IMPACT - Cancer Incidence

Texas Regions Included in the Cancer Incidence Study

Lung Cancer

Colon Cancer

Breast Cancer

Prostate Cancer

Cervical Cancer

Melanoma of the Skin

Cancer Incidence

Cancer is a major cause of death and illness in Texas. One in three residents is expected to develop cancer in his or her lifetime. The collection of information about separate cases of cancer through a central cancer registry is vital to the success of efforts to reduce the cancer burden. In 1994, the Texas Cancer Registry (TCR) at the Texas Department of Health (TDH) was awarded more than one million dollars from the United States Centers for Disease Control and Prevention (CDC) to enhance the expansion of the statešs central cancer registry. This funding will allow for complete and rapid collection of statewide cancer incidence data. These data are used in a variety of public health programs, including:

Identifying high risk populations for cancer control initiatives;
Detecting cancer incidence trends that indicate environmental or other risk factors that can be controlled or removed by intervention; and
Evaluating the effectiveness of cancer control interventions.

The Texas Cancer Registry uses a two-tiered system of data collection. The central office in Austin has responsibility for system-wide quality control, data consolidation procedures, and data analyses. Regional registries serve as the primary data collection facilities. In 1995, two new regional registries were established in Arlington and Houston, and the existing regional registries in Lubbock and San Antonio were expanded. The central and regional registries provide for complete coverage of eight of the 11 public health regions in Texas. The eight targeted public health regions encompass 88 percent of the state population and represent approximately 83 percent of all estimated 1995 cancer incidence cases. However, the goal of the TCR continues to be to collect cancer incidence data for the entire state.

Cancer data are reported from a number of sources including hospitals, hospital-based tumor registries, clinical laboratories, and cancer treatment centers. To ensure complete reporting, the regional registries work with all existing cancer-reporting sources in their areas. The TCR strongly supports electronic reporting of cancer case information, a method that greatly reduces the burden on reporting facilities and results in more timely cancer information for Texas. Many Texas hospitals are already using software packages compatible with those of the TCR. Reporting software based on the TCR system is being developed for distribution to those facilities not currently reporting electronically.

The addition of new regional offices and the effort to increase use of electronic reporting are just two examples of the modifications and enhancements under way in the TCR. The Texas Cancer Registry continues to grow and adapt to meet the goal of statewide monitoring of cancer incidence and to serve as the state resource for cancer control data.

METHODS

Incidence data from five regions of Texas for the years 1985-1991 were consolidated to produce the information presented. In 1990, these regions had a combined population of 5.1 million, of which 49 percent were males and 51 percent were females. The racial and ethnic makeup included 46 percent White (Whites and members of other races, who are not Hispanic), 48 percent Hispanic, and six percent African-American.

All reports of cancer received from the regions were reviewed to eliminate multiple reports of a single case and to determine primary cancer sites. Data are presented on primary malignant (invasive) neoplasms of the lung, colon, breast, cervix (including carcinoma in situ), and prostate and melanoma of the skin. Rates were standardized with the direct method of adjustment, using the United States 1970 standard million population, and are presented per 100,000 population. The TDH Bureau of State Health Data and Policy Analysis provided age-, gender-, racial/ethnic-, and year-specific population estimates for the calculation of rates. White, African-American, and Hispanic incidence rates are compared for those cancer sites with sufficient numbers.

RESULTS

Average annual age-adjusted and age-specific cancer rates are presented graphically for those cancer sites primarily targeted for cancer control activities: lung, colon, breast, prostate, cervix, and melanoma of the skin.

CONCLUSIONS

Males had consistently higher cancer incidence rates than females did for sites affecting both sexes. African-American males had the highest incidence rates for lung, colon, and prostate cancers. Incidence rates for White males exceeded those of African-American males for melanoma of the skin only; for all other sites, incidence rates for White males were similar to or slightly lower than those for African-American males. Hispanic males had low incidence rates for all cancer sites in this publication.

Among Texas women, Whites had the highest rates of melanoma of the skin and lung and breast cancers. Hispanic women had the highest rates of cervical cancer, and African-American women had the highest rates of colon cancer. Hispanic females had the lowest cancer incidence rates overall (among both males and females) for the cancer sites presented except cervical cancer. Diagnosis of cervical cancer at an invasive stage was more likely among Hispanic and African-American women of all ages and among Texas women 55 years of age or older regardless of race/ethnicity.