Cancer By County
Lung And Bronchial Cancer3-6

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Risk Factors

Cigarette smoking is the major cause of lung cancer and is estimated to cause 87 percent of the lung cancer cases. Environmental tobacco smoke (or second-hand smoking) also increases the risk of lung cancer among non-smokers and is estimated to account for about two percent of the lung cancer cases. Smokers of cigars and pipes also are at an increased risk of lung cancer, though not as much as cigarette smokers. Long-term exposure to high levels of radon gas indoors is a risk factor for lung cancer, particularly among smokers.

Occupational exposure to asbestos (workers in mining and milling of asbestos, manufacture of asbestos products, shipbuilding, construction, building maintenance or demolition, asbestos abatement, vehicle brake repair), radon (uranium miners), inorganic arsenic (mining and smelting involving arsenic, pesticide application, wood preservation), polycyclic hydrocarbons (soots, tars, mineral oils, coke oven emissions), chromium (stainless steel production, welding, chromate production, chrome plating, chrome pigment, tanning), chloromethyl methyl ethers (chemical plant workers, laboratory workers, polymer makers), and vinyl chloride (vinyl chloride polymerization) are associated with lung cancer. Smoking combined with exposure to most of these materials compounds the risk of lung cancer. Occupational exposures are estimated to contribute to 13 percent of the lung cancers.

Individuals with a family history of lung cancer or who have a non-malignant lung disease such as tuberculosis or asthma are at higher risk for lung cancer, as are people of lower socio-economic status. Exposure to high levels of ionizing radiation such as from radiation therapy and atomic bomb fallout in Japan increases the risk of lung cancer. Air pollution, particularly the byproducts of the combustion of fossil fuels, appears to increase lung cancer, but it has been difficult to study. Increased vitamins A, C, and E and other micronutrients from eating fresh fruits and vegetables may protect against lung cancer.

Prevention and Control

Nearly all lung cancer could be prevented by avoiding tobacco. Ten years after quitting the ex-smoker's risk of lung cancer is reduced to half that of a person who continues to smoke. Since smoking usually begins in adolesence it is very important to prevent tobacco use among young people. Workers' exposure to carcinogenic substances should be minimized and homes with elevated levels of radon should be remediated. Diets rich in vegetables and fruits also may decrease the chances of lung cancer. Early detection of lung cancer is difficult because the symptoms do not appear until late in the disease process.

Incidence and Mortality in the U.S.

Lung cancer is the third most common cancer in the U.S. with 171,500 new cases estimated for 1998. The incidence rate is higher among men than women and the incidence increases with age. The incidence rate is now declining in men, but is still increasing, though more slowly, in women. This pattern reflects the growing popularity of cigarette smoking among women over the past several decades. The survival rates for lung cancer are 40 percent for one year and 14 percent for five years. The one-year survival rate has increased due to improved surgical treatment.

Approximately 160,100 deaths due to lung cancer are expected to occur in 1998 in the U.S., making it the leading cause of cancer death. Mortality rates due to lung cancer are higher among black men than among white men. Among men lung cancer mortality rates increased greatly between 1940 and 1979 after which the increase slowed. Currently, the mortality rate is declining among men. Conversely, the lung cancer mortality rates among women began to increase sharply in the 1960s and are still increasing. Since 1987, more U.S. women have died each year from lung cancer than from breast cancer, which was the leading cause of cancer death in women for over 40 years previous to 1987.

Incidence in New Jersey - 1986-1996

Tables 28 through 32 contain lung cancer incidence data for the counties for 1986 through 1996. Figure 11 shows the statewide trends. Statewide, black men had much higher rates of lung cancer than white men. White and black women had very similar rates, which were much lower than the rates for black and white men (see Figure 11). This pattern held for all the counties except in Bergen, Cape May, and Gloucester white men had higher rates than black men (see Table 32). In general, the rates of lung cancer declined over the years for black and, especially, white men, while the rates increased slightly for black and white women (see Figure 11). Changing smoking patterns are thought to be responsible for these trends.

Conclusion

The most important means to continue the reduction in lung cancer among men and to reverse the increase in lung cancer among women is avoidance of smoking. Workers' exposures to carcinogenic substances should continue to be minimized and homes with elevated levels of radon should be remediated. Diets rich in vegetables and fruits also may decrease the risk of lung cancer.

