title: Temporal trends in geographic disparities in small-area-level colorectal cancer incidence and mortality in the United States.
abstract: OBJECTIVE
  We examined the extent of changes in absolute and relative geographic disparities in six colorectal cancer (CRC) indicators using data about persons aged 50 and older from 195 counties in the 1988-2006 Surveillance, Epidemiology, and End Results Program database.
  
  
  METHODS
  County-level trends in six colorectal cancer indicators (overall CRC incidence, descending colon cancer incidence, proximal colon cancer incidence, late-stage CRC incidence, CRC mortality, and 5-year probability of CRC death) were summarized using the estimated annual percentage change. Observed county rates were smoothed using Bayesian hierarchical spatiotemporal methods to calculate measures of absolute and relative geographic disparity and their changes over time.
  
  
  RESULTS
  During the study period, absolute disparity for all six indicators decreased (CRC incidence: 43.2%; proximal colon cancer: 31.9%; descending colon cancer: 52.8%; late-stage CRC: 50.0%; CRC mortality: 57.8%; 5-year CRC-specific probability of death: 12.2%). Relative disparity remained stable for all six indicators over the entire study period.
  
  
  CONCLUSIONS
  Important progress has been made toward achieving the Healthy People 2010 and NCI strategic objectives for reducing geographic disparities, although absolute and relative disparities remain in CRC.
authors.affiliation: Department of Medicine, Division of Health Behavior Research, Washington University School of Medicine, Saint Louis, MO, USA. mschootm@wustl.edu
authors.forename: Mario
authors.initials: M
authors.lastname: Schootman
authors.forename: Min
authors.initials: M
authors.lastname: Lian
authors.forename: Anjali D
authors.initials: AD
authors.lastname: Deshpande
authors.forename: Amy
authors.initials: A
authors.lastname: McQueen
authors.forename: Sandi L
authors.initials: SL
authors.lastname: Pruitt
authors.forename: Donna B
authors.initials: DB
authors.lastname: Jeffe
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001499:Bayes Theorem; D015179:Colorectal Neoplasms / Q000453:epidemiology* / Q000401:mortality; D005260:Female; D054624:Health Status Disparities; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D014481:United States / Q000453:epidemiology