CANCER of the COLON Data Highlights There were 7,011 resident cases of colon cancer diagnosed in 1996. It was the third most common cancer site among both males and females, accounting for over 10 percent of all the new cancer cases recorded for 1996. The average annual age-adjusted incidence rate for colon cancer during the period of 1992-96 was over 38 percent higher among males than for females, but differences by race were not as evident. Annual age-adjusted incidence rates during the ten years from 1987 to 1996 showed decreases among whites of both sexes but no clear trend among black males and black females. During the period of 1992-96, over 77 percent of the colon cancer cases were dianosed among Pennsylvania residents 65 years of age or older. Males tended to have the highest average annual (1992-96) age-specific incidence rates. In 1996, there were 3,070 residents who died due to colon cancer. Average annual age-adjusted death rates for 1992-96 showed males with higher rates than females (20.5 compared to 14.2), and blacks with higher rates than whites of both sexes. When colon cancer is detected and treated at an early localized stage, the five-year survival rate is excellent. In 1996, over 42 percent of all cases were diagnosed as in situ or localized disease. Between 1987 and 1996, there were no evident trends in the annual age-adjusted death rates among black males and black females; however, the rates for white males and white females have been lower in recent years. FIGURE 5 Average Annual Age-Adjusted Incidence and Mortality Rates* by Sex and Race, Incidence Mortality Race/Sex All Cases/Deaths All Males All Females 16.8 20.5 20.1 14.2 13.9 18.5 26.3 38.5 33.1 32.7 36.0 45.8 45.3 50.0 0 12 24 36 48 60 Age-Adjusted Rate *per 100,000 1970 U.S. standard million population. Risk Factors Etiological factors are not precisely known; diets high in fat and/or low in fiber content are associated. Adenomatous polyps. Familial polyposis syndrome. Inflammatory bowel disease. Early Detection Evidence shows that annual occult-blood screening and sigmoidoscopy reduces mortality. The American Cancer Society recommends an annual digital exam starting at age 40 and, starting at age 50, an annual occult blood stool test and periodic sigmoidoscopy. Pennsylvania Department of Health - Pennsylvania Cancer Incidence and Mortality 1992-1996 - Page 52
Cancer of the Colon: INCIDENCE TABLE 5-A Number of Cancer Cases, Age-Adjusted Incidence Rates and Range for 95% Confidence Intervals by Sex, Race and Year, Pennsylvania Residents, 1987-1996 All Cases* All Races* White Black All Races* White Black Year No. Rate CI+/- No. Rate CI+/- No. Rate CI+/- No. Rate CI+/- No. Rate CI+/- No. Rate CI+/- No. Rate CI+/- 1996 7,011 39.1 0.9 3,353 46.4 1.6 3,083 45.7 1.6 224 50.1 6.6 3,658 33.6 1.1 3,363 33.2 1.1 256 36.0 4.4 1995 6,651 37.3 0.9 3,167 44.1 1.5 2,930 43.8 1.6 209 46.1 6.3 3,484 32.1 1.1 