Colorectal Cancer In New Jersey
1979-1997

Incidence

Overall Incidence - 1979-1997

During the years 1979 through 1997 between 5,230 and 5,870 newly diagnosed cases of colorectal cancer among New Jersey residents were reported each year. In 1997 colorectal cancer accounted for over 13 percent of all newly diagnosed cancers in New Jersey, with 5,394 new cases. The annual age-adjusted incidence rate rose from 61.8 to 63.5 per 100,000 between 1979 and 1985, then decreased steadily to 50.9 in 1997. (See Figures 1 and 2.) The aging of the population is reflected in the slower decrease in the number of colorectal cancer cases after 1985 compared to the decrease in the age-adjusted rates after that year.


Figure 1
Colorectal Cancer Incidence
By Year, New Jersey - 1979-1997


Figure 2
Colorectal Cancer Incidence Rates
By Year, New Jersey - 1979-1997




Age-Adjusted Incidence Rates by Gender and Race - 1979-1997

From 1979 to 1997, over 91 percent of New Jersey men with newly diagnosed colorectal cancer were white, and just over 7 percent were black. This distribution was similar among women with colorectal cancer, with over 90 percent white and 8 percent black. Men, regardless of race, had a consistently higher age-adjusted incidence rate than women. However, while annual incidence rates (except in 1995) were higher in white men than in black men, white and black women demonstrated similar incidence rates throughout the years 1979 and 1997.

The age-adjusted incidence rate of white men increased until 1985, and then fell steadily each year. The incidence rate of black men fluctuated until 1990, then fell each year through 1993, then rose between 1993 and 1997, with a peak above the white male incidence rate in 1995. Preliminary colorectal cancer incidence data for 1998 show that the age-adjusted incidence rates of white and black men rose to 63.3 and 64.0 per 100,000, respectively.

The age-adjusted incidence rate among white women dropped gradually from 1979 to 1997, and the incidence rate among black women fluctuated for all years. However, the preliminary 1998 data show the age-adjusted incidence rates for both white and black women rising slightly, to 43.8 and 48.8, respectively. (See Figure 3 and Tables 16 and 17 in Appendix II.)


Figure 3
Colorectal Cancer Incidence Rates
By Gender And Race, New Jersey - 1979-1997*


*Age-adjusted to the 1970 U.S. standard population.

Age-Specific Incidence Rates by Gender and Race

In the years 1979 through 1997 combined, the age-specific incidence rates increased with each successive five-year age group, with the exception of the over 85 age group in black men. In the younger age groups (20-24 through 50-54) black men and black women had higher incidence rates than their white counterparts, while the reverse was true in age-groups beyond 55. After age 50- 54, the differences between whites and blacks and men and women generally increased for each successive age group, except the over 85 age group in which the incidence rate for black men was lower than that for white women. (See Figure 4 and Tables 18 and 19 in Appendix II.)


Figure 4
Colorectal Cancer Age-Specific Incidence Rates
By Race And Gender, New Jersey - 1979-1997



For people below age 50, there was no change in age-specific incidence rates from 1979 to 1997. The age groups over 50 showed little change in incidence rates until 1988, after which they began to decline. Each successive age group showed a more pronounced decline from 1988 to 1997. (See Figures 5 and 6, and Tables 20 through 23 in Appendix II). Note: Figures were not included for black incidence rates by age group because the incidences were too unstable due to small numbers.


Figure 5
Colorectal Cancer Incidence Rates
By Age Group, White Males, New Jersey
1979-1997




Figure 6
Colorectal Cancer Incidence Rates
By Age Group, White Females, New Jersey
1979-1997




Age-Adjusted Incidence Rates by County

The age-adjusted incidence rates showed a wide range among the twenty-one counties of New Jersey for the years 1979 through 1997. (See Table 1.) This variation may be attributed to the usual random fluctuations in disease occurrence, differences in screening rates, and thus detection, and differences in the prevalence of risk factors for colorectal cancer. (See Tables 6 through 10 in the next section for details on the stage at diagnosis by county.) Tables 2 through 5 show the change in age-adjusted incidence rates over a ten-year period from 1988 to 1997. (Note: The years 1979 through 1987 are not included in Tables 2 through 5; earlier reports include 1979 through 1996.)

