cancer and jefferson county
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Cancer and Jefferson County. A Presentation. Prepared by the University of Louisville, School of Public Health Depts. of Epidemiology and Clinical Investigation Sciences and Occupational and Environmental Health, and the Lung Cancer Project. Should I be concerned?. - PowerPoint PPT PresentationTRANSCRIPT
Cancer and Cancer and Jefferson CountyJefferson County
Prepared by the University of Louisville, School of Public Health Depts. of Epidemiology and Clinical Investigation Sciences and Occupational and Environmental Health, and the Lung Cancer Project
A Presentation
Should I be concerned? We all should be concerned about air
quality and look for ways to reduce emissions of chemicals, especially air toxics
And we should keep the risks in perspective
“Good surveillance does not necessarily ensure the making of right decision, but it reduces the chances of the wrong ones.”
Alexander Langmuir, MD, MPH; Director of Epidemiology for CDC from 1949-1969
Problem Chemicals & Community Concerns
Butadiene Sources: Vehicles, 3 manufacturers (plans in place to
reduce) Chromium
Sources: Electricity generation, boilers, plating Acrylonitrile
Sources: 2 manufacturers (plans in place to reduce)
Understanding cancer risk “one-in-a-million”
Cancer risk is enormous “Everybody wants to go to heaven, but
nobody wants to die” – Aging is a critical factor in cancer increase & risk
Environmental risk is incredibly small 1/1,000,000 is an enormous prevention
goal, NOT a useful thing to fear
Region 4 Air ToxicsRanked Risk Screening
Analysis
11/1000
0.001/1000
WF AAF WM AAM
Age 70
Age 70 + Ever0
5
10
15
20
25
Cancer Risk to Age 70 and Ever: Breast Cancer for Women, Prostate Cancer for Men
African-American men’s risk for prostate cancer rises from 1:8 until age 70 and then to 1:5 ever (lifetime) risk.
Cancer Risk to Age 70, Ever, and Environmental Increase
21.5
21.5
18.3
18.3
15 20 25 30 35 40 45 50
males
one-yr
females
one-yr To 70EverEnv.
….
Risk to age 70 is 215,000/1,000,000; environmental protection aims to keep that to 215,001/1,000,000
Data Monitoring in Rubbertown
EPA monitoring identified Jefferson County as having the highest health risk posed by air quality, in the Southeastern US.
State funding permitted follow-up air monitoring studies to be performed in the Rubbertown area during 2001
Disease risk is also able to be assessed for asthma and cancer.
Treatment [First Course]
3.8
15.4
30.8
6.7
33.3
6.6
23.1
26.926.7 26.7
0
5
10
15
20
25
30
35
None Surg RadTx Chem/Rtx All Other
Perc
ent
WFAfrAmF
Stage at Diagnosis
65.4
26.9
7.7
26.7
4033.3
0
10
20
30
40
50
60
70
Earlier IV Unstaged
Perc
ent
WF
AAF
Considerable Stage Difference
Comparisons by Race for Stage, Treatment, Payor
No Trtx and ‘all Other’ varies
Method of Payment is quite different by race, and from the Overall Hospital Pattern
Payment Pattern Uof L [All Admissions] vs Adencocarcinoma of the Lung 1999-2001
37
17.1
7.311.7 12
2326.9
7.74
40
6.7 7.3
19.414.9
19.2 19.213.313.3
05
1015202530354045
Med
icai
d
Med
icar
e
Com
mer
cial
Priv
ate
Wel
fare
All O
ther
% P
ayin
g
All UofL
AdenoLung wfAdenoLung bf
University of Louisville and BCC Lung Cancer, Adenocarcinoma for Females: 1999-2000
00.10.20.30.40.50.60.70.80.9
1
0 6 mos. 1 Yr. 18 mo. 2 Yrs. 30 mo. 3 Yrs.
Perc
ent
Sur
vivi
ng
WF
AAF
“The reason for collecting, analyzing, and disseminating information on a disease is to control that disease. Collection and analysis should not be allowed to consume resources if action does not follow.”Foege, Hagan, Newton: International
Journal of Epidemiology, 5: 29-37. 1976.
Michael R. Hicks, MAVoice: 502-852-4061 Fax: 502-852-3294E-mail: [email protected]
Fairouz Saad, MPHVoice: 502-852-4061 Fax: 502-852-3294E-mail: [email protected]
Tim E. Aldrich, Ph.D., MPHVoice: 502-852-3006 Fax: 502-852-3294E-mail: [email protected]
University of Louisville School of Public Health and Information SciencesDept. Epidemiology and Clinical Investigation Sciences Louisville, Kentucky 40202
‘Its amazing what you can see when you look...” Yogi Berra