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Table 28.
Lung Cancer Incidence
By County, White Males, New Jersey - 1986-19961

COUNTY 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996
(Prelim.)

No.

Rate

No.

Rate

No.

Rate

No.

Rate

No.

Rate

No.

Rate

No.

Rate

No.

Rate

No.

Rate

No.

Rate

No.

Rate

Atlantic

99

103.3

126

125.8

99

98.9

82

82.0

103

101.7

96

92.9

89

85.5

85

83.4

105

98.0

70

63.4

90

80.6

Bergen

370

79.4

370

80.8

391

85.0

347

74.1

366

78.7

352

75.5

350

73.6

341

71.3

343

71.1

341

71.0

288

59.6

Burlington

130

87.4

137

90.8

146

95.0

148

94.0

156

97.8

162

101.8

170

106.8

152

94.3

134

81.8

140

83.6

135

79.3

Camden

202

101.7

198

97.4

205

98.7

166

80.6

215

103.4

212

104.3

185

87.9

201

96.8

197

93.6

171

80.4

198

94.8

Cape May

67

105.3

66

107.5

58

92.0

66

102.7

63

92.4

69

104.8

78

111.0

51

83.3

62

96.6

58

82.1

71

95.3

Cumberland

55

91.5

57

96.1

65

110.3

65

104.3

77

121.4

56

88.8

58

92.7

56

90.9

55

90.1

42

68.5

64

106.5

Essex

219

77.6

198

70.8

205

74.9

206

77.7

189

73.7

208

80.7

177

68.7

184

71.8

173

67.8

174

70.7

181

72.3

Gloucester

85

104.3

90

104.9

100

112.2

79

87.7

105

114.4

92

98.1

105

111.4

106

112.5

97

101.3

95

98.0

95

98.2

Hudson

263

106.6

240

99.2

225

95.6

227

97.3

211

93.6

195

84.4

193

82.9

210

91.1

177

78.0

176

76.0

195

84.7

Hunterdon

43

102.4

27

62.8

33

76.6

37

85.4

29

65.6

44

95.0

46

96.9

39

82.6

37

77.5

49

98.5

26

51.7

Mercer

109

80.2

112

81.6

117

85.8

114

82.9

128

92.3

128

92.6

112

81.2

141

100.3

109

78.7

100

71.8

93

66.2

Middlesex

265

95.7

255

87.5

251

88.5

262

90.2

259

86.2

245

81.5

259

83.9

218

72.4

243

80.1

268

88.0

262

84.7

Monmouth

208

84.7

236

93.5

235

93.9

192

77.0

218

87.3

250

97.0

252

96.0

223

85.5

203

76.7

204

75.3

201

72.5

Morris

132

75.6

143

83.5

150

81.9

149

80.8

151

81.7

146

78.9

126

66.3

129

67.9

133

69.6

133

68.9

132

68.4

Ocean

268

91.4

265

86.4

304

101.0

290

94.9

290

91.6

296

90.5

294

88.3

263

77.7

281

79.8

291

85.6

289

79.9

Passaic

174

84.5

179

87.1

176

86.4

170

85.3

157

77.8

179

89.2

154

77.2

167

83.1

146

73.3

160

78.6

131

63.7

Salem

26

88.1

28

93.1

30

97.3

21

68.0

27

79.1

32

102.4

35

109.2

26

84.4

31

96.8

30

94.0

20

60.5

Somerset

84

80.1

82

82.5

75

72.5

69

67.8

87

79.2

64

59.7

78

69.7

75

66.2

89

79.1

78

68.1

71

60.7

Sussex

46

96.8

52

109.0

53

113.3

48

98.0

35

73.1

46

89.6

49

97.7

60

119.2

56

108.9

41

77.0

43

81.4

Union

192

76.3

187

74.3

213

86.5

184

75.0

165

66.9

185

75.9

184

76.2

156

63.4

161

65.2

155

63.3

158

66.2

Warren

49

115.1

40

91.0

37

81.3

53

121.7

52

110.7

47

101.6

42

85.7

47

100.5

40

80.4

49

97.6

39

74.8

STATE

3086

88.2

3090

87.5

3170

89.6

2976

83.9

3087

86.3

3104

86.3

3037

83.4

2930

80.3

2872

77.8

2825

76.1

2782

74.1


1Incidence rates - per 100,000 males, age-adjusted to the 1970 U.S. standard population. Cases of unknown county are included in the State numbers and rates. Source: New Jersey State Cancer Registry.