Table 1
Colorectal Cancer Incidence And Incidence Rates
By County, Race, And Gender, New Jersey
1979-1997*


COUNTY MALE FEMALE
WHITE BLACK OTHER
& UNK.
WHITE BLACK OTHER
& UNK.
No. Rate No. Rate No. No. Rate No. Rate No.
Atlantic 1,460 73.7 186 59.7 11 1,581 54.2 230 47.8 6
Bergen 6,221 71.0 163 58.4 147 6,089 48.3 220 52.1 128
Burlington 1,949 69.5 204 71.8 27 1,946 49.4 166 49.0 40
Camden 2,680 70.5 282 60.9 28 2,796 49.6 290 43.1 36
Cape May 1,014 80.4 26 55.8 8 992 55.4 44 60.2 5
Cumberland 840 71.9 88 70.2 14 788 47.6 73 39.3 6
Essex 3,705 70.5 1,186 63.0 69 3,817 47.3 1,433 49.2 78
Gloucester 1,106 68.4 93 56.5 24 1,174 52.3 93 42.1 10
Hudson 3,306 71.9 241 59.5 96 3,380 47.9 321 53.7 94
Hunterdon 536 64.7 8 132.0 8 519 47.8 6 62.5 ---
Mercer 1,917 74.6 250 66.4 27 1,920 50.1 246 45.4 17
Middlesex 3,955 75.4 120 47.5 84 3,468 48.1 151 46.6 79
Monmouth 3,454 72.6 205 57.7 64 3,506 49.7 212 41.4 35
Morris 2,306 68.3 47 64.9 45 2,247 46.4 53 50.8 42
Ocean 4,577 74.1 37 59.3 29 4,237 49.1 49 55.7 37
Passaic 2,723 69.7 180 52.7 43 2,728 46.8 213 41.5 30
Salem 371 62.3 58 68.3 6 385 47.7 49 43.1 ---
Somerset 1,193 62.4 54 75.3 23 1,121 42.7 47 46.9 13
Sussex 680 74.8 9 126.6 9 651 50.2 6 79.6 ---
Union 3,375 71.1 398 71.5 64 3,392 48.9 396 49.7 61
Warren 664 77.1 --- --- --- 665 53.0 5 40.2 ---
STATE 48,087 71.5 3,842 62.1 858 47,451 48.7 4,309 47.7 765

*Incidence rates - per 100,000 population, age-adjusted to the 1970 U.S. standard population. Cases of unknown county are included in the State numbers and rates. The dashes indicate fewer than five cases. Incidence rates were not calculated for people of other or unknown race. Source: New Jersey State Cancer Registry.


Table 2
Colorectal Cancer Incidence And Incidence Rates
By County, White Males, New Jersey - 1988-1997*

