Abstract A90: Changes in lung cancer rate over four years in a tobacco producing state: Examining the effect of race and gender

Abstract

Abstract Objective: According to a recent CDC report, lung cancer rates have declined in several states during 19975-2005. Tennessee, being a tobacco producing State, has received a large settlement from the tobacco industry and engaged in quit smoking program since 2006. Effective October 2007, the state also banned smoking in public places. However, the effect of this ban and smoking cessation program on lung cancer rates remains unknown. This presentation examines whether the lung cancer rates have changed over four years (2005-2008), and whether they vary by race and gender. Methods: We extracted relevant data pertaining to primary diagnosis of lung cancer (adenocarcinoma, ICD-9 codes of 160-165) and demographics from Tennessee Hospital Discharge Data system (HDDS) for 2005-2008. Data for each year pertained to 3,500 patients, mostly white (79%) and males (56.8%) with an average age of 66 years. To examine the effect of race and gender on cancer rate, we computed lung cancer prevalence rates per CDC procedures for age-adjusted rates (per 100,000 hospitalized patient population standardized to 2000 Census). Results: Our analyses show that the overall rates of lung cancer increased during four years by 26.3% (from 61.6/100K in 2005 to 77.8/100K in 2008). The increase was larger for blacks than whites (66.0% vs. 42.2%, p<.001). In general, in each year, rates were higher for blacks than whites (48.2 vs. 46.2 in 2005, 57.9 vs. 54.5 in 2006, 71.1 vs. 64.9 in 2007, and 80.0 vs. 65.7 in 2008). Similarly in each year, rates were higher for males than females (75.5 vs. 50.6 in 2005, 75.2 vs. 48.1 in 2006, 92.1 vs. 62.1 in 2007, and 93.8 vs. 65.3 in 2008). Further analyses revealed that (i) higher black rates were largely driven by higher rates among black males, and (ii) rates increased linearly from ages 45 through 74 years, and this was true for both black and white patients (both males and females). After age 84, rates dropped dramatically reflecting increasing mortality. Conclusion: Lung cancer rates have increased for both blacks and males. However, it is too early to tell if smoking cessation programs, banning asbestos use and smoking in public places will produce the desired decline in lung cancer rates. The results at present point to the need for more population-based intensive smoking cessation programs in Tennessee to lower lung cancer rates. Citation Format: Baqar A. Husaini, Van Cain, Mehhan Novotny, Zaheed Samad, Robert Levine. Changes in lung cancer rate over four years in a tobacco producing state: Examining the effect of race and gender. [abstract]. In: Proceedings of the Sixth AACR Conference: The Science of Cancer Health Disparities; Dec 6–9, 2013; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2014;23(11 Suppl):Abstract nr A90. doi:10.1158/1538-7755.DISP13-A90