Colorectal Cancer In New Jersey
1979-1997

Executive Summary

Introduction

This report examines colorectal cancer incidence and mortality in New Jersey from 1979 through 1997 and presents data on subtypes of colorectal cancer and stage at diagnosis, which is an important factor in the survival of colorectal cancer patients. It also compares New Jersey incidence and mortality with that of the U.S. for the combined years 1993 through 1997. Information on colorectal screening and prevention is also included. (Please see the Glossary for definitions of incidence and mortality as well as other terms.)

The report was based on data that had been received and undergone quality assurance as of the summer of 2000. As the report was being prepared, preliminary data for 1998 became available and were included. In December, 2000, incidence data for 1998 and several years prior were published and differ somewhat from the numbers and rates in this report because the New Jersey State Cancer Registry is constantly being updated.

General Information on Colorectal Cancer

Colorectal cancer is the third most commonly diagnosed cancer among both men and women in the U.S., although the incidence of colorectal cancer is considerably greater in men than in women. It is the second most common cause of cancer death among men and the third among women. The risk of colorectal cancer increases with age, and age-specific incidence rates per 100,000 persons are highest among men and women over 70 years of age. Since 1990, the U.S. incidence of colorectal cancer has been slightly higher among blacks than whites. The risk factors for colorectal cancer include a personal or family history of colorectal cancer and certain inherited diseases. Research is ongoing on suspected risk factors including red meat consumption, high fat intake, obesity, low physical activity, and alcohol consumption. Scientists are also considering the role of genetic factors in colorectal cancer risk.

Colorectal Cancer Incidence in New Jersey

From 1979 through 1997 colorectal cancer incidence in New Jersey fluctuated between about 5,000 and 6,000 new cases per year, with a peak in 1985 at 5,870 cases. The annual age- adjusted incidence rate (new cases per 100,000) hovered near 60 until peaking in 1985 at 63.5 and subsequently dropping steadily to 50.9 in 1997. Each year men had a higher age- adjusted incidence rate than women, regardless of race, and white men had a higher rate than black men except in 1995. Between 1985 and 1997, the incidence rates dropped among white men, white women, and black women, but increased among black men.

Colorectal Cancer Stage at Diagnosis

The annual percentage of colorectal cancers diagnosed in the early stages (in situ and localized) rose by eighteen percent between 1985 and 1997, from 33.4 percent to 39.3 percent. The increase was greatest among black men and women. By 1997, the percent of colorectal cancers diagnosed in the early stages among the four gender and race groups had begun to converge, ranging from 37.2 percent among black women to 43.1 percent among black men.

Colorectal Cancer Mortality in New Jersey

The age-adjusted mortality rate from colorectal cancer in New Jersey steadily declined from 27 deaths per 100,000 people in 1979 to 18 deaths per 100,000 people in 1997. The decline occurred in all race and gender groups, but was most pronounced in white men and women. Over the years men had higher mortality rates than women, regardless of race. Black women had higher mortality rates than white women with the disparity widening over time.

Differences Between Men and Women and Blacks and Whites

Gender is a stronger determinant of colorectal cancer incidence and mortality rates than race. Female colorectal cancer incidence rates were consistently lower than male incidence rates, regardless of race. In earlier years (before 1990) whites tended to have higher incidence rates than blacks, especially in the male population. Since the early 1990s, however, incidence rates for blacks and whites converged until they were nearly equal.

Colorectal Screening in New Jersey

According to recent surveys in New Jersey, among residents age 50 and over, a higher percentage of women than men are conducting the blood stool test with a home kit, but a higher percentage of men than women are having sigmoidoscopies. However, the majority of citizens age 50 and over had not ever had a stool test nor a sigmoidoscopy. An even higher percentage have not had these screenings at the recommended time intervals.

Colorectal Cancer in New Jersey Compared with the U.S.

For all race and gender groups, colorectal cancer incidence and mortality rates were higher in New Jersey than in the U.S. as a whole for the years 1993 through 1997 combined. White men in New Jersey had the highest incidence and mortality rates and white women in New Jersey had the second highest incidence and third highest mortality rates in the U.S.

Conclusions

Although colorectal cancer incidence and mortality have steadily declined in recent years, it remains a major cause of illness and death in New Jersey. At this time, increased attention to screening for colorectal cancer and promoting healthier lifestyles are the best methods for addressing this public health problem.


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