3,184 31.4 1.1 269 38.7 4.6 1994 6,818 38.4 0.9 3,229 45.1 1.6 2,971 44.5 1.6 238 53.5 6.8 3,587 33.4 1.1 3,307 33.0 1.1 255 36.5 4.5 1993 6,738 38.5 0.9 3,218 45.8 1.6 2,968 45.3 1.6 222 51.3 6.7 3,520 33.2 1.1 3,235 32.7 1.1 259 37.9 4.6 1992 6,809 39.1 0.9 3,350 47.7 1.6 3,109 47.4 1.7 215 49.2 6.6 3,459 33.1 1.1 3,230 33.1 1.1 208 31.0 4.2 1991 6,573 38.5 0.9 3,128 45.5 1.6 2,902 45.4 1.7 210 47.2 6.4 3,445 33.5 1.1 3,155 33.0 1.2 264 38.2 4.6 1990 6,657 39.5 0.9 3,191 47.1 1.6 2,966 47.0 1.7 212 50.5 6.8 3,466 34.4 1.1 3,189 34.0 1.2 258 39.5 4.8 1989 6,643 40.6 1.0 3,177 48.1 1.7 2,963 48.1 1.7 195 46.5 6.5 3,466 35.3 1.2 3,199 35.0 1.2 240 37.1 4.7 1988 6,690 41.0 1.0 3,152 47.8 1.7 2,941 47.9 1.7 179 43.7 6.4 3,538 36.1 1.2 3,279 36.1 1.2 245 37.7 4.7 1987 6,340 39.4 1.0 3,154 48.2 1.7 2,959 48.4 1.7 172 41.8 6.2 3,186 33.1 1.1 2,934 32.8 1.2 229 35.8 4.6 * Includes any unknowns. NOTES: Age-adjusted rates are per 100,000 and are computed by the direct method using the 1970 U.S. standard million population. Rates based on less than 20 events are considered statistically unreliable. The value of CI+/- added to and subtracted from the age-adjusted rate = 95% confidence interval. The value of CI+/- was calculated using a formula for estimating the standard error or SE (see Technical Notes). 55 FIGURE 5-A Age-Adjusted Incidence Rates by Sex and Race Pennsylvania Residents, 1987-1996 50 45 Rate per 100,000 40 35 30 25 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 Year Pennsylvania Department of Health - Pennsylvania Cancer Incidence and Mortality 1992-1996 - Page 53
Cancer of the Colon: INCIDENCE TABLE 5-B Average Annual Age-Specific Incidence Rates by Sex and Race Age Group All Cases All Races White Black All Races White Black Total 56.5 56.4 58.4 40.9 56.6 58.7 40.9 Under 5 - - - - - - - 5-9 - - - - - - - 10-14 - - - - - - - 15-19 0.1 0.2 0.2-0.1 0.1-20-24 0.4 0.5 0.6-0.3 0.2 0.4 25-29 1.1 1.1 1.1 1.8 1.1 1.2 0.4 30-34 2.1 2.4 2.2 3.6 1.9 1.8 2.5 35-39 4.3 4.4 4.2 5.9 4.2 4.2 3.8 40-44 9.5 9.8 9.1 14.1 9.3 8.4 15.8 45-49 18.9 20.8 20.0 29.1 17.1 17.0 17.8 50-54 38.7 44.6 42.7 64.6 33.1 30.6 53.9 55-59 68.9 83.6 82.3 104.9 55.8 54.0 74.1 60-64 110.5 132.6 131.7 144.3 91.6 89.5 109.5 65-69 180.2 225.0 222.4 248.6 144.5 143.1 159.4 70-74 248.2 303.2 300.0 334.8 208.5 206.1 229.1 75-79 322.0 384.0 383.1 374.5 282.7 283.6 265.5 80-84 394.6 440.2 445.1 314.4 370.1 372.6 301.6 85+ 373.9 436.1 432.2 517.8 349.2 350.7 318.2 NOTE: Rates are per 100,000 population (1992-1996) for each specified group. 600 FIGURE 5-B Average Annual Age-Specific Incidence Rates by Sex and Race 400 Rate per 100,000 200 0 Under 5 5-9 10-14 20-24 30-34 40-44 50-54 60-64 70-74 80-84 15-19 25-29 35-39 45-49 55-59 65-69 75-79 Age Group 85+ Pennsylvania Department of Health - Pennsylvania Cancer Incidence and Mortality 1992-1996 - Page 54