COUNTY 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997
No. Rate No. Rate No. Rate No. Rate No. Rate No. Rate No. Rate No. Rate No. Rate No. Rate
Atlantic 90 87.4 79 75.1 85 80.5 75 71.8 84 76.5 94 86.9 65 59.2 75 67.1 69 63.4 71 64.8
Bergen 326 71.5 331 71.7 315 67.9 330 69.6 354 75.1 315 65.6 287 60.0 309 64.4 268 55.4 305 62.0
Burlington 144 96.5 94 59.7 118 75.2 101 63.0 118 72.7 100 61.5 111 67.8 127 75.8 111 65.7 111 65.3
Camden 161 78.4 142 70.7 146 70.7 137 65.8 128 62.9 128 59.2 136 65.2 143 66.7 144 67.9 122 58.3
Cape May 74 111.0 59 86.1 63 90.1 64 95.2 58 81.0 60 79.8 47 66.8 54 76.5 44 64.1 50 69.7
Cumberland 45 74.4 42 65.5 43 67.6 47 74.4 52 78.1 41 61.2 48 72.8 32 50.8 49 76.9 43 67.6
Essex 192 71.3 192 71.5 186 71.3 183 69.6 187 71.6 145 56.1 149 57.3 149 57.8 145 57.0 142 55.5
Gloucester 54 62.1 53 60.2 67 77.3 67 70.0 69 71.7 62 64.1 66 69.2 54 56.0 64 64.2 65 63.8
Hudson 188 79.9 181 79.4 182 79.3 169 72.1 172 73.6 161 68.6 134 57.1 135 57.8 139 60.2 144 60.0
Hunterdon 37 83.7 30 69.0 45 99.6 27 58.1 31 68.9 40 81.4 25 49.6 24 48.9 34 64.2 33 64.6
Mercer 118 86.3 100 72.1 96 68.8 121 88.5 114 81.2 80 57.4 84 58.5 77 53.1 96 64.9 79 55.9
Middlesex 225 78.7 223 77.4 226 75.0 195 66.2 221 73.7 213 72.1 206 67.9 192 62.2 243 81.0 218 69.4
Monmouth 184 73.7 170 67.3 190 74.8 196 75.7 167 63.5 181 68.4 195 72.2 179 65.0 204 73.2 185 65.7
Morris 106 59.7 132 75.9 112 60.9 118 64.7 96 50.9 121 64.1 115 58.7 120 61.2 137 68.9 130 64.2
Ocean 236 74.6 273 80.8 275 79.3 251 69.9 249 67.4 235 63.6 233 63.5 251 63.4 255 64.3 260 65.9
Passaic 145 71.2 153 74.6 153 74.5 139 68.7 123 60.7 137 66.3 142 68.0 132 62.6 137 67.0 107 50.9
Salem 22 68.0 22 68.0 16 51.1 22 66.0 19 56.7 13 38.4 20 60.1 24 73.5 21 62.3 16 50.3
Somerset 68 68.5 53 52.8 72 69.0 62 58.1 62 58.8 60 53.1 63 54.2 74 62.9 65 54.2 67 53.2
Sussex 32 67.7 33 66.3 39 82.0 40 81.4 44 85.4 42 83.8 30 58.9 26 47.2 35 65.0 47 84.9
Union 217 87.2 178 72.8 181 72.6 203 82.7 163 65.7 165 66.1 149 59.6 141 56.9 130 51.3 127 48.8
Warren 34 74.1 49 108.4 32 71.4 39 85.2 40 83.7 49 100.8 36 70.9 27 53.3 35 67.5 52 97.1
STATE 2,702 76.4 2,591 72.7 2,647 73.6 2,590 71.3 2,553 69.6 2,446 66.0 2,343 62.5 2,346 62.0 2,427 63.9 2,381 61.8


*Incidence rates - per 100,000 population, age-adjusted to the 1970 U.S. standard population. Cases of unknown county are included in the State numbers and rates. The years 1979-1987 are not included; 1979-1996 are included in earlier reports. Source: New Jersey State Cancer Registry.

Table 3
Colorectal Cancer Incidence And Incidence Rates
By County, White Females, New Jersey - 1988-1997*

