The impact of climate change on cancer incidence in U.S. women: Who is most affected?
Authors: Johnson Caitlin Ruth , Liao Cheng-I , Jiang Ruolin Lorraine , Kapp Daniel Stuart , Chan John K 
Published: June 2023

10525 Background: To determine the association between cancer incidence and regional climate change among U.S. women. Methods: Data on climate change-associated cancers (breast, lung, melanoma) were obtained from the United States Cancer Statistics (USCS) database from 2001-2019. Climate change data were obtained from federal reports, insurance companies, and nonprofits. States greatly impacted by, moderately affected by, and most resistant to climate change were analyzed. SEER*Stat 8.3.9.2 and Joinpoint regression program 4.9.0.0 were used to calculate cancer incidences and trends per 100,000. Average annual percentage change (AAPC) was used to describe trends. Age-adjusted incidences were adjusted by the U.S. 2000 standard population. Results: Prior studies suggest that breast, lung, and skin cancers are associated with climate change. States greatly impacted by climate change were FL, TX, LA, CA, SC, OK, KS, UT, AR, GA, NC, AL, and MO. States most resistant to climate change were VT, MN, ME, NH, MI, HI, RI, PA, MA, CO, AK, IL, and WY. Breast cancer incidence decreased overall by -0.12% per year from 2001-2019 (p = 0.001). Of states with significant AAPCs, those greatly impacted and moderately affected by climate change had increases of 0.34% (p = 0.008) and 1.31% (p = 0.002) while incidence among resistant states decreased at -0.31% (p = 0.03) per year. Regarding race, minority populations in greatly impacted states had higher increases at 0.83% for Blacks (p < 0.001), 2.21% for Asians (p = 0.003), and 2.38% for Hispanics (p = 0.01) and remained unchanged for Whites (p = 0.4). Melanoma incidence increased overall by 1.59% per year from 2001-2019 (p = 0.008). Of states with significant AAPCs, those greatly impacted by climate change had the largest increases at 2.82% (p = 0.002) while moderately affected and climate-resistant states had increases of 2.37% (p < 0.001) and 2.24% (p < 0.001). Incidence decreased at -1.10% for the overall Black population (p = 0.007). In climate-impacted states, incidence increased for Whites at 2.23% (p < 0.001) and remained unchanged for Asians (p = 0.9), Hispanics (p = 0.9), and Blacks (p = 0.3). Lung cancer incidence decreased overall by -0.73% per year from 2001-2019 (p < 0.001). Moderately affected and climate-resistant states had larger AAPC decreases at -1.24% (p = 0.004) and -1.34% (p < 0.001). In states greatly impacted by climate change, overall incidence only decreased by -0.94 (p < 0.001) with incidence decreasing for Blacks at -1.56% (p < 0.001), Hispanics at -6.78% (p < 0.001), and Whites at -0.41% (p = 0.02) while remaining unchanged for Asians (p = 0.1). Conclusions: This data suggests that women in states greatly impacted by climate change had larger increases in climate change-associated cancers. Particularly regarding breast cancer, climate change appears to negatively impact racial minorities when compared to White populations. Further studies are warranted to better understand these trends.