Geographic Differences in Lung Cancer Incidence: A Study of a Major Metropolitan Area within Southeastern Pennsylvania.

Yaqian Zhu,Thomas P Mckeon,Anil Vachani,Wei-Ting Hwang,Vicky Tam,Trevor M Penning

doi:10.3390/ijerph17249498

Abstract

This study investigated the geographic variation and the clustering of lung cancer incidence rates in Philadelphia and the surrounding areas using addresses at the time of diagnosis. Using 60,844 cases from Pennsylvania Cancer Registry, we calculated and mapped the age-adjusted incidence rates for five Pennsylvania (PA) counties near Philadelphia between 1998–2007 and 2008–2017. We identified ZIP codes with significantly higher incidence rates than the state rates and examined their demographic and exposure characteristics. Further, we tested for spatial autocorrelation and identified spatial clusters using Moran’s I statistic. Our results showed that approximately one in four ZIP codes had an incidence rate that was significantly higher than the PA state rate in each period studied. Clusters of higher incidences were detected in the southeastern part of PA bordering New Jersey. These areas tended to be more populated, of lower socioeconomic status, and closer to manufacturing facilities and major highways. Possibly driven by the community and environmental factors, the observed differences in disease incidence suggest the importance of including residential location in risk assessment tools for lung cancer.

Highlights

Lung cancer is the leading cause of death from cancer in the United States, reporting 228,150 new diagnoses and 142,670 deaths in 2019 [1]
ZIP codes with a higher incidence of lung cancer tended to lie along the lower right side of the study region, along the PA border with NJ
With high lung cancer incidence relative to the PA state rates and located clusters or “hotspots” of results demonstrated that lung cancer incidence rates were not the same across the ZIP codes highOur incidences

Summary

Introduction

Lung cancer is the leading cause of death from cancer in the United States, reporting 228,150 new diagnoses and 142,670 deaths in 2019 [1]. The national 5-year survival rate for 2010–2016 has been estimated to be 20.5% [1]. A recent report noted lung cancer constitutes the second most common type of cancer and the most common cause of cancer deaths in Pennsylvania (PA) in 2018 [2]. Lung and bronchus cancer incidence rates in PA have been decreasing in recent years, Pennsylvania still. Res. Public Health 2020, 17, 9498; doi:10.3390/ijerph17249498 www.mdpi.com/journal/ijerph

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