 |
|
Mortality/Incidence Rates, Male All Sites A
Guide to Reading the Numbers
This data is calculated from a publicly accessible database compiled by the North American Association of Central Cancer Registries (NAACR) for 1993 to 1997 (available April 2000). The data have been organized with the provinces/states with the lowest fatality rates at the top (1), and the highest fatality rates at the bottom (62). For
instance, in this chart, the state of Hawaii ranks at the top. The
mortality rate is listed in the first column: 106.1 deaths per 100,000
people. In the last column, the incidence rate indicates that 307
cases of cancer per 100,000 people were diagnosed in the same period.
The middle column of numbers then gives us a Mortality/Incidence Ratio or
the overall mortality rate from cancer during the years
1993-97 divided by the incidence rate (rate of newly
diagnosed cases in 1993-97). Again using Utah as an example, the
rate of death from cancer in Utah is 34.56% of the rate of
men newly diagnosed with the disease. Similarly, near the bottom of
the chart, Newfoundland, 57th in the rankings, has 169.1
men per 100,000 dying during 1993-97 and 296.7
new cases diagnosed per 100,000 population in 1993-97, resulting
in a mortality/incidence ratio of about 57%. Put another
way, on the surface it appears that a higher proportion of men
with all types of cancer in Ontario die than in Utah, the best-case
scenario. While a comparison of cancer survival rates between
provinces and states would have been more accurate than the mortality/incidence
ratio, these were not available. A
few cautionary notes about reading the numbers: please consult an
epidemiologist before drawing any conclusions from them. An epidemiologist
will likely warn you of the problem of using very small statistical
samplings like Yukon or the Northwest Territories as the data can
be very distorted. Distortions can also occur due to differences in introduction
of screening programs that may inflate incidence rates in order
to ultimately reduce mortality rates. So rather than jumping
to conclusions that local rankings are indications of alarming trends,
it is perhaps more useful to look more closely at treatment and screening
on a province-by-province basis. To what extent the “health-consciousness”
of a population plays a part is also an issue, as a healthier population
not only has a lower mortality rate, but a better ability to fight
cancer if they get it. However, the extent to which screening and
more importantly treatment come to play in statistics in which the
preponderance of Canadian province seem to get consistently low rankings
seem to be very pressing questions. Further, the degree to which we
seem to be incapable of useful benchmarks that satisfy the public
need to know where we stand calls for a way of putting these numbers
in perspective.
(Source: Chen VW, Howe HL, Wu XC, Hotes JL, Correa CN (eds). Cancer in North America, 1993-1997. Volume Two: Mortality. Springfield, IL: North American Association of Central Cancer Registries, April 2000.) |
