UICC World Cancer Congress 2006

Objective: This study began as a descriptive analysis of the disparities present with cancer outcomes in Southern Appalachia. This is a distinct region of fourteen counties and cites in Upper-East Tennessee, and extreme Southwest Virginia. The specific aim was to examine Behavioral Risk Factor Surveillance System [BRFSS] data [e.g., knowledge, attitudes, practices] with outcomes [mortality] to identify populations- at-risk. The time period 1998-2003 was selected for the analysis owing to availability of complete years of data. Breast and colon cancer were identified for the analysis based on their clearly defined screening recommendations.

Methods: Cause-specific, race and gender specific, age-adjusted mortality data were obtained for the six-year time period from the National Center for Health Statistics webpage [http://cdc.gov/wonder]. BRFSS data for each state was obtained from their respective state agency collecting these data. All data were age-adjusted to the 2000 U.S. standard population for comparison. Simple binomial tests were used to identify differences in proportion between the race-gender subgroups, within and between geographic strata. The data were aggregated using the county-level codes [place of residence] to form the geographic unit of analysis.

Results: Distinct disparities are present for African-Americans living in Southern Appalachia. Additionally, we observed differences with these disparities by gender. Screening patterns varied by the types of cancer, and within race-gender sub-groups. These findings were consistent with an unusual age-specific distribution for this rural, African American population. Further studies are in-progress to compare the differences between African American in urban and rural settings for both screening practices, and outcomes.