title: Racial disparities of pancreatic cancer in Georgia: a county-wide comparison of incidence and mortality across the state, 2000-2011.
abstract: Understanding the geographic distribution of pancreatic cancer is important in assessing disease burden and identifying high-risk populations. This study examined the geographic trends of pancreatic cancer incidence, mortality, and mortality-to-incidence ratios (MIRs) in Georgia, with a special focus on racial disparities of disease. Directly age-adjusted pancreatic cancer incidence and mortality rates for Georgia counties (N = 159) were obtained for 2000-2011. Maps of county age-adjusted disease rates and MIRs were generated separately for African Americans and Caucasians. Cluster analyses were conducted to identify unusual geographic aggregations of cancer cases or deaths. Pearson correlation coefficients were calculated to examine associations between county health factors (e.g., health behaviors, clinical care, and physical environment) and pancreatic cancer incidence or mortality rates. African Americans displayed a significantly higher age-adjusted incidence (14.6/100,000) and mortality rate (13.3/100,000), compared to Caucasians. Cluster analyses identified five significant incidence clusters and four significant mortality clusters among Caucasians; one significant incidence cluster and two significant mortality clusters were identified among African Americans. Weak but significant correlations were noted between physical environment and pancreatic cancer incidence (ρ = 0.16, P = 0.04) and mortality (ρ = 0.18, P = 0.02) among African Americans. A disproportion burden of pancreatic cancer incidence and mortality was exhibited among African Americans in Georgia. Disease intervention efforts should be implemented in high-risk areas, such as the southwest and central region of the state. Future studies should assess health behaviors and physical environment in relationship with the spatial distribution of pancreatic cancer.
authors.affiliation: Department of Epidemiology and Biostatistics, College of Public Health, University of Georgia, Athens, Georgia.
authors.forename: Lindsay
authors.initials: L
authors.lastname: Brotherton
authors.affiliation: Department of Epidemiology and Biostatistics, College of Public Health, University of Georgia, Athens, Georgia.
authors.forename: Michael
authors.initials: M
authors.lastname: Welton
authors.affiliation: Department of Epidemiology and Biostatistics, College of Public Health, University of Georgia, Athens, Georgia.
authors.forename: Sara W
authors.initials: SW
authors.lastname: Robb
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D005006:Ethnicity; D005260:Female; D062306:Geography, Medical; D005845:Georgia / Q000453:epidemiology / Q000208:ethnology; D054624:Health Status Disparities; D049674:History, 21st Century; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009026:Mortality; D010190:Pancreatic Neoplasms / Q000453:epidemiology* / Q000266:history / Q000401:mortality; D018426:SEER Program; D012959:Socioeconomic Factors; D055815:Young Adult
keywords: Cluster analysis; pancreatic cancer; racial disparities