Rebecca L. Siegel|Liora Sahar|Anthony Robbins|Ahmedin Jemal
Where Can Colorectal Cancer Screening Interventions Have the Most Impact?
American Cancer Society|American Cancer Society|American Cancer Society|American Cancer Society
although colorectal cancer death rates united states declined half since 1970 large geographic disparities persist spatial identification highrisk areas facilitate targeted screening interventions close gapwe used getisord gi statistic within arcgis identify contemporary colorectal cancer hotspots spatial clusters counties high rates based countylevel mortality data national vital statistics system hotspots compared remaining aggregated counties nonhotspot united states plotting trends 1970 2011 calculating rate ratios rr trends quantified using joinpoint regressionspatial mapping identified three distinct hotspots contemporary united states colorectal cancer death rates elevated highest rates largest hotspot encompassed 94 counties lower mississippi delta arkansas 17 illinois 16 kentucky 3 louisiana 6 mississippi 27 missouri 15 tennessee 10 2009 2011 rates 40 higher nonhotspot united states rr 140 95 confidence interval ci 134146 despite 18 lower 1970 1972 rr 082 95 ci 078086 elevated risk similar blacks whites notably rates among black men delta increased steadily 35 per year 1970 1990 since remained unchanged rates hotspots west central appalachia eastern virginianorth carolina 18 9 higher respectively nonhotspot united states 2009 2011advanced spatial analysis revealed large pockets united states excessive colorectal cancer death ratesthese welldefined areas warrant prioritized screening intervention