Towards a more comprehensive understanding of cancer burden in North Carolina: priorities for intervention.
OBJECTIVE
To apply 4 measures of population burden in examining cancer burden in North Carolina and to identify priorities for intervention.


METHODS
Four measures were used: incidence, mortality, prevalence, and years of potential life lost (YPLL). The North Carolina Central Cancer Registry provided summary data on incidence and mortality and record-level data that were examined using SEER*Stat software to calculate prevalence. North Carolina vital statistics (mortality) data and life expectancy estimates stratified by age, race, and sex were used to calculate YPLL. Each cancer site was ranked according to burden for each of the 4 individual burden measures and summarized into an overall rank. Burden was examined overall and by sex and race.


RESULTS
Four cancers--lung/bronchus, female breast, prostate, and colon/rectum--accounted for approximately 57% of the total cancer incidence, prevalence, mortality, and YPLL in North Carolina. Patterns of burden in gender and race subgroups were similar, although non-whites often had higher mortality rates than did whites despite similar incidence rates. An estimated 207,583 people were living with cancer in 2004 Breast and prostate cancer accounted for 42% of these survivors. Lung/bronchus cancer was the most severe cancer, accounting for more deaths and years of life lost than any other 5 cancers combined.


CONCLUSIONS
Each of the 4 measures provides unique insight and guidance for cancer coordination and control efforts. Lung/bronchus, female breast, prostate, and colon/rectum cancers accounted for the majority of North Carolina's cancer burden and should be priorities for intervention.
Carpenter
William R
WR
Department of Health Policy and Management, School of Public Health, University of North Carolina at Chapel Hill, USA. bill.carpenter@unc.edu
Beskow
Laura M
LM
Blocker
Deborah E
DE
Forlenza
Michael J
MJ
Kim
Annice E
AE
Pevzner
Eric S
ES
Rose
John M
JM
Tran
Anh N
AN
Webber
Kelly H
KH
Knight
Karen
K
O'Malley
Michael S
MS
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008017:Life Expectancy; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000453:epidemiology / Q000401:mortality*; D009657:North Carolina / Q000453:epidemiology; D011159:Population Surveillance; D015995:Prevalence; D012737:Sex Factors; D013534:Survival