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This study is a descriptive, epidemiologic investigation of
the incidence and mortality patterns of colorectal cancer
from 1995-2000, using data from the Kentucky Cancer
Registry. The project will examine the incidence and
mortality trends in colorectal cancer by stage and anatomic
subsite and through comparison of the Appalachian and
non-Appalachian counties in Kentucky. Demographic and health
care indicators of the stage of disease for colorectal
cancer (early vs. late) will be examined and the patterns of
treatment for colorectal cancer will be described, focusing
especially on the use of adjuvant therapies by stage of
disease, by region (Appalachian vs. non-Appalachian) in
Kentucky.
For
decades, reports have documented that residents of the
Appalachian region of the United States have higher rates
of poverty, lower educational levels, more limited access
to health care services, and a higher prevalence of risk
factors for poor health outcomes. For some cancers (e.g.,
cervical cancer and breast cancer), it has been documented
that the populations residing in the Appalachian region of
the U.S. have higher cancer incidence and mortality rates
than non-Appalachian populations. However, an age-adjusted
comparison of incidence and mortality rates for colorectal
cancer comparing the Appalachian region of Kentucky to the
rest of the state from 1995-2000 does not, in general,
reveal an excess incidence or mortality for colorectal
cancer in the Appalachian population. Comparisons of
age-adjusted rates by region (Appalachian vs.
non-Appalachian counties) are not sufficient for designing
and evaluating cancer control efforts, understanding the
risk factors in a given population, or assessing
compliance with screening guidelines. There is a strong
need for detailed, regional studies that examine the
patterns (incidence and mortality trends) and distribution
of colorectal cancer by anatomic site and stage of disease
and the treatments obtained by cancer patients. Such
efforts are necessary to investigate potential high-risk
demographic subgroups and evaluate ongoing cancer control
efforts focused on the population residing in eastern
Kentucky. The results of this study may identify
inadequately screened or treated high-risk subgroups for
targeted cancer control efforts in the state.
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