Cancer incidence and mortality in Newark, N. J. 1970-1974: a national comparison

New Jersey has acquired the invidious label "Cancer Alley U. S. A." based upon a national cancer mortality analysis. However, a cancer incidence survey conducted in Newark, the largest metropolitan industrial city in New Jersey, showed that age-adjusted Newark rates for all sites were comparable to the Third National Cancer Survey (TNCS) and Surveillance, Epidemiology and End Results (SEER) populations, except for black males who had statistically lower rates compared with the SEER population only. However, Newark did have statistically higher incidence of the following: (a) esophagus cancer among white men, black men, and black women; and (b) cervix, uterus, ovary, and bladder cancers among black women. Age-adjusted Newark cancer mortality for all sites was not statistically different from the SEER experience, except for an excessive cancer mortality among white men for stomach and esophagus; white women for stomach, colon-rectum, and uterus; black men for esophagus and colon-rectum; black women for colon-rectum, cervix, uterus, and ovary. An analysis of Newark mortality/incidence ratios suggests that the excessive cancer burden for the majority of sites studied resulted from poor end results of therapy, probably due to either late diagnosis, poor compliance, and/or suboptimal therapy. The Newark data cast doubt on the validity of the use of mortality data only in referring pejoratively to New Jersey as "Cancer Alley U. S. A."