Bruce N Leistikow1, Alexander Tsodikov. 1. Department of Public Health Sciences, University of California, Davis, CA 95616, USA. NLeistikow@ucdavis.edu
Abstract
BACKGROUND: Estimates that smoking contributes 38-72% of the United States (US) Black male cancer death rate leave a wide range of uncertainty. This paper uses additional and regional data, and refined methods, to reassess that range. METHODS: This study uses lung cancer rates as an exposure index, linear regression, age adjusted US 1950-2001 and US regional 1969-2001 death rates (rates), and the formula: smoking-attributable fraction (SAF)=(1-((rate in the unexposed) / (rate in the exposed))). Estimated lung cancer rates in the unexposed range between rates predicted for a population with no smoking-attributable lung cancers to rates seen in "nonsmokers." RESULTS: Lung cancer death rates predicted 99.9% and 99.8% of the variances in non-lung non-stomach cancer death rates from 1950-1980 and 1950-1988, respectively (each P<0.0001). That suggests 2001 all-sites cancer death SAFs of 63% (sensitivity range 60-66%) nationally and from 43% in the Northeast to 67% in the South. CONCLUSIONS: Smoking may cause most premature cancer deaths and temporal and regional cancer death rate disparities in Black men.
BACKGROUND: Estimates that smoking contributes 38-72% of the United States (US) Black male cancer death rate leave a wide range of uncertainty. This paper uses additional and regional data, and refined methods, to reassess that range. METHODS: This study uses lung cancer rates as an exposure index, linear regression, age adjusted US 1950-2001 and US regional 1969-2001 death rates (rates), and the formula: smoking-attributable fraction (SAF)=(1-((rate in the unexposed) / (rate in the exposed))). Estimated lung cancer rates in the unexposed range between rates predicted for a population with no smoking-attributable lung cancers to rates seen in "nonsmokers." RESULTS: Lung cancer death rates predicted 99.9% and 99.8% of the variances in non-lung non-stomach cancer death rates from 1950-1980 and 1950-1988, respectively (each P<0.0001). That suggests 2001 all-sites cancer death SAFs of 63% (sensitivity range 60-66%) nationally and from 43% in the Northeast to 67% in the South. CONCLUSIONS: Smoking may cause most premature cancer deaths and temporal and regional cancer death rate disparities in Black men.
Authors: Gary G Bennett; Kathleen Y Wolin; Cassandra A Okechukwu; Carlotta M Arthur; Sandy Askew; Glorian Sorensen; Karen M Emmons Journal: J Immigr Minor Health Date: 2008-08