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Table 29.
Lung Cancer Incidence
By County1, Black Males, New Jersey - 1986-19961

COUNTY 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996
(Prelim.)

No.

Rate

No.

Rate

No.

Rate

No.

Rate

No.

Rate

No.

Rate

No.

Rate

No.

Rate

No.

Rate

No.

Rate

No.

Rate

Atlantic

18

121.5

16

107.2

20

139.1

18

115.5

9

54.4

16

100.1

16

100.3

17

98.2

9

49.3

16

81.4

19

105.7

Bergen

11

84.1

5

36.0

11

74.7

12

69.7

16

95.9

20

122.2

14

81.0

15

94.5

6

38.7

10

55.4

13

64.8

Burlington

17

113.3

15

106.4

27

172.6

22

128.5

25

142.8

17

113.8

9

53.0

21

106.2

19

92.4

10

51.3

17

80.1

Camden

31

128.1

34

131.4

34

132.4

33

124.7

35

129.7

25

94.4

39

145.1

36

127.2

24

87.1

32

104.0

30

96.1

Cumberland

7

98.1

15

229.5

15

221.0

13

196.2

12

179.2

13

191.0

10

150.0

15

180.4

8

94.5

17

224.8

12

154.8

Essex

137

140.3

140

137.1

146

147.7

145

141.9

136

130.5

152

148.1

130

127.4

139

129.8

133

126.5

125

118.3

117

108.3

Gloucester

13

161.9

7

84.6

13

158.1

7

83.4

---

---

9

94.6

14

148.2

9

93.3

10

98.7

---

---

11

94.6

Hudson

33

154.0

31

145.4

30

139.9

20

79.9

24

102.3

23

97.0

31

138.4

31

126.9

19

74.2

13

59.4

29

110.7

Mercer

26

127.0

25

123.3

41

200.6

26

134.9

36

161.2

22

99.3

24

102.6

28

121.8

29

131.2

28

110.7

26

106.9

Middlesex

12

91.0

20

149.4

13

92.5

17

125.6

20

140.2

17

122.9

15

91.1

22

162.6

18

112.9

16

98.6

14

83.7

Monmouth

22

118.0

12

64.8

21

114.6

21

111.9

12

65.8

14

74.0

18

85.3

24

116.8

28

130.6

21

94.6

25

104.2

Passaic

28

163.7

27

130.3

16

79.7

22

110.6

14

65.0

18

86.9

20

104.1

28

146.2

15

68.5

22

100.4

20

85.8

Salem

9

208.0

6

155.2

5

103.6

5

125.1

11

238.5

---

---

6

132.7

6

120.6

---

---

7

138.6

---

---

Union

34

117.2

39

122.9

39

138.4

32

96.9

36

108.1

33

102.7

36

109.9

39

126.6

38

112.9

36

100.7

29

79.2

STATE

408

127.0

399

121.3

443

136.2

407

119.8

404

115.4

404

117.2

403

114.1

446

123.2

378

102.2

368

97.5

384

97.0


1Incidence rates - per 100,000 males, 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, Somerset, Sussex, and Warren counties. The dashes indicate fewer than five cases. Source: New Jersey State Cancer Registry.

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Table 30.
Lung Cancer Incidence
By County, White Females, New Jersey - 1986-19961

COUNTY 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996
(Prelim.)

No.

Rate

No.

Rate

No.

Rate

No.

Rate

No.

Rate

No.

Rate

No.

Rate

No.

Rate

No.

Rate

No.

Rate

No.

