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190 Spatial Analysis and Descriptive Statistics of Melanoma Rates in Vermont

Tuesday, June 11, 2013
Exhibit Hall A (Pasadena Convention Center)
Nathaniel Schafrick , Vermont Department of Health, Burlington, VT
Alison Johnson , Vermont Department of Health, Burlington, VT
Jennifer Kachajian , Vermont Department of Health, Burlington, VT
Elisabeth Wirsing , Vermont Department of Health, Burlington, VT
Lori Cragin , Vermont Department of Health, Burlington, VT

BACKGROUND: Vermont has among the highest incidence rates of melanoma in the United States. In this study, we assessed county-level and sub-county-level melanoma rates in order to distinguish what county level and sub-county level trends in melanoma incidence exist in Vermont.

METHODS: Analysis was conducted using a limited-identifiers cancer registry data set that included all cutaneous melanoma cases from 2001 to 2010. Incidence rates and standardized incidence ratios (SIRs) comparing age-adjusted county rates to statewide rates were calculated, using Byar’s Z values to determine statistical significance. Additionally, town-level incidence rates were calculated and mapped in order to assess geographic trends. Incidence was stratified by sex, age at diagnosis, cancer stage at diagnosis, and primary payer at diagnosis.

RESULTS: From 2001 to 2010, Vermont had a statewide incidence rate of 29.0 per 100,000 person-years (95% CI: 27.7, 30.4). Bennington County had the highest incidence rate of all counties in VT, and was significantly higher than the statewide rate (SIR=1.40, p ≤ 0.001). This rate held when stratifying by sex (Females: SIR=1.38 p=0.003; Males: SIR=1.43, p=0.003). Incidence in Lamoille county was also significantly higher than that of the statewide rate (SIR=1.31, p=0.014). Franklin and Orleans Counties had incidence rates significantly lower than the state rate (Franklin: SIR=0.73, p=0.001; Orleans: SIR=0.73, p=0.012). In addition to this county-level heterogeneity in melanoma incidence, mapping of town-level incidence rates indicates sub-county spatial heterogeneity in melanoma incidence.

CONCLUSIONS: Analysis of county-level and sub-county-level geographic trends indicates that localized targeting of skin cancer interventions, including educational campaigns and screening programs, may be useful. Furthermore, in-depth analysis of these trends may inform hypotheses that can be used in future studies where surviving individuals listed on the cancer registry are contacted for participation.

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