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Show Table 1. Percentage of Cigarette Smoking Prevalence Among Utah and United States Adult Populations, 18 Years of Age and Older, Selected Years 1965-1995* Year 1965 1966 1970 1974 1978 1979 1980 1983 1985 1986 1987 Utah NA NA NA NA NA NA NA NA 15.6 18.2 15.0 United States Year 42.4 42.6 37.4 37.1 34.1 33.5 33.2 32.1 30.1 NA 28.8 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 Utah 14.7 16.4 16.7 14.3 15.6 14.4 15.7 13.2 15.9 13.8 United States 28.1 NA 25.5 25.7 26.5 25.0 25.5 NA NA NA Data sources: National Health Interview Surveys: United States 1965-94. National Center for Health Statistics, Hyattsville, Maryland; Centers for Disease Control and Prevention (1986). Cigarette smoking among adults-United States, 1994. Morbidity and Mortality Weekly Report, 45(27), 588-590; National Center for Chronic Disease Prevention and Health Promotion, Behavioral Surveillance Branch, Behavior Risk Factor Surveillance System 1996-1997 Survey Data, CD-ROM; and personal correspondence (February 1999) with the Bureau of Health Promotion and Risk Reduction, Utah Department of Health. Combining knowledge of the number of disease cases with the recommended timing of select therapeutic procedures and follow-up care may also be helpful in public health planning. Initial treatment and follow-up care is strictly related to the time the disease is diagnosed. Typically, the demand for treatment and care are most concentrated immediately after diagnosis and decline with years survived. Hence, the prevalence estimates in this paper are presented according to time from diagnosis; that is, by calendar year prevalence will be reported according to cases diagnosed within the last year, five, ten, fifteen, or twenty years. Smoking-Related Cancers Tobacco is a very carcinogenic substance linked to several cancer sites. The first studies to suggest a possible link between cigarette smoking and lung cancer occurred in the 1950s (Doll and Hill, 1950; Cigarettes, 1953; Cigarette Smoking, 1954; Cigarettes; Miller and Monahan, 1954; Norr, 1952). Epidemiological studies have since provided convincing evidence of the causal association between cigarette smoking and at least seven cancer sites in men (U.S. Department of Health and Human Services, 1989). In addition to lung cancer (Doll and Peto, 1981), increased risk due to cigarette smoking occurs for cancers of the larynx (Elwood, Pearson, Skippen, Jackson, 1984), oral cavity and pharynx (Elwood et al., 1984), esophagus (Schottenfield, 1984), bladder (U.S. Department of Health and Human Services, 1982), kidney (U.S. Department of Health and Human Services, 1982), and pancreas (Gordis and Gold, 1984). The impact of smoking on the prevalence of each of these cancer sites will be assessed here. SEER Data Cancer prevalence estimates are based on population-based tumor registry data in the Surveillance, Epidemiology, and End Results (SEER) Program of the National Cancer Institute. The SEER catchment areas cover five states (Connecticut, Iowa, New Mexico, Utah, and Hawaii), four metropolitan areas (Detroit, Atlanta, San Francisco-Oakland, and Seattle-Puget Sound), and represent about 10% of the United States population. The SEER Program began in 1973 and is the primary source of national estimates of cancer incidence and survival data (Ries et al., 1997). The SEER registries ensure cancer patient ascertainment by abstracting hospital records, clinical and nursing home records, records from private pathology laboratories and radiotherapy units, and death certificates. Because cancer incidence data is not available for the entire United States, smoking-related cancer prevalence data are compared between Utah and SEER (with Utah removed). We assume that data from SEER (with Utah removed) are representative of the United States for those cancer sites considered. Utah is removed from SEER because it is one of the original nine standard SEER areas. Only diagnosed invasive cancers for white males are considered in the analysis. 11 |