Cancer of the Colon: INCIDENCE TABLE 5-C Total Number of Cancer Cases by Age, Sex and Race Age Group All Cases* All Races* White Black All Races* White Black Total 34,029 16,319 15,063 1,108 17,708 16,319 1,247 Under 5 0 0 0 0 0 0 0 5-9 0 0 0 0 0 0 0 10-14 0 0 0 0 0 0 0 15-19 6 4 4 0 2 2 0 20-24 16 10 10 0 6 4 1 25-29 47 24 20 4 23 22 1 30-34 99 55 44 8 44 37 6 35-39 201 102 88 12 99 89 9 40-44 422 213 180 25 209 168 33 45-49 723 388 339 41 335 299 31 50-54 1,228 683 597 72 545 453 78 55-59 1,932 1,109 1,001 100 823 719 95 60-64 3,037 1,682 1,543 124 1,355 1,206 132 65-69 5,001 2,762 2,541 196 2,237 2,047 176 70-74 6,144 3,147 2,918 206 2,997 2,760 212 75-79 6,256 2,891 2,712 159 3,365 3,161 191 80-84 5,013 1,954 1,859 77 3,059 2,889 147 85+ 3,904 1,295 1,207 84 2,609 2,463 135 * Includes any unknowns. FIGURE 5-C Stage of Disease at Diagnosis, Percent by Sex and Race Pennsylvania Residents, 1996 50 In Situ 40 34.9 38.8 37.0 33.8 34.4 42.1 41.4 Local Regional Distant 30 28.0 Percent 20 16.4 21.5 17.3 19.8 10 9.9 7.8 6.2 10.8 0 Number and Percent of Cases Microscopically Confirmed: 6,850-97.7% Pennsylvania Department of Health - Pennsylvania Cancer Incidence and Mortality 1992-1996 - Page 55
Cancer of the Colon: MORTALITY TABLE 5-D Number of Deaths, Age-Adjusted Death Rates and Range for 95% Confidence Intervals by Sex, Race and Year, Pennsylvania Residents, 1987-1996 All Deaths* All Races* White Black All Races* White Black Year No. Rate CI+/- No. Rate CI+/- No. Rate CI+/- No. Rate CI+/- No. Rate CI+/- No. Rate CI+/- No. Rate CI+/- 1996 3,070 16.2 0.6 1,423 19.3 1.0 1,298 18.8 1.0 123 27.1 4.8 1,647 13.9 0.7 1,518 13.7 0.7 126 16.7 2.9 1995 3,067 16.5 0.6 1,445 19.7 1.0 1,325 19.4 1.0 114 25.2 4.6 1,622 14.2 0.7 1,470 13.8 0.7 145 19.9 3.2 1994 3,049 16.6 0.6 1,512 20.9 1.1 1,392 20.7 1.1 113 25.3 4.7 1,537 13.5 0.7 1,417 13.2 0.7 117 16.5 3.0 1993 3,120 17.1 0.6 1,493 21.0 1.1 1,369 20.6 1.1 121 28.0 5.0 1,627 14.4 0.7 1,480 14.1 0.7 143 19.5 3.2 1992 3,175 17.7 0.6 1,522 21.5 1.1 1,407 21.3 1.1 112 25.7 4.8 1,653 15.2 0.7 1,511 14.8 0.7 137 19.8 3.3 1991 3,045 17.3 0.6 1,489 21.5 1.1 1,373 21.3 1.1 114 26.5 4.9 1,556 14.3 0.7 1,420 14.0 0.7 135 19.4 3.3 1990 3,210 18.6 0.6 1,580 23.4 1.2 1,460 23.2 1.2 119 28.3 5.1 1,630 15.3 0.7 1,496 15.1 0.8 130 19.4 3.3 1989 3,241 18.9 0.7 1,562 23.1 1.1 1,442 22.9 1.2 116 28.3 5.2 1,679 15.9 0.8 1,556 15.9 0.8 120 17.7 3.2 1988 3,217 19.1 0.7 1,497 22.4 1.1 1,389 22.3 1.2 101 24.8 4.8 1,720 16.8 0.8 1,566 16.5 0.8 152 22.9 3.6 1987 3,335 20.2 0.7 1,617 24.6 1.2 1,492 24.3 1.2 122 29.9 5.3 1,718 17.1 0.8 1,572 16.8 0.8 145 22.0 3.6 * Includes any unknowns. NOTES: Age-adjusted rates are per 100,000 and are computed by the direct method using the 1970 U.S. standard million population. Rates based on less than 20 events are considered statistically unreliable. The value of CI+/- added to and subtracted from the age-adjusted rate = 95% confidence interval. The value of CI+/- was calculated using a formula for estimating the standard error or SE (see Technical Notes). FIGURE 5-D Age-Adjusted Death Rates by Sex and Race Pennsylvania Residents, 1987-1996 35 30 Rate per 100,000 25 20 15 10 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 Year Pennsylvania Department of Health - Pennsylvania Cancer Incidence and Mortality 1992-1996 - Page 56
