Published in Cancer Detection and Prevention 2004; 28(4).

Geographic pattern of cancers related to tobacco and alcohol in Connecticut: implications for cancer control

Anthony P. Polednak, PhD

Department of Public Health, Connecticut Tumor Registry, 410 Capitol Avenue, P. O. Box 340308, Hartford, CT 06134-0308, USA

The purpose of this study was to examine the geographic distribution of standardized incidence ratios (SIRs) for Connecticut's 169 towns for 18,382 cancers diagnosed in 1995-­2000 at sites most strongly associated with tobacco and/or alcohol (i.e, lung, oral cavity­pharynx, and esophagus), with consideration of census-derived indicators of socioeconomic status (SES) at the town level. For males, the state's four largest towns, all in the highest poverty-rate quartile, had statistically significantly elevated SIRs for both lung cancer and oral cavity­pharynx cancers, and also had elevated SIRs for esophageal cancer. Two of these four towns also had statistically significantly elevated SIRs for oral cavity­pharynx cancer for females. SIRs for both males and females were lowest for the lowest poverty quartile and highest for the highest poverty quartile, for each cancer-site group. Among 15,271 patients diagnosed with their first cancer at any of the selected sites in 1995-­2000, risk of diagnosis of a second primary cancer at any of these sites (139 patients) was highest in the highest poverty-rate quartile. These surveillance methods should be useful for targeting cancer control efforts aimed at prevention or cessation of tobacco and/or heavy alcohol use, and early detection or chemoprevention of these cancers, including second primary cancers.

KEY WORDS: Esophageal cancer, Lung cancer, Oral cancer, Pharyngeal cancer.