COUNTY 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997
No. Rate No. Rate No. Rate No. Rate No. Rate No. Rate No. Rate No. Rate No. Rate No. Rate
Atlantic 75 51.4 82 52.2 93 56.5 71 45.3 80 52.0 83 55.5 77 49.8 76 43.2 78 48.3 70 45.4
Bergen 342 51.3 339 49.7 306 45.3 331 48.0 328 47.2 296 42.3 284 39.2 301 44.4 321 46.3 273 38.8
Burlington 105 49.9 108 52.2 96 44.5 100 44.9 115 49.1 119 51.0 115 48.7 110 47.4 117 50.9 102 42.3
Camden 138 44.9 144 46.8 161 50.7 187 61.3 133 43.2 136 43.8 141 43.2 128 38.8 156 49.9 137 42.6
Cape May 60 65.9 60 68.0 55 63.7 54 57.4 60 60.2 63 51.7 45 40.6 60 54.2 43 43.1 43 41.7
Cumberland 41 48.6 46 50.2 42 45.7 40 44.0 37 39.8 40 41.8 41 44.5 28 31.4 33 37.3 41 48.9
Essex 209 47.1 228 54.0 204 48.4 190 46.6 161 38.3 164 44.1 167 43.3 149 38.5 182 46.7 162 42.1
Gloucester 56 46.0 66 53.5 60 48.9 68 51.9 75 58.7 61 44.7 75 54.9 71 53.8 72 53.2 61 45.5
Hudson 177 47.3 179 49.4 163 43.3 166 45.4 154 43.0 183 49.8 197 53.9 137 39.0 149 39.9 145 37.9
Hunterdon 28 49.3 25 38.0 20 32.0 32 50.3 28 46.7 36 65.5 32 52.5 32 49.6 25 34.6 42 57.8
Mercer 103 52.1 92 47.3 99 47.0 87 40.9 104 49.4 100 43.5 80 35.4 98 45.2 101 47.1 94 42.2
Middlesex 229 58.7 195 49.5 197 48.0 188 45.7 176 42.3 186 44.5 160 38.5 164 39.1 181 43.0 196 45.1
Monmouth 201 52.0 194 50.1 197 53.2 201 51.4 205 51.8 185 46.8 165 42.2 199 46.4 170 43.8 186 42.6
Morris 104 41.1 118 44.4 142 54.2 129 48.6 98 36.4 111 39.0 123 45.4 133 48.1 124 41.5 133 48.3
Ocean 235 49.4 259 51.3 221 42.4 217 41.2 229 43.3 218 40.9 234 43.6 231 40.9 243 40.8 253 46.3
Passaic 162 51.6 154 51.5 139 44.1 143 45.1 149 48.4 137 46.2 129 38.9 115 35.9 115 38.1 128 42.6
Salem 9 18.8 21 49.2 23 53.7 30 61.0 23 52.1 21 45.6 22 47.6 32 70.1 11 24.9 20 36.5
Somerset 55 39.5 52 38.7 80 52.5 45 29.6 69 44.1 59 39.5 54 34.8 67 42.4 46 27.0 68 41.4
Sussex 39 57.4 36 51.8 37 52.0 36 47.7 29 43.0 39 53.6 34 47.1 24 29.5 27 39.2 34 46.5
Union 193 52.7 192 51.3 177 47.8 183 49.7 160 42.1 146 37.8 148 38.4 155 40.5 154 41.8 156 43.1
Warren 40 57.5 27 39.8 52 73.3 41 60.6 35 50.7 41 58.6 31 44.1 36 52.9 39 54.2 37 44.8
STATE 2,602 50.0 2,623 50.0 2,568 48.3 2,549 47.5 2,449 45.3 2,424 44.7 2,356 42.8 2,347 42.5 2,387 43.3 2,381 42.8

*Incidence rates - per 100,000 population, age-adjusted to the 1970 U.S. standard population. Cases of unknown county are included in the State numbers and rates. The years 1979-1987 are not included; 1979-1996 are included in earlier reports. Source: New Jersey State Cancer Registry.

Table 4
Colorectal Cancer Incidence And Incidence Rates
By County, Black Males, New Jersey - 1988-1997*


COUNTY 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997
No. Rate No. Rate No. Rate No. Rate No. Rate No. Rate No. Rate No. Rate No. Rate No. Rate
Atlantic 9 57.6 12 75.4 6 39.4 10 63.0 9 46.1 11 63.3 14 74.3 14 73.0 5 26.0 11 56.2
Bergen 11 81.3 6 34.8 7 48.9 7 44.7 8 44.4 14 88.4 10 59.9 11 61.9 10 51.4 7 35.6
Burlington 13 77.5 11 76.5 10 76.9 20 113.6 12 75.1 13 78.8 12 66.3 13 61.9 12 60.1 12 66.1
Camden 10 42.1 17 72.0 18 66.8 16 64.1 13 48.6 14 48.4 16 55.1 20 66.0 15 49.4 15 53.2
Cumberland 5 84.6 - - - - 5 67.8 7 103.4 - - - - 6 74.4 7 97.8 6 78.8
Essex 73 73.0 63 61.6 70 70.2 67 66.7 75 72.1 62 58.1 59 54.7 85 80.2 78 72.8 62 55.6
Gloucester - - 9 111.7 6 67.3 6 60.5 - - 5 45.1 6 59.7 7 61.5 - - - -
Hudson 8 40.4 13 67.0 14 55.0 12 45.8 15 64.9 12 58.4 14 58.8 14 55.3 17 59.7 26 93.0
Mercer 10 52.8 14 69.3 14 62.7 14 72.8 13 64.2 13 60.1 14 54.7 20 83.4 18 77.9 19 77.7
Middlesex 7 61.2 7 54.5 6 45.8 6 47.9 6 45.4 5 28.2 8 47.1 10 52.6 5 27.7 10 48.0
Monmouth 12 61.1 12 66.7 11 62.0 15 77.8 9 41.7 - - 9 42.1 7 32.5 12 53.1 9 37.7
Passaic 15 90.2 8 39.3 7 37.5 6 24.7 8 36.0 13 62.6 11 48.0 19 77.6 10 43.0 11 42.4
Union 29 98.7 18 49.6 17 61.0 21 65.6 27 86.2 21 56.3 27 82.9 30 90.9 22 62.6 26 65.9
State 213 66.1 206 62.6 211 63.4 215 62.7 215 60.0 203 55.3 217 58.0 266 70.4 228 58.9 244 59.9

