Abstract B143: Temporal trends in colorectal cancer mortality in the five regions of Georgia, 1975-2018: A Joinpoint regression analyses
Authors: Tsai Meng-Han , Cabral Daramola N. , Moore Justin X. , Cortes Jorge 
Published: December 2023

Abstract
Background: Colorectal cancer (CRC) is the third leading cause of death in Georgia. There remain significantly higher CRC mortality rates in the five public health regions of Georgia (Clayton, West Central, East Central, Southeast, and Northeast regions) in comparison to the rates in the State of Georgia. However, studies that examined temporal trends in CRC mortality rates in small geographic regions are still limited. The aim of this study was to analyze the time trends in mortality due to CRC within five regions of Georgia, stratified by age groups to assess any changes in mortality trends for the period 1975 -2018. Methods: Surveillance, Epidemiology, and End Results (SEER) Program SEER*Stat Database: Mortality - All COD, Aggregated with County, Total U.S. were used to select 1975-2018 CRC mortality data. We conducted Joinpoint regression analyses of the trends in age-adjusted mortality rates (ADMRs) due to CRC, stratified by the five regions of Georgia. Age differences in mortality were also examined. The average annual percent change (AAPC) and annual percent change (APC) with confidence intervals of 95% were calculated. Results: A total of 12,972 deaths from CRC were reported in these five regions during the period 1975-2018. The ADMR of CRC were 24.4, 24.9, 23.4, 22.7, and 25.7 per 100,000 in Clayton, East Central, Southeast, Northeast, and West Central regions, respectively. The mortality rates for CRC decreased from 1975 to 2018 in Clayton, Northeast, and Southeast regions (AAPC: -1.7% to -3.4%, p-value&lt;0.05). One Joinpoint trend found a significant reduction in mortality in the East Central (1984-2018) (APC: -4.1%, p-value&lt;0.001) and West Central (1981-2018) regions (APC: -3.2%, p-value=0.003). When examining age differences, patients aged 75 years or older had a significant decrease in mortality from 1975 to 2018 except in the East Central region (AAPC: -2.4% to -4.5%, p-value&lt;0.05). In the East Central region, one Joinpoint demonstrated a significant decrease in mortality during 1987-2018 for the 60-74 age group and during 1984 -2018 for 75+ age group (APC: -5.1% & -6.1%, respectively; both p-value&lt;0.05). Reduced mortality rates were also found from 1984 to 2018 in the 60-74 age group in the Northeast region (APC: -4.3%, p-value&lt;0.001). However, Northeast Georgians aged 15-59 years demonstrated a non-significant trend for increase in mortality from 1975 to 2018 (AAPC: 2.1%, p-value=0.181). Conclusion: The regional burden of colorectal cancer varied across the five regions of Georgia with CRC mortality rates decreased significantly in the Clayton, Northeast, and Southeast regions. Although reduced mortality rates were found in older patients in most regions, younger patients living in Northeast regions demonstrated a slight increase in mortality. Increased CRC risk awareness, culturally tailored prevention strategies through timely CRC screening uptake, and improved access to cancer treatment are extremely important to reduce the CRC burden, especially in the most affected regions in Georgia.
Citation Format: Meng-Han Tsai, Daramola N. Cabral, Justin X. Moore, Jorge Cortes. Temporal trends in colorectal cancer mortality in the five regions of Georgia, 1975-2018: A Joinpoint regression analyses [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr B143.