New Mexico and Alaska buck this trend, as they also possess relatively high mortality rates from stomach cancer (NCHS 2009). Other regional demographics, however, help to bear out the racial factor as one of the primary determinants of geographical trends in stomach cancer mortality.
The Southern region especially contains the highest rates of incidence and mortality, especially in the states stretching East from New Mexico to the Atlantic (Texas, Louisiana, Arkansas, Mississippi, Alabama, Georgia, and South Carolina) (NCHS 2009). The New England area states -- Connecticut, Massachusetts, Rhode Island, and New York especially, also have increased mortality rates when compared to the rest of the nation (NCHS 2009). The Midwest as a whole, on the other hand, has very low rates of incidence and mortality, as do the northernmost New England states -- Vermont, New Hampshire, and Maine (NCHS 2009). These regions tend to be more homogenously white in their racial make-up then the regions and states with higher rates of stomach cancer mortality.
The inclusion of California, Nevada, and Illinois in the states with the highest rates of mortality and incidence of stomach cancer shows another facet of the geographic breakdown of stomach cancer incidence and mortality rates. These states are all regionally isolated in their rates, being surrounded by states with significantly lower rates of stomach cancer mortality (NCHS 2009). These states also have large urban areas -- the largest in the United States, as a matter of fact, when Boston and New York City (which reside in states already noted for their increased mortality rates) are taken out of the picture -- such as Las Vegas and Reno, Los Angeles, San Diego, and San Francisco, and Chicago. Urban areas are home to larger proportions of most minority groups, including (and perhaps especially) African-Americans, so again there is a racial explanation for the observed geographical demographics of stomach cancer incidence and mortality rates (NCHS 2009). The slightly higher relative mortality rates in North Dakota and New Mexico remain the only states for which this explanation does not appear to be applicable.
Largely due to the overwhelming effect of age on the incidence rates of stomach cancer, time characteristics regarding the disease are difficult to ascertain and are largely inconsequential in practical terms. As nearly two thirds of all cases occur in patients over sixty five years of age, with the majority of these being diagnosed over the age of seventy, only a small number of individuals live to fully combat stomach cancer, though the cancer is not especially virulent or mortality inducing in younger ages. This can clearly be seen when a comparison of age-adjusted mortality rates due to stomach cancer in the United States are compared to the five-year survival rates for patients diagnosed with stomach cancer.
The overall mortality rate of stomach cancer in the United States from 2002 to 2006 was 3.95% (NCHS 2009). Comparatively, the relative survival rate five years after diagnosis with stomach cancer was 25.7% across the United States from the period of 1999-2005 (the closest five-year period to the period from which adjusted mortality rates were calculated for which information was available) (Horner et al. 2009). Despite nearly three-quarters of all stomach cancer patients dying within five years of their diagnosis with stomach cancer, the age-adjusted mortality rate of the disease is well under five percent. The disease does not have time to produce cyclical trends or other significant time characteristics, as it overwhelmingly affects elderly individuals and therefore has a low long-term survival rate.
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CDC. (2009). United States Cancer Statistics: 1999 -- 2005 Incidence and Mortality Web-based Report. Atlanta: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention and National Cancer Institute; 2009. Accessed 25 October 2009. http://apps.nccd.cdc.gov/uscs/
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NCHS. (2009). U.S. mortality files, National center for health statistics, Centers for disease control and prevention. Accessed 25 October 2009. http://seer.cancer.gov/csr/1975_2006/browse_csr.php?section=24&page=sect_24_table.15.html
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