Rate

Atlantic

61

44.3

59

47.8

78

62.3

72

50.3

76

57.1

85

61.0

74

58.4

74

52.6

74

52.2

76

57.2

68

46.9

Bergen

226

37.8

251

41.7

251

41.9

234

39.1

258

42.9

277

45.8

270

43.5

255

42.9

251

40.7

229

37.0

264

41.9

Burlington

64

34.4

80

41.6

75

36.3

90

45.8

95

45.6

92

45.8

94

46.2

123

60.6

95

46.9

96

44.8

103

48.9

Camden

97

37.4

130

46.6

129

47.7

128

48.3

124

45.8

142

51.5

142

49.3

139

53.1

163

59.8

155

54.8

125

43.6

Cape May

31

45.9

28

38.0

54

65.9

52

66.0

34

45.3

50

56.1

53

65.5

47

55.9

52

66.0

49

51.7

52

62.4

Cumberland

28

33.3

28

36.8

38

47.8

30

37.1

37

43.5

49

56.8

46

58.2

42

56.9

41

50.3

28

36.3

41

52.3

Essex

152

37.7

126

34.1

155

41.7

135

37.5

131

36.9

132

36.1

142

38.6

133

39.0

139

37.5

169

45.9

149

42.3

Gloucester

52

49.1

47

44.0

58

51.9

61

54.2

56

47.3

51

43.8

50

42.4

66

54.1

68

55.4

70

58.5

71

57.9

Hudson

123

35.6

134

41.9

160

46.7

159

49.1

154

47.7

109

35.4

128

39.9

130

40.6

130

40.4

133

39.9

135

40.9

Hunterdon

18

33.2

17

31.6

24

41.1

21

37.0

29

52.3

24

39.7

36

62.4

22

35.8

36

59.1

29

47.7

22

40.8

Mercer

75

42.1

60

33.3

66

33.4

80

43.4

83

45.3

90

46.4

76

40.6

81

43.2

72

39.4

77

43.5

109

60.3

Middlesex

128

36.7

156

43.5

154

41.7

163

44.1

168

43.3

193

51.1

173

44.2

180

45.8

164

42.1

185

46.9

217

55.2

Monmouth

138

42.4

144

42.8

180

53.3

157

47.7

185

55.9

170

51.1

181

52.1

171

49.6

182

52.5

177

53.2

175

50.2

Morris

88

37.5

102

43.3

97

41.4

109

45.7

86

35.8

107

42.5

101

41.7

110

44.4

110

42.9

116

44.9

115

44.9

Ocean

159

42.8

169

45.1

168

42.8

183

44.3

228

51.0

186

44.1

204

50.0

225

55.1

216

52.1

218

47.7

245

54.4

Passaic

101

36.0

105

37.2

106

39.8

117

44.0

118

43.6

100

35.9

106

38.4

104

36.8

94

35.8

121

44.3

104

38.5

Salem

18

47.1

12

32.0

19

48.2

20

51.0

22

55.5

15

35.1

18

48.4

18

42.1

20

50.6

22

63.2

21

50.0

Somerset

41

34.2

40

32.0

47

35.9

35

26.5

54

37.5

55

42.2

58

40.8

66

46.1

46

30.8

44

30.4

55

36.7

Sussex

24

42.0

24

43.3

31

48.2

28

41.2

30

45.0

45

69.9

29

43.9

38

59.3

25

36.5

36

55.9

29

40.5

Union

116

34.0

118

35.7

114

34.8

123

36.6

130

40.6

136

42.7

103

31.7

127

39.3

118

35.6

118

35.6

120

37.6

Warren

24

37.7

25

41.8

22

38.4

36

58.3

30

51.7

26

44.4

34

54.2

30

42.9

38

63.2

33

54.1

37

61.8

STATE

1764

38.3

1855

40.4

2026

43.5

2033

43.7

2132

45.2

2134

45.3

2118

44.3

2181

46.0

2135

44.6

2181

45.1

2257

46.4


1Incidence rates - per 100,000 females, age-adjusted to the 1970 U.S. standard population. Cases of unknown county are included in the State numbers and rates. Source: New Jersey State Cancer Registry.

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Table 31.
Lung Cancer Incidence
By County1, Black Females, New Jersey - 1986-19961

COUNTY 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996
(Prelim.)

No.

Rate

No.

Rate

No.

Rate

No.

Rate

No.

Rate

No.

Rate

No.

Rate

No.

Rate

No.

Rate

No.

Rate

No.