*Incidence rates - per 100,000 population, age-adjusted to the 1970 U.S. standard population. Cases of unknown county are included in the State numbers and rates. Counties with six or more years of fewer than five cases each year were removed from the table - Cape May, Hunterdon, Morris, Ocean, Salem, Somerset, Sussex, and Warren counties. The dashes indicate fewer than five cases. The years 1979-1987 are not included; 1979-1996 are included in earlier reports. Source: New Jersey State Cancer Registry.

Table 5
Colorectal Cancer Incidence And Incidence Rates
By County, Black Females, New Jersey - 1988-1997*


COUNTY 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997
No. Rate No. Rate No. Rate No. Rate No. Rate No. Rate No. Rate No. Rate No. Rate No. Rate
Atlantic 15 60.6 15 64.5 10 42.8 9 36.0 15 58.5 13 48.3 14 40.9 10 33.4 12 38.6 19 62.7
Bergen - - 14 58.7 14 57.6 10 41.1 14 59.2 - - 18 65.7 13 51.3 10 33.4 13 45.7
Burlington 12 71.6 7 39.0 11 58.4 9 51.4 7 35.6 15 60.5 10 48.1 8 34.2 9 36.9 10 43.8
Camden 18 53.3 12 34.0 22 59.2 12 30.8 15 38.1 8 20.7 17 40.1 27 63.6 15 33.9 22 49.9
Essex 88 55.9 77 47.1 70 43.9 89 55.0 69 41.0 85 50.1 92 54.9 83 48.9 74 43.4 89 51.3
Hudson 17 52.4 19 54.9 24 72.2 20 59.0 20 58.2 14 40.7 19 53.1 22 62.9 16 43.8 24 64.5
Mercer 10 37.0 12 41.2 7 22.8 20 65.7 9 28.0 18 56.3 19 56.9 16 48.5 18 52.0 20 56.2
Middlesex 6 34.4 5 21.6 10 55.5 9 48.5 10 53.2 10 50.4 8 36.9 9 44.3 14 60.9 14 60.4
Monmouth 9 33.9 9 32.8 13 48.9 11 40.0 14 48.3 9 30.8 16 48.5 14 42.0 15 44.4 11 34.4
Passaic 11 43.5 8 31.2 8 27.9 15 47.0 12 36.1 13 41.1 13 31.4 9 25.9 15 42.5 22 69.3
Union 21 50.5 24 55.3 21 45.1 19 41.0 25 53.1 23 50.0 13 26.9 25 50.7 21 41.2 25 49.0
State 240 50.5 216 44.0 234 47.0 241 46.9 235 45.1 239 44.4 266 47.9 270 48.4 240 41.5 282 48.5

*Incidence rates - per 100,000 population, age-adjusted to the 1970 U.S. standard population. Cases of unknown county are included in the State numbers
and rates. Counties with six or more consecutive years of fewer than five cases each year were removed from the table - Cape May, Cumberland, Gloucester, Hunterdon,
Morris, Ocean, Salem, Somerset, Sussex, and Warren counties. The dashes indicate fewer than five cases. The years 1979-1987 are not included; 1979-1996 are included in earlier reports. Source: New Jersey State Cancer Registry


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