Cancer of the Colon: MORTALITY TABLE 5-E Number of Deaths and Average Annual Age-Specific Death Rates by Sex and Race All Deaths* All Races* White Black All Races* White Black Age Group No. Rate No. Rate No. Rate No. Rate No. Rate No. Rate No. Rate Total* 15,481 25.7 7,395 25.6 6,791 26.3 583 21.5 8,086 25.9 7,396 26.6 668 21.9 Under 5 0-0 - 0-0 - 0-0 - 0-5-9 0-0 - 0-0 - 0-0 - 0-10-14 0-0 - 0-0 - 0-0 - 0-15-19 3 0.1 3 0.1 3 0.2 0-0 - 0-0 - 20-24 7 0.2 5 0.2 5 0.3 0-2 0.1 2 0.1 0-25-29 14 0.3 6 0.3 6 0.3 0-8 0.4 7 0.4 1 0.4 30-34 30 0.6 17 0.7 16 0.8 1 0.5 13 0.6 11 0.5 2 0.8 35-39 53 1.1 28 1.2 19 0.9 8 3.9 25 1.1 22 1.0 3 1.3 40-44 149 3.4 79 3.6 65 3.3 13 7.3 70 3.1 59 2.9 11 5.3 45-49 264 6.9 149 8.0 135 8.0 12 8.5 115 5.9 96 5.5 17 9.8 50-54 476 15.0 261 17.1 230 16.5 29 26.0 215 13.1 188 12.7 27 18.7 55-59 740 26.4 397 29.9 356 29.3 37 38.8 343 23.3 291 21.9 48 37.5 60-64 1,219 44.4 691 54.5 630 53.8 60 69.8 528 35.7 469 34.8 56 46.5 65-69 2,010 72.4 1,132 92.2 1,020 89.3 110 139.5 878 56.7 787 55.0 89 80.6 70-74 2,523 101.9 1,318 127.0 1,218 125.2 97 157.6 1,205 83.8 1,108 82.7 92 99.4 75-79 2,737 140.9 1,343 178.4 1,249 176.5 92 216.7 1,394 117.1 1,280 114.8 109 151.5 80-84 2,536 199.6 1,086 244.7 1,030 246.6 54 220.5 1,450 175.4 1,347 173.7 103 211.3 85+ 2,718 260.3 880 296.3 809 289.7 70 431.5 1,838 246.0 1,727 245.9 110 259.2 * Includes any unknowns. NOTE: Rates are per 100,000 population (1992-1996) for each specified group. FIGURE 5-E Average Annual Age-Specific Death Rates by Sex and Race 500 400 Rate per 100,000 300 200 100 0 Under 5 5-9 10-14 15-19 20-24 25-29 30-34 35-39 40-44 45-49 Age Group 50-54 55-59 60-64 65-69 70-74 75-79 80-84 85+ Pennsylvania Department of Health - Pennsylvania Cancer Incidence and Mortality 1992-1996 - Page 57
Cancer of the Colon: INCIDENCE TABLE 5-F Number of Cases, Average Annual Age-Adjusted Incidence Rates and Range for 95% Confidence Intervals by County and Sex, Total Total County Cases No. Rate CI+/- No. Rate CI+/- County Cases No. Rate CI+/- No. Rate CI+/- All Counties 34,029 16,319 45.8 0.7 17,708 33.1 0.5 Adams 213 107 45.9 8.7 106 33.0 6.3 Juniata 60 27 43.3 16.3 33 39.1 13.3 Allegheny 4,014 2,045 48.1 2.1 1,969 29.3 1.3 Lackawanna 801 391 54.2 5.4 410 33.2 3.2 Armstrong 244 141 56.1 9.3 103 30.4 5.9 Lancaster 989 454 38.2 3.5 535 31.0 2.6 Beaver 558 291 46.2 5.3 267 29.5 3.5 Lawrence 329 148 45.6 7.3 181 36.4 5.3 Bedford 101 43 27.2 8.1 58 26.0 6.7 Lebanon 339 151 42.2 6.7 188 38.0 5.4 Berks 914 445 42.1 3.9 469 30.2 2.7 Lehigh 820 414 45.9 4.4 406 30.3 2.9 Blair 502 226 54.9 