Little geographic variation in mortality is seen for premenopausal women. The geographic, racial, and socioeconomic patterns of cervical cancer mortality are mainly to variations in the prevalence of human papillomavirus and the use of Pap smears to detect premalignant lesions, which can then be cured. There is some evidence that farming and agricultural exposures may contribute to the geographic variation in prostate cancer, including high rates among whites in north central and northwestern areas, and among blacks in parts of the Southeast. Bladder cancer Bladder cancer among men has clustered in the urban Northeast since the 1950s, particularly in areas with chemical industries. Increased risk of bladder cancer is seen among truck drivers and other workers exposed to motor exhausts.
Cigarette smoking accounts for one-half of bladder cancer cases.
High rates have persisted among men and women in parts of the Northeast, especially in northern New England, prompting new studies to elucidate reasons for this unusual pattern. A recent correlation study suggests no link between non- Hodgkin's lymphoma and sunlight exposure, in contrast to some earlier studies. There is a link between pesticide use by men in central areas of the country and non-Hodgkin's lymphoma. New studies are attempting to clarify reasons for the upward trend in the incidence of this cancer. Multiple myeloma Elevated rates seen in the black population are at least partly due to socioeconomic factors.