidemiology* / Q000209:etiology* / Q000517:prevention & control; D011203:Poverty; D011315:Preventive Medicine; D012307:Risk Factors; D018426:SEER Program / Q000706:statistics & numerical data*; D012907:Smoking / Q000009:adverse effects*; D016540:Smoking Cessation