MD2Assgn1_HOLTS_A_PUBH6035

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PUBH 6035 Epidemiology: Uncovering the Science of Public Health – Winter 2022 Module 2 Assignment: Descriptive Epidemiology Case Study (50 points) To complete the assignment, access the following resource: Hint: Don’t forget to label your answers. For example, when reporting incidence rates the answer should not just be a number, but a number with a label (12.68 cases per 100,000 persons per year, not just 12.68). Similarly, when reporting percentages, make sure to include the % label. Points will be deducted for missing labels. Another hint: Don’t round the numbers in your answers up or down. Report them as they are found on the website. Part 1: SEER Incidence – All Cancer Sites Combined, by Sex Select the following settings:  Get Started With a Cancer Site: All Cancer Sites Combined  Choose a Statistic to Explore: SEER Incidence  Click on the “Recent Rates” tab  Under “Compare by:” make sure “Sex” is highlighted and click on “Both Sexes,” “Female,” and “Male”  Under “More Options” leave “Precision” at 0.1 and unclick Show Standard Error and Show Confidence Interval  Right above the bar chart click on the “Data Table” tab 1. What is the 5-year age-adjusted incidence rates for all cancer sites combined in both sexes from 2015-2019? (1 point) Both sexes-445.5 cases per 100,000 persons per year. 2. What is the 5-year age-adjusted incidence rates for all cancer sites combined in females from 2015-2019? (1 point) Female-419.9 cases per 100,000 persons per year. 3. What is the 5-year age-adjusted incidence rates for all cancer sites combined in males from 2015-2019? (1 point) Male-484.7 cases per 100,000 persons per year. 4. Describe each of these sex-specific rates (males vs females) in words by putting these data into a sentence (don’t forget the denominators!). Then, discuss how these two rates compare to each other (for example, which rate is higher? By how much?) Answer in complete sentences. (4 points) 1 National Cancer Institute. Surveillance, Epidemiology and End Results Program. SEER*Explorer. https://seer.cancer.gov/explorer/ Click on “Get Started” and follow directions below to answer each question.

The incident rate for males was 484.7 cases in 2015-2019, of all cancers combined per 100,000 persons per year. The incident rate for females was 419.9 cases in 2015-2019, of all cancers combined per 100,000 persons per year. Cancer combined incidence rate is higher in males by 64.8 cases per 100,000 persons per year. 5. The rates in this table are age-adjusted, which means that the differences in rates seen between the populations are not due to age, but to other factors. Why is it important to adjust for the effects of age, particularly for cancer incidence and mortality? (4 points) Almost all disease or health outcomes occur at different rates in different age groups or two different periods. Age compositions aid in comparing mortality or disease risk in two populations and ensuring the differences in incidence or deaths from one year to another or between one geographic area and another. *Continue to next page for Part 2* 2

Part 2: SEER Incidence – Stomach, by Race/Ethnicity Select the following settings:  Get Started With a Cancer Site: Stomach  Choose a Statistic to Explore: SEER Incidence  Click on the “Recent Rates” tab  Under “Compare by:” make sure “Race/Ethnicity” is highlighted and click on “All Races,” “Black,” and “White”  Under “More Options” leave “Precision” at 0.1 and unclick Show Standard Error and Show Confidence Interval  Right above the bar chart click on the “Data Table” tab 6. What is the 5-year age-adjusted incidence rates for stomach cancer in all races from 2015-2019? (1 point) All races- 7.1 cases per 100,000 persons per year. 7. What is the 5-year age-adjusted incidence rates for stomach cancer in Blacks from 2015-2019? (1 point) Black people- 9.8 cases per 100,000 persons per year. 8. What is the 5-year age-adjusted incidence rates for stomach cancer in Whites from 2015-2019? (1 point) Caucasians- 6.4 cases per 100,000 persons per year. 9. Describe each of these race-specific rates (Blacks vs Whites) in words by putting these data into a sentence (don’t forget the denominators!). Then, discuss how these two rates compare to each other (for example, which rate is higher? By how much?) Answer in complete sentences. (4 points) The incident rate for blacks was 9.8 cases 2015-2019 of newly diagnosed stomach cancer per 100,000 persons per year. The incident rate for Whites was 6.4 cases 2015-2019 of newly diagnosed stomach cancer per 100,000 persons per year. The four-year study on incident rates for stomach cancer is higher in Blacks by 3.4 cases per 100,000 persons per year. 10. Is the information in the table enough by itself to draw conclusions as to why these race-specific statistics are similar or different? Why or why not? (4 points; explanation needed for full credit) No, there is not enough information within the table to conclude why African Americans have higher incident rates for stomach cancer than Caucasians. Research states that many factors, including ethnicity, may contribute to cancers. Determinants such as lifestyle behaviors like diet, physical exercise, and smoking. Genetic factors involving inherited genes and a family history of a particular disease. Socioeconomic factors entail education and income level, access to health insurance, and routine medical screenings. Cultural factors and age are factors to be considered as well. 3

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*Continue to next page for Part 3* 4

