title: Long-term all-sites cancer mortality time trends in Ohio, USA, 1970-2001: differences by race, gender and age.
abstract: BACKGROUND
  There were significant changes in cancer mortality in the USA over the last several decades, in the whole country and in particular states. However, no in depth analysis has been published so far, dealing with changes in mortality time trends in the state of Ohio. Since the state of Ohio belongs to the states of relatively high level of all-sites mortality in both males and females, it is of interest to analyze recent changes in mortality rates, as well as to compare them with the situation in the rest of the USA. The main aim of this study was to analyze, describe and interpret all-sites cancer mortality time trends in the population of the State of Ohio.
  
  
  METHODS
  Cancer mortality data by age, sex, race and year for the period 1970-2001 were obtained from the Surveillance Research Program of the National Cancer Institute SEER*Stat software. A joinpoint regression methodology was used to provide estimated annual percentage changes (EAPCs) and to detect points in time where significant changes in the trends occurred.
  
  
  RESULTS
  In both, males and females mortality rates were higher in blacks compared with whites. The difference was bigger in males (39.9%) than in women (23.3%). Mortality rates in Ohio are generally higher than average USA rates--an overall difference was 7.5% in men in 1997-2001, and 6.1% in women. All-sites mortality trends in Ohio and in the whole USA are similar. However, in general, mortality rates in Ohio remained elevated compared with the USA rates throughout the entire analyzed period. The exceptions are the rates in young and middle-aged African Americans.
  
  
  CONCLUSIONS
  Although direction of time trends in Ohio are similar in Ohio and the whole US, Ohio still have cancer mortality rates higher than the US average. In addition, there is a significant discrepancy between white and black population of Ohio in all-sites mortality level, with disadvantage for Blacks. To diminish disparities in cancer mortality between African Americans and white inhabitants of Ohio efforts should be focused on increasing knowledge of black people regarding healthy lifestyle and behavioral risk factors, but also on diminishing socioeconomic differences, and last but not least, on better access to medical care.
authors.affiliation: Cancer Prevention Institute, Dayton, Ohio, USA. jerzytycz@yahoo.com
authors.forename: Jerzy E
authors.initials: JE
authors.lastname: Tyczynski
authors.forename: Hans J
authors.initials: HJ
authors.lastname: Berkel
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D044383:Black People; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009316:National Institutes of Health (U.S.); D009369:Neoplasms / Q000453:epidemiology* / Q000401:mortality*; D009820:Ohio; D012307:Risk Factors; D018426:SEER Program; D012737:Sex Factors; D012984:Software; D013997:Time Factors; D014481:United States; D044465:White People; D001741:Black or African American