CANCER INCIDENCE AMONG PREDOMINANTLY BLACK, RURAL-POOR POPULATIONS INSOUTHERN STATES

Background. A seven-county, predominantly black, rural-poor population in Alabama is targeted for a program aimed at improving access to sta te-of-the-art cancer care. This paper presents combined age-adjusted c ancer incidence rates for predominantly black, rural counties in North Carolina and Georgia similar to the Alabama counties and compares the se rates with Surveillance, Epidemiology, and End Results (SEER) incid ence rates. Methods. Cancer incidence data from 1990 to 1993 were obta ined from the Georgia Center for Cancer Statistics for 10 rural counti es with predominantly black populations. Likewise, cancer incidence da ta from 1990 to 1993 were obtained for seven rural-poor counties in No rth Carolina from the North Carolina Central Cancer Registry. SEER inc idence rates from 1990 to 1992 were obtained for nine SEER sites. Resu lts. The overall cancer incidence rate from North Carolina and Georgia is lower by 22% than the SEER rate. Cancer incidence rates for cancer s of the breast, colon/recturn, lung, and prostate were at least 15% l ower than the SEER rates, while the invasive cervical cancer rate was 1.78 times higher than the SEER rate. Conclusion. Blacks comprise abou t 50% of the population in these counties. In contrast, the SEER popul ation is predominantly white, and the black population is primarily ur ban. Estimates of the number of cancer cases in black, rural-poor popu lations based on SEER incidence rates is not reflective of the cancer experience in these populations.