Part 3: U.S. Mortality – Breast, by Age Select the following settings:  Get Started With a Cancer Site: Breast  Choose a Statistic to Explore: U.S. Mortality  Click on the “Recent Trends” tab  Under “Compare by:” make sure “Age” is highlighted and click on “Ages <50,” “Ages 50-64,” and “Ages 65+”  Under “More Options” leave “Precision” at 0.1 and unclick Show Standard Error and Show Confidence Interval  Right above the bar chart click on the “Data Table” tab  Under “Table Display” click on “Rates” 11. What was the age-adjusted mortality rate for ages <50 from breast cancer in 2008? (1 point) Ages <50- 4.7 cases per 100,000 persons per year. 12. What was the age-adjusted mortality rate for ages 50-64 from breast cancer in 2012? (1 point) Ages 50-64- 38.5 cases per 100,000 persons per year. 13. What was the age-adjusted mortality rate for ages 65+ from breast cancer in 2019? (1 point) Ages 65+- 88.3 cases per 100,000 persons per year. 14. Describe each of these age-specific rates (ages<50, ages 50-64, and ages 65+) in words by putting these data into a sentence (don’t forget the denominators!). Then, discuss how these three rates compare to each other (for example, which rate is higher? By how much?) Answer in complete sentences. (4 points) The mortality rate for women with breast cancer for ages <50 in 2008 was 4.7 cases per 100,000. The age-adjusted mortality rate for females ages 50-64 in 2012 was 38.5 cases per 100,000 persons per year. Breast Cancer for ages 65+ in 2019 is 88.3 cases per 100,000 persons per year. The older population (65+) has a higher rate of breast cancer. 15. Examine the rates of breast cancer in ages 65+ by year between 2000 and 2019. Is there a pattern to the change in the rates over time? That is, are the rates increasing, decreasing, or staying the same over time? Use data from the table in your answers to these questions, and answer in complete sentences. (4 points) The mortality rate for breast cancer in ages 65+between 2000 and 2019 decreased by 28.3 cases. *Continue to next page for Part 4* 5

Part 4: Survival – Lung and Bronchus, 5-Year Survival by Subtype Select the following settings:  Get Started With a Cancer Site: Lung and Bronchus  Choose a Statistic to Explore: Survival  Click on the “5-Year Survival” tab  Under “Compare by:” make sure “Subtype” is highlighted and click on “ALL,” “Adenocarcinoma,” “Large Cell Carcinoma,” “Small Cell Carcinoma,” and “Squamous Cell Carcinoma” (all subtypes)  Under “Additional Comparison” select “Sex” and click on “Both Sexes,” “Female,” and “Male”  Under “More Options” leave “Precision” at 0.1 and unclick Show Standard Error and Show Confidence Interval  Right above the bar chart click on the “Data Table” tab 16. What was the 5-year relative survival rate for lung and bronchus cancer between 2012- 2018 for both sexes? (1 point) The survival rate for lung and bronchus cancer between 2012-2018 for both sexes is 22.9%. 17. What was the 5-year relative survival rate for Adenocarcinoma between 2012-2018 for both sexes? (1 point) The survival rate for Adenocarcinoma between 2012-2018 for both sexes is 29.8%. 18. What was the 5-year relative survival rate for Large Cell Carcinoma between 2012- 2018 for both sexes? (1 point) The survival rate for Large Cell Carcinoma between 2012-2018 for both sexes was 18.6%. 19. What was the 5-year relative survival rate for Small Cell Carcinoma between 2012- 2018 for both sexes? (1 point) The survival rate for Small Cell Carcinoma between 2012-2018 for both sexes is 7.2%. 20. What was the 5-year relative survival rate for Squamous Cell Carcinoma between 2012-2018 for both sexes? (1 point) The survival rate for Squamous Cell Carcinoma between 2012-2018 for both sexes is 22.5%. 21. Describe in words the differences in these 5-year relative survival rates by subtype. (4 points) The 5-year relative survival percentages vary within each Lung and Bronchus cancer. For example, Adenocarcinoma is a 29.8% survival rate, and Small Cell Carcinoma is a 7.2 % survival, meaning that an individual has a higher chance of surviving with Adenocarcinoma versus Small Cell Carcinoma. Lung, Bronchus, and Squamous Cell Carcinoma have a more reasonable existence rate than Large Cell Carcinoma. 22. Now look at these same statistics by subtype for Females and Males separately. Describe the similarities or differences you see in the 5-year relative survival by sex. (4 points) Females have a higher survival rate for all Lung and Bronchus cancers than males. Females 6

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for Adenocarcinoma are 34.6%, whereas males are 24.5%. Male Large Cell Carcinoma survival rate is 17.3%, with females at 20.4%. Small Cell Carcinoma for females is 8.3%, and for males at 6.0%. The survival rate for males with Squamous Cell Carcinoma is 21.0 % compared to females having a 25.0% survival rate. The similarity for Lung cancers would be that both males and females have a low survival rate with Small Cell Carcinoma, even though the females (8.3%) survival rate is higher than the males (6.0%). 23. Based on the information provided by this table , how would you target public health strategies to improve lung and bronchus cancer survival rates? Would you target certain subtypes and/or sexes? What epidemiological evidence does the table provide that is useful? What information does it not provide? Note: Do not just name general prevention strategies. Instead, use the information in the table to inform your answer. Be sure to answer all four questions above. Please answer in complete sentences. (4 points)  The public health would use target strategies such as educational workshops, 30- second advertisements per social media, and big, eye-catching posters that would provide quick insight on things that cause and improve lung and bronchus cancers.  Specific subtypes would be targeted, such as starting with the most common or worse, like Large Cell Carcinoma. Research indicates that Large Cell Carcinoma is bigger and spreads faster. Both sexes would be addressed because that decreases the chance of female survival rates while only focusing on males.  The table provides the most common types of cancers and who is affected by the cancers the most. The percentages provide the public health professionals a count that would give an idea of where to strategize.  Information that was not provided is determinants or factors that may contribute to cancer, like ethnicity. Knowing the factors helps to understand the development and survival rates of cancers. Lifestyle behaviors (physical activity), socioeconomic factors (education and income), genes (inherited or family history), culture (beliefs), and age all provide insight into one having cancer. Knowing the risk factors for males, females, or people leads public health to good research and helps educate the community on healthy behavior. *End of worksheet* 7