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Mississippi Delta residents exhibited higher GI cancer rates than non-Delta residents
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SAN DIEGO — Gastrointestinal cancers exhibited higher rates among Mississippi Delta residents than those of non-Delta counties, and higher rates than the entire United States, according to data presented at the 2012 Digestive Disease Week Annual Meeting.
In 2007, a report by the Census Bureau indicated that Mississippi was the poorest state in the country, while also ranked in last place among all the states for health care with the highest rate of obesity, hypertension, diabetes and adult inactivity. Within the state, Mississippi Delta counties are particularly under-privileged compared to non-Delta counties.
To determine the health care disparity between Mississippi Delta and non-Delta residents, James Z. Whatley, MD, and colleagues from the Digestive Diseases division at the University of Mississippi Medical Center in Jackson, Mississippi compared age-adjusted incidence rates of GI cancer from the Mississippi Cancer Registry and the CDC’s National Program of Cancer Registries for the 20 Delta counties, 62 non-Delta counties, the entire state and the entire US.
“When we compared the GI cancer incidence rates, as well as mortality rates, we found that the rates in the Delta were significantly higher than the rest of Mississippi and even the rest of the United States,” Whately told HemOnc Today. “It is fairly well known that several factors, including obesity and diabetes, can contribute to certain cancers, namely colorectal cancer. When we looked at the health care data, we observed that Mississippi was in the bottom five of all the states — including rates of obesity, diabetes, hypertension, income and the number of primary care physicians — which prompted us to consider how much access Delta residents have to screening for colorectal cancer.”
The GI cancer sites assessed included esophagus, stomach, small intestine, colon and rectum, colon excluding rectum, rectum and rectosigmoid junction, pancreas, liver and intrahepatic bile duct and gallbladder. Each cancer was evaluated separately to determine the effect of race. In addition, the population estimates for 2005 are adjusted to account for population shifts due to Hurricane Katrina.
According to the results of the study, between 2003 and 2007, a total of 12,667 cases of invasive GI cancers were diagnosed in Mississippi and 2,559 cases from the Delta area. When compared to the general US population, Mississippians exhibited higher rates of colon and rectal cancers in both Caucasians and African Americans — however, Mississippi demonstrated a lower overall rate for gallbladder cancer than the general US in both African American and Caucasian groups.
“There are only 5 gastroenterologists in the Delta area serving a population of approximately 550,000 residents, which equivalent to about 0.9 gastroenterologists per 100,000 people,” Whately said. “In the rest of Mississippi, there are roughly 85 gastroenterologists serving a population of nearly 3 million people. There is an obvious health disparity there which could certainly be a contributing factor as to why there are such high incidence rates in the Delta area.”
In addition, both within the Delta and non-Delta counties, GI cancer rates were observed to be much higher among African Americans except for cancers of the liver and intrahepatic bile duct, gallbladder, and rectum.
According to Whatley “One item of note in this study is that gallbladder, liver and intrahepatic bile duct cancers were observed to be lower in Mississippi than the rest of the country, and despite a higher rate of GI cancer, Delta residents actually exhibited a lower rate of all-site cancer than the rest of Mississippi.”
Disclosure: Researchers reported no relevant financial disclosures.
For more information:
- Whatley JZ. #Sa1782: Gastrointestinal Cancers in Mississippi. Presented at: the 2012 Digestive Disease Week Annual Meeting; May 19-22, 2012; San Diego.