7.2 276 43.1 5.1 Luzerne 1,284 602 53.2 4.2 682 35.9 2.7 Bradford 154 84 45.6 9.8 70 26.8 6.3 Lycoming 369 166 47.5 7.2 203 36.5 5.0 Bucks 1,269 641 46.2 3.6 628 32.6 2.5 McKean 131 62 40.5 10.1 69 30.9 7.3 Butler 479 207 47.2 6.4 272 41.2 4.9 Mercer 319 152 37.6 6.0 167 28.3 4.3 Cambria 497 236 42.3 5.4 259 30.1 3.7 Mifflin 155 63 44.1 10.9 92 39.1 8.0 Cameron 18 7 39.6 29.3 11 30.5 18.0 Monroe 284 151 51.1 8.2 133 34.5 5.9 Carbon 229 116 54.5 9.9 113 36.6 6.7 Montgomery 1,814 870 41.2 2.7 944 30.0 1.9 Centre 216 99 38.4 7.6 117 32.1 5.8 Montour 56 29 52.7 19.2 27 27.3 10.3 Chester 839 405 41.3 4.0 434 32.8 3.1 Northampton 728 350 46.5 4.9 378 35.7 3.6 Clarion 118 55 47.1 12.4 63 41.3 10.2 Northumberland 374 172 50.7 7.6 202 39.0 5.4 Clearfield 225 112 43.9 8.1 113 30.6 5.6 Perry 86 43 40.5 12.1 43 30.8 9.2 Clinton 102 46 39.7 11.5 56 35.4 9.3 Philadelphia 4,485 2,025 50.8 2.2 2,460 37.7 1.5 Columbia 193 98 51.6 10.2 95 32.3 6.5 Pike 48 28 24.8 9.2 20 15.3 6.7 Crawford 257 121 44.8 8.0 136 38.0 6.4 Potter 40 22 40.7 17.0 18 22.8 10.5 Cumberland 467 213 38.4 5.2 254 29.8 3.7 Schuylkill 554 259 46.3 5.6 295 32.7 3.7 Dauphin 689 316 47.1 5.2 373 37.1 3.8 Snyder 71 37 37.0 11.9 34 26.1 8.8 Delaware 1,601 809 50.7 3.5 792 31.5 2.2 Somerset 202 99 37.2 7.3 103 27.5 5.3 Elk 114 52 44.0 12.0 62 40.2 10.0 Sullivan 15 10 44.0 27.3 5 17.1 15.0 Erie 633 312 41.3 4.6 321 28.7 3.1 Susquehanna 102 45 35.2 10.3 57 29.8 7.7 Fayette 515 233 48.1 6.2 282 39.5 4.6 Tioga 115 54 40.3 10.7 61 38.2 9.6 Forest 15 8 39.0 27.0 7 25.1 18.6 Union 109 53 53.7 14.5 56 37.5 9.8 Franklin 347 156 41.8 6.6 191 36.1 5.1 Venango 167 86 46.4 9.8 81 32.0 7.0 Fulton 27 11 26.3 15.5 16 33.0 16.2 Warren 132 67 45.6 10.9 65 32.0 7.8 Greene 94 38 30.7 9.8 56 33.9 8.9 Washington 597 267 38.3 4.6 330 32.7 3.5 Huntingdon 108 48 39.4 11.1 60 35.1 8.9 Wayne 136 79 53.4 11.8 57 28.3 7.3 Indiana 207 106 42.9 8.2 101 28.2 5.5 Westmoreland 1,187 555 42.9 3.6 632 34.1 2.7 Jefferson 141 60 39.0 9.9 81 39.5 8.6 Wyoming 76 39 50.3 15.8 37 34.3 11.1 York 955 462 47.5 4.3 493 36.6 3.2 NOTES: Age-adjusted rates are per 100,000 and are computed by the direct method using the 1970 U.S. standard million population. Rates based on less than 20 events are considered statistically unreliable. The value of CI+/- added to and subtracted from the age-adjusted rate = 95% confidence interval. The value of CI+/- was calculated using a formula for estimating the standard error or SE (see Technical Notes). Pennsylvania Department of Health - Pennsylvania Cancer Incidence and Mortality 1992-1996 - Page 58