Rate

Atlantic

15

70.7

15

72.5

12

52.1

14

64.2

8

34.5

18

70.3

15

62.5

14

59.1

8

29.6

15

47.2

16

55.8

Bergen

10

49.2

13

60.1

8

36.7

7

33.0

---

---

7

28.4

7

30.8

6

26.3

14

53.1

7

26.6

6

24.0

Burlington

8

48.9

7

34.9

8

37.8

8

40.5

11

51.4

11

43.4

6

30.6

9

46.3

9

39.4

8

29.7

13

51.4

Camden

19

58.8

14

41.6

11

32.5

13

36.9

15

40.2

17

46.7

27

70.3

19

47.0

20

48.0

21

49.1

20

47.5

Cumberland

---

---

5

54.8

---

---

---

---

5

53.0

6

56.1

10

85.7

5

50.1

7

64.0

---

---

---

---

Essex

59

39.2

65

43.6

76

49.4

64

42.0

69

44.3

65

41.5

68

42.3

75

45.4

92

55.6

78

46.7

69

41.1

Gloucester

5

52.9

---

---

---

---

6

49.2

6

49.6

6

49.5

6

46.2

5

38.6

7

45.2

---

---

6

40.9

Hudson

8

23.3

13

38.1

15

46.7

17

52.2

16

45.1

16

44.6

16

43.5

13

35.3

19

52.1

17

45.6

8

20.4

Mercer

9

33.8

7

25.2

12

40.6

11

36.9

13

43.4

9

29.0

14

43.5

14

43.1

19

57.6

10

30.3

15

42.7

Middlesex

---

---

6

38.0

5

29.4

---

---

6

29.4

7

40.9

6

32.4

9

41.6

10

50.5

10

44.3

10

42.1

Monmouth

14

57.8

---

---

10

41.6

7

26.9

13

51.3

11

42.0

7

24.8

15

49.3

23

76.5

7

22.4

10

32.2

Passaic

9

36.8

11

44.9

12

45.3

7

27.5

6

24.4

14

44.6

9

32.2

10

33.8

10

32.8

17

50.7

5

16.1

Union

13

31.6

15

35.6

20

46.5

23

53.5

16

36.7

25

53.9

19

39.1

17

37.9

16

32.9

22

44.0

18

37.4

STATE

185

41.2

189

41.2

200

42.5

198

41.7

197

40.6

225

45.0

221

43.0

225

42.8

264

49.3

233

42.0

213

38.0


1Incidence rates - per 100,000 females, 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. Source: New Jersey State Cancer Registry.

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Table 32.
Lung Cancer Incidence
By County, Race And Gender, New Jersey - 1986-1996 Combined1

COUNTY

MALE

FEMALE

WHITE

BLACK

WHITE

BLACK

Number

Rate2

Number

Rate2

Number

Rate2

Number

Rate2

Atlantic

1044

92.0

174

96.5

797

53.6

150

55.7

Bergen

3859

74.5

133

73.5

2766

41.4

88

34.2

Burlington

1610

92.2

199

102.9

1007

45.4

98

41.3

Camden

2150

94.7

353

117.0

1474

48.8

196

47.4

Cape May

709

97.4

22

87.6

502

56.2

27

68.6

Cumberland

650

95.9

137

174.4

408

46.3

51

44.4

Essex

2114

73.5

1500

132.0

1563

39.0

780

44.7

Gloucester

1049

103.8

100

97.3

650

50.7

56

40.6

Hudson

2312

90.3

284

110.5

1495

41.7

158

40.8

Hunterdon

410

81.1

---

---

278

43.7

---

---

Mercer

1263

82.9

311

128.0

869

42.8

133

39.1

Middlesex

2787

85.4

184

114.9

1881

45.1

76

36.6

Monmouth

2422

85.4

218

99.0

1860

50.0

121

40.0

Morris

1524

74.3

41

95.6

1141

42.3

24

38.7

Ocean

3131

87.6

43

105.2

2201

48.2

14

26.1

Passaic

1793

80.4

230

102.5

1176

38.9

110

35.0

Salem

306

87.9

65

128.7

205

48.1

36

54.4

Somerset

852

71.4

44

82.0

541

35.9

23

37.0

Sussex

529

96.8

---

---

339

47.9

---

---

Union

1940

71.8

391

110.0

1323

36.8

204

40.9

Warren

495

96.8

6

118.3

335

49.8

---

---

STATE

32959

83.0

4444

114.8

22816

43.9

2350

42.5


1Incidence rates - per 100,000 females, 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. Source: New Jersey State Cancer Registry.
2Average annual rate.

Figure 11.

Figure 11
*1996 data are preliminary. Source: New Jersey State Cancer Registry.