Geographic pattern of cancers related to tobacco and alcohol in Connecticut: implications for cancer control

The purpose of this study was to examine the geographic distribution of standardized incidence ratios (SIRs) for Connecticut’s 169 towns for 18,382 cancers diagnosed in 1995–2000 at sites most strongly associated with tobacco and/or alcohol (i.e, lung, oral cavity–pharynx, and esophagus), with consideration of census-derived indicators of socioeconomic status (SES) at the town level. For males, the state’s four largest towns, all in the highest poverty-rate quartile, had statistically significantly elevated SIRs for both lung cancer and oral cavity–pharynx cancers, and also had elevated SIRs for esophageal cancer. Two of these four towns also had statistically significantly elevated SIRs for oral cavity–pharynx cancer for females. SIRs for both males and females were lowest for the lowest poverty quartile and highest for the highest poverty quartile, for each cancer-site group. Among 15,271 patients diagnosed with their first cancer at any of the selected sites in 1995–2000, risk of diagnosis of a second primary cancer at any of these sites (139 patients) was highest in the highest poverty-rate quartile. These surveillance methods should be useful for targeting cancer control efforts aimed at prevention or cessation of tobacco and/or heavy alcohol use, and early detection or chemoprevention of these cancers, including second primary cancers.