Trends in cancer incidence and mortality in Missouri

Cancer is the second leading cause of death in Missouri. Several factors influence public health planning and policy-making decisions, including assessment of the trends in disease and in related risk factors, of overall disease burden on the population, and of the effectiveness of intervention programs. To assess the influence of statewide cancer screening, education, and intervention programs on Missouri's cancer burden, recent trends in cancer incidence and mortality rates among Missourians were analyzed.

Age-standardized cancer incidence rates from 1985-1992 and cancer mortality rates from 1985-1994 and 1990-1996 were calculated by race, age group, and sex using data collected by the Missouri Cancer Registry and the Missouri Center for Health Statistics. Rates for each year examined were logged and regressed onto year.

Between 1985 and 1992, the rate of cancer incidence increased by 16.1% (p < .05). From 1985-1994, cancer mortality rate increased by 3.5% (p < .05). Mortality among males, however, decreased between 1990 and 1996. This decrease was particularly pronounced among African-American males. Missouri males endured greater incidence of and mortality from cancer than Missouri females. Elderly males (both African American and white) exhibited the greatest increase in cancer incidence over the periods examined (+27.3% and +31.8% increase respectively, p < .05). Racial differences were nonexistent for cancer incidence rates, but the cancer mortality rate for African Americans was 45% greater than that for whites.

Although Missouri cancer incidence and mortality rates are higher now compared to 16 years ago, data are presented that indicate a slight decline in mortality rates over the past six years. The recent decline (1990-96) in mortality was present only among men, particularly African-American men. The incidence increase was particularly important for women. Despite the implementation of some programs designed to target minorities and undeserved populations at greater risk, these data indicate that large demographic differences in cancer incidence and mortality still persist. A greater commitment to cancer screening, access to treatment, and cancer prevention programs are necessary to meet Missouri's year 2000 goals for cancer incidence and mortality.