LSU Health New Orleans Louisiana Tumor Registry Releases 4th Census Tract Cancer Incidence Report
Leslie Capo, Director of Information Services
LSU Health New Orleans Louisiana Tumor Registry (LTR) has published the fourth report of statewide cancer incidence rates by census tract. The publication, which reports 2008-2017 combined cancer incidence data, found that 81% of the census tracts in Louisiana met publication criteria for all cancers combined. For specific cancer types, fewer census tracts met the criteria. For the Louisiana census tracts meeting the criteria, the incidence rates for all cancers combined and for specific cancer types were compared with the corresponding rates for the entire state. The numbers of census tracts with statistically significantly higher incidence rates as compared to the rates for Louisiana varied by cancer type. Overall, 299 census tracts had statistically significantly higher incidence rates for all cancers combined and/or for one or more specific cancer types.
The release of cancer incidence data is governed by the federal patient privacy law
and federal standards for producing valid data. To protect patient confidentiality,
HIPAA prohibits publication of health information by geographic area when the underlying
population is 20,000 or less. The United States Cancer Statistics standards for generating
reliable cancer incidence rates require case counts of 16 or more to report. To increase
the number of census tracts meeting the publication criteria, LTR combined 10 years
of data – 2008-2017.
The cancer incidence rate is the number of newly diagnosed cancer cases in a specified
population during the specified years, usually expressed as the number of cancers
per 100,000 population.
Census tracts are small, relatively permanent statistical subdivisions of a parish.
Census tracts generally have a population size between 1,200 and 8,000 people. Of
the 1,148 census tracts in Louisiana, 932 met the publication criteria for all cancers
combined. For specific cancer types, fewer census tracts met the criteria.
For all cancers combined, of the 932 census tracts meeting the publication criteria
when 2008-2017 data were combined, 81 census tracts from 29 parishes had statistically
significantly higher incidence rates as compared with Louisiana, and 98 census tracts
had lower incidence rates.
The census tract with the highest incidence rate that is statistically significant
for all cancers combined in Louisiana is 22115950707, which is Fort Polk South in
Vernon Parish. The second and third statistically significantly higher rates are found
in Orleans Parish – the Desire Neighborhood and the CBD/Warehouse District.
Regarding the so-called “Cancer Alley,” a commonly used term that has no scientific
validity, results are mixed. In the industrial corridor, consisting of Ascension,
East Baton Rouge, Iberville, St. Charles, St. James, St. John, and West Baton Rouge
parishes, the report documents significantly higher cancer incidence, as well as significantly
lower cancer incidence rates as compared with Louisiana, for some cancers in some
individual census tracts.
For example, in St. John the Baptist Parish, of the 11 census tracts meeting the publication
criteria, no census tracts had significantly higher incidence rates than the state
average for all cancers combined. With an annual population of 2,472 during the ten-year
reporting period, the census tract where the Denka plant is located had an average
of 14 cases of various cancer types per year. The incidence rate in this tract was
not statistically significantly different from Louisiana as a whole. St. John also
had one census tract (70200) closer to the border of St. Charles Parish with a significantly
higher prostate cancer and non-Hodgkin Lymphoma incidence – representing an annual
average of 4.8 prostate cases in an annual population of 3,353 men over the reporting
period and 1.6 non-Hodgkin Lymphoma cases in an annual population of 6,997 men and
women over the reporting period.
Conversely, three census tracts in St. John Parish had statistically significantly
lower cancer incidence rates compared with Louisiana for all cancers combined over
the reporting period (70700, 70900, and 71100).
There are census tracts with a statistically higher cancer incidence rate than Louisiana
for all cancers combined in Acadia, Ascension, Bossier, Caddo, Calcasieu, De Soto,
East Baton Rouge, East Feliciana, Iberia, Iberville, Jefferson, Lafayette, Lafourche,
Orleans, Ouachita, Rapides, St. Bernard, St. James, St. Landry, St. Martin, St. Mary,
St. Tammany, Terrebonne, Vermillion, Vernon, Washington, Webster, West Baton Rouge,
and Winn parishes.
Results for the most common specific cancer types include:
- Cancers of the Lung and Bronchus: Of the 846 census tracts meeting the publication criteria, 69 census tracts in 34 parishes had statistically significantly higher incidence rates than Louisiana, and 64 census tracts had lower rates.
- Prostate Cancer: Of the 470 census tracts meeting the publication criteria, 37 census tracts in 17 parishes had statistically significantly higher incidence rates than Louisiana, and 39 had lower rates.
