LSUHealthNO LA Tumor Registry Reports 1st Census Tract Cancer Incidence

LSU Health New Orleans Louisiana Tumor Registry (LTR) has published statewide cancer incidence by census tract for the first time. The publication, which reports 2006-2014 combined cancer incidence data, found that one-fifth of the census tracts in Louisiana that met publication criteria had statistically significantly higher incidence rates for all cancers combined and/or for one or more specific cancer types compared to the state rates.

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 comply with federal law and standards, LTR had to combine nine years of data – 2006-2014.

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, 877 met the publication criteria for all cancers combined. For specific cancer types, fewer census tracts met the criteria.

For all cancers combined, of the 877 census tracts meeting the publication criteria when 2006-2014 data were combined, 60 census tracts from 23 parishes had statistically significantly higher incidence rates as compared with Louisiana. Results for the most common specific cancer types include:

Cancers of the Lung and Bronchus: Of the 784 census tracts meeting the publication criteria, 61 census tracts in 30 parishes had statistically significantly higher incidence rates than Louisiana.

Prostate Cancer: Of the 386 census tracts meeting the publication criteria, 31 census tracts in 13 parishes had statistically significantly higher incidence rates than Louisiana.

Female Breast Cancer: Of the 420 census tracts meeting the publication criteria, 11 census tracts in 7 parishes had statistically significantly higher incidence rates than Louisiana.

Colorectal Cancer: Of 363 census tracts meeting the publication criteria, 48 census tracts in 29 parishes had statistically significantly higher incidence rates than Louisiana.

Cancers of the Kidney and Renal Pelvis: Of 93 census tracts meeting the publication criteria, 18 census tracts in 11 parishes had statistically significantly higher incidence rates than Louisiana.

Findings for other cancer types include:

Non-Hodgkin lymphoma: Of 77 census tracts meeting the publication criteria, 13 census tracts in 7 parishes had statistically significantly higher incidence rates than Louisiana.

Urinary Bladder Cancer: Of 67 census tracts meeting the publication criteria, 15 census tracts in 10 parishes had statistically significantly higher incidence rates than Louisiana.

Leukemia: Of 11 census tracts meeting the publication criteria, 4 census tracts in 3 parishes had statistically significantly higher incidence rates than Louisiana.

Cancers of the Liver and Intrahepatic Bile Duct: There is only one census tract meeting the criteria. This census tract had a statistically significantly higher incidence rate than Louisiana.

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, two census tracts had significantly higher incidence rates than the state average for all cancers combined. With an annual population of 2,537 during the nine-year reporting period, the census tract where the Denka plant is located had an average of 15 cases of various cancer types per year. The other higher-than-average census tract (near the border of St. Charles Parish), had an annual population of 2,840 and an average of 19 cases of various cancer types per year during the nine-year reporting period. St. John also had one census tract in a different part of the parish with a significantly higher prostate cancer incidence – representing an annual average of 4 cases in an annual population of 3,503 over the reporting period.

Conversely, two census tracts in St. John Parish had statistically significantly lower cancer incidence rates compared with Louisiana for all cancers combined over the reporting period.

Besides St. John Parish, there are also census tracts with a statistically higher cancer incidence rate than Louisiana for all cancers combined in Acadia, Bossier, Caddo, Calcasieu, De Soto, East Baton Rouge, Iberia, Iberville, Jefferson, Lafayette, Orleans, Ouachita, Rapides, St. Bernard, St. Charles, St. Landry, St. Mary, St. Tammany, Terrebonne, Vermillion, Washington and Webster parishes.

“The cancer incidence information we publish can be used in many ways,” notes Xiao-Cheng Wu, MD, MPH, Professor and Director of the Louisiana Tumor Registry at LSU Health New Orleans School of Public Health. “Providing a clear picture of areas with higher incidence rates for all cancers combined and specific cancer types not only guides cancer reduction policy and special studies by qualified scientists to determine the why behind the statistics, but it can also help educate the citizens of Louisiana about the importance of reducing their exposure to modifiable risk factors, such as tobacco use, obesity, unhealthy diet, physical inactivity, occupational and environmental exposures, and certain pathogens, as well as complying with cancer screening guidelines to minimize their chances of developing cancer.”

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 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 guides and supports 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 eight consecutive years. One of only 18 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 here.