Cancer of the Colon: MORTALITY TABLE 5-G Number of Deaths, Average Annual Age-Adjusted Death Rates and Range for 95% Confidence Intervals By County and Sex, Total Total County Deaths No. Rate CI+/- No. Rate CI+/- County Deaths No. Rate CI+/- No. Rate CI+/- All Counties 15,481 7,395 20.5 0.5 8,086 14.2 0.3 Adams 101 55 23.2 6.1 46 11.6 3.4 Juniata 28 15 23.6 11.9 13 14.7 8.0 Allegheny 1,926 968 22.5 1.4 958 13.8 0.9 Lackawanna 413 190 24.9 3.5 223 17.0 2.2 Armstrong 99 49 19.5 5.5 50 14.4 4.0 Lancaster 470 223 18.6 2.4 247 13.1 1.6 Beaver 249 123 18.9 3.3 126 12.5 2.2 Lawrence 147 70 21.3 5.0 77 14.9 3.3 Bedford 49 20 12.8 5.6 29 12.0 4.4 Lebanon 155 79 21.8 4.8 76 14.6 3.3 Berks 450 200 18.9 2.6 250 14.8 1.8 Lehigh 331 147 15.9 2.6 184 12.3 1.8 Blair 206 96 24.1 4.8 110 16.5 3.1 Luzerne 596 268 22.9 2.7 328 17.2 1.9 Bradford 78 37 20.2 6.5 41 14.7 4.5 Lycoming 160 65 18.0 4.4 95 16.5 3.3 Bucks 572 282 20.7 2.4 290 13.9 1.6 McKean 55 29 18.9 6.9 26 10.8 4.2 Butler 172 78 17.8 4.0 94 13.5 2.7 Mercer 148 74 17.8 4.1 74 12.2 2.8 Cambria 225 104 18.3 3.5 121 13.5 2.4 Mifflin 54 21 14.5 6.2 33 14.5 4.9 Cameron 10 5 30.9 27.1 5 12.4 10.9 Monroe 130 69 23.3 5.5 61 14.9 3.7 Carbon 82 39 19.1 6.0 43 14.2 4.2 Montgomery 805 378 17.5 1.8 427 12.6 1.2 Centre 90 35 13.7 4.5 55 15.5 4.1 Montour 32 17 31.8 15.1 15 15.7 7.9 Chester 359 164 17.0 2.6 195 14.1 2.0 Northampton 271 139 18.5 3.1 132 11.4 1.9 Clarion 60 30 25.6 9.2 30 19.4 6.9 Northumberland 134 63 18.7 4.6 71 11.5 2.7 Clearfield 106 45 17.8 5.2 61 15.8 4.0 Perry 34 16 15.3 7.5 18 12.5 5.8 Clinton 44 22 18.2 7.6 22 13.1 5.5 Philadelphia 2,131 1,015 24.8 1.5 1,116 15.9 0.9 Columbia 79 30 15.2 5.4 49 16.2 4.5 Pike 30 17 15.5 7.4 13 9.0 4.9 Crawford 98 49 18.9 5.3 49 13.9 3.9 Potter 22 12 21.3 12.1 10 11.0 6.8 Cumberland 231 107 19.3 3.7 124 13.5 2.4 Schuylkill 303 146 26.3 4.3 157 17.3 2.7 Dauphin 295 140 20.6 3.4 155 14.8 2.3 Snyder 45 22 21.0 8.8 23 16.3 6.7 Delaware 747 356 21.7 2.3 391 14.6 1.4 Somerset 114 61 22.4 5.6 53 12.2 3.3 Elk 55 21 18.1 7.7 34 20.2 6.8 Sullivan 11 6 24.9 19.9 5 15.2 13.3 Erie 273 148 19.5 3.1 125 10.6 1.9 Susquehanna 54 25 20.1 7.9 29 12.9 4.7 Fayette 244 123 25.2 4.5 121 16.7 3.0 Tioga 33 16 12.0 5.9 17 11.1 5.3 Forest 4 3 11.9 13.5 1 3.1 6.1 Union 45 17 17.7 8.4 28 20.9 7.7 Franklin 151 71 18.6 4.3 80 13.6 3.0 Venango 75 37 19.8 6.4 38 15.3 4.9 Fulton 11 5 11.8 10.3 6 10.3 8.2 Warren 43 25 17.2 6.7 18 9.6 4.4 Greene 45 19 15.0 6.7 26 16.9 6.5 Washington 279 139 19.5 3.2 140 12.6 2.1 Huntingdon 54 25 20.0 7.8 29 13.9 5.1 Wayne 56 34 23.0 7.7 22 11.0 4.6 Indiana 96 46 18.1 5.2 50 12.6 3.5 Westmoreland 490 218 16.6 2.2 272 14.0 1.7 Jefferson 64 34 22.3 7.5 30 12.1 4.3 Wyoming 31 16 20.1 9.8 15 13.6 6.9 York 431 197 20.1 2.8 234 16.5 2.1 NOTES: Age-adjusted rates are per 100,000 and are computed by the direct method using the 1970 U.S. standard million population. Rates based on less than 20 events are considered statistically unreliable. The value of CI+/- added to and subtracted from the age-adjusted rate = 95% confidence interval. The value of CI+/- was calculated using a formula for estimating the standard error or SE (see Technical Notes). Pennsylvania Department of Health - Pennsylvania Cancer Incidence and Mortality 1992-1996 - Page 59