- Female Breast Cancer: Of the 519 census tracts meeting the publication criteria, 23 census tracts in 10 parishes had statistically significantly higher incidence rates than Louisiana, and 28 census tracts had lower rates.
- Colorectal Cancer: Of the 701 census tracts meeting the publication criteria, 55 census tracts in 29 parishes had statistically significantly higher incidence rates than Louisiana, and 24 census tracts had lower rates.
- Cancers of the Kidney and Renal Pelvis: Of the 179 census tracts meeting the publication criteria, 22 census tracts in 10 parishes had statistically significantly higher incidence rates than Louisiana, and none had lower rates.
Findings for other cancer types include:
- Non-Hodgkin lymphoma: Of the 120 census tracts meeting the publication criteria, 14 census tracts in 7 parishes had statistically significantly higher incidence rates than Louisiana, and none had lower rates.
- Urinary Bladder Cancer: Of the 121 census tracts meeting the publication criteria, 26 census tracts in 16 parishes had statistically significantly higher incidence rates than Louisiana, and none had lower rates.
- Melanoma of the Skin: Of the 122 census tracts meeting the publication criteria, 66 census tracts in 18 parishes had statistically significantly higher incidence rates than Louisiana, and none had lower rates.
- Pancreas: Of the 26 census tracts meeting the publication criteria, 8 census tracts in 6 parishes had statistically significantly higher incidence rates than Louisiana, and none had lower rates.
- Oral Cavity & Pharynx: Of the 21 census tracts meeting the publication criteria, 6 census tracts in 6 parishes had statistically significantly higher incidence rates than Louisiana, and none had lower rates.
- Leukemia: Of the 29 census tracts meeting the publication criteria, 8 census tracts in 7 parishes had statistically significantly higher incidence rates than Louisiana, and none had lower rates.
- Thyroid: Of the 39 census tracts meeting the publication criteria, 16 census tracts in 11 parishes had statistically significantly higher incidence rates than Louisiana, and none had lower rates.
- Corpus Uterus: Of the 3 census tracts meeting the publication criteria, 1 census tract in 1 parish had a statistically significantly higher incidence rate than Louisiana, and none had lower rates.
- Liver and Intrahepatic Bile Duct: Of the 7 census tracts meeting the publication criteria, 7 census tracts in 5 parishes had statistically significantly higher incidence rates than Louisiana, and none had lower rates.
- Stomach: Of the 2 census tracts meeting the publication criteria, 1 census tract in 1 parish had a statistically significantly higher incidence rate than Louisiana, and none had lower rates.
- Myeloma: Only 1 census tract met the publication criteria and the rate was statistically significantly higher than Louisiana.
“Although the COVID-19 pandemic has adversely affected everyone, LTR was able to generate
data and publish this report meeting the expected timeline, which reflects the continued
commitment of all our staff to our mission,” notes Xiao-Cheng Wu, MD, MPH, Professor
and Director of the Louisiana Tumor Registry at LSU Health New Orleans School of Public
Health. “I hope the updated report will help with cancer prevention and control efforts
at all levels to reduce suffering and death from cancer in Louisiana.”
LSU Health New Orleans Louisiana Tumor Registry is a statewide population-based cancer
registry authorized by law to collect data on all reportable cancer cases occurring
among Louisiana residents. A registry serves as an official count of a specific thing
and its associated identifying information.
A cancer registry systematically collects data on reportable cancers, which includes
patient demographics, cancer type, stage at diagnosis, and the first course of treatment,
as well as survival. This information is used to answer questions such as: Are more
or fewer people getting colorectal cancer from one reporting period to the next?
LTR's job is to collect high-quality cancer data, which guide and support cancer prevention
and control activities, as well as many other cancer-related programs and research.
Policymakers, state health departments, cancer control programs and other qualified
health professionals decide if further action is warranted based on the LTR data.
LTR's excellence is attested by the National Cancer Institute (NCI), the Centers for
Disease Control and Prevention (CDC), and the North American Association of Central
Cancer Registries (NAACCR). LTR consistently achieves the benchmark of 98% case completeness
set forth by NCI and has received first place awards for the quality and completeness
of its data from NCI’s Surveillance, Epidemiology, and End Results (SEER) program
for the past 11 consecutive years. One of only 21 cancer registries in the country
comprising NCI’s SEER Program, LTR is considered to be one of the leading cancer registries
in the nation.
The complete report, with maps, is available online.