Higher Rates

Health-care experts blame smoking and obesity for higher rates of certain cancers in Fulton and Montgomery counties compared to the state averages.

The counties exceed the average annual state rates for 2007-11 in lung and bronchial, colorectal and bladder cancers, while being lower for prostate and female breast cancers, based on the state Health Department’s Cancer Registry. These disparities are generally paralleled in the Capital District counties of Schenectady, Albany, Saratoga and Rensselaer.

The Fulton County incidence of lung and bronchial per 100,000 males is 91.8 and 71.3 for females, compared with the state rates of 75.5 and 55.7, respectively. Similarly, Fulton County’s mortality rates for this cancer is 64 per 100,000 males and 45.5 for females, versus state rates of 52.6 and 35.4.

Likewise, Montgomery County’s incidence is 81.8 for males and 76.6 for females, and the mortality rate is 63.3 for males and 37.4 for females.

Michael Seilback, vice president for public policy and communications with the American Lung Associations of the Northeast, said higher lung and bronchial cancer rates and mortality parallel smoking rates.

“We know that smoking rates are higher upstate than downstate,” he said.

While smoking rates have been dropping statewide, the decrease is more dramatic in the New York City area, where higher tobacco taxes and smoke-free zone laws were implemented sooner and the city health department has been aggressive in encouraging smoking cessation, Seilback said.

Dr. Leslie Kohman, chief medical officer for the Eastern Division of the American Cancer Society, agrees “smoking is going to be the main indicator.”

Using state and national statistics, Kohman pointed out average annual smoking rates are higher in Fulton and Montgomery counties: 24.6 percent in Fulton County and 23 percent in Montgomery County, compared with the state’s 18 percent and the nation’s 21 percent.

She also says higher incidence and mortality for urinary bladder cancer in the two counties also are smoking related. Per 100,000, incidence rates for Fulton County for males and females are 47.7 and 14.7, and mortality rates, 10.9 and 0.9, respectively.

Similarly, Montgomery County’s incidence rates are 60.4 and 12, and mortality rates are 10.3 and 2.8. Comparable statewide incidence rates are 41.9 and 10.6, while mortality is 7.9 and 2.3, the only positive difference being a lower female mortality rate in Fulton County.

Among cancers, lung and bronchial cancer is the No. 1 killer, with only a five-year average survival rate, said Seilback.

“It’s killing an awful lot of people,” he said.

It is the deadliest form of cancer in the state, claiming more than 4,700 males and 4,300 females annually, according to Health Department numbers. Lung cancer may take time to develop. Because more men than women are current and former smokers, they are diagnosed with lung cancer more often, but women have begun to catch up.

What makes lung cancer so deadly is it can be well-advanced and even metastasized – or spread – beyond the lungs before a diagnosis is made, Seilback said. He noted early general symptoms such as a cough or back pain might be dismissed by the smoker as nothing unusual.

Colorectal cancer incidence and mortality per 100,000 is also higher than the state average in Fulton and Montgomery counties. Fulton County’s incidence is 55.3 for males and 50.6 for females, while mortality rates are 25.3 for men and 16.9 for women. Montgomery County’s incidence is 60.6 and 48.8, and mortality, 15.6 and 12.9. Both exceed the state average incidence of 51.6 and 39.8 and mortality of 18.4 and 13.2, except for a lower mortality rate for men in Montgomery County.

The factors predisposing the public to cancer are many, such as family history, socioeconomics, ethnicity, exposure to cancer-causing substances called carcinogens, poor diet, lack of exercise and radiation.

Dr. Kohman says weight control, diets containing more fruits and vegetables, and exercise are the most important factors in reducing the incidence of colorectal cancer.

She singled out obesity as the most important predisposing factor. Compared with the statewide average obesity rate of 24.5 percent, Fulton County’s rate is 27 percent and Montgomery County’s is 31 percent, she said.

Cancer of the prostate, which is a male organ below the bladder, is less frequent in Fulton and Montgomery counties than the statewide average. Fulton County’s incidence is 151.7 and Montgomery County’s is 127.8, compared with the state’s 163.4. At a 21.8 mortality rate, Fulton County is a little higher than the state’s 21.2, while Montgomery County’s is lower, at 15.5.

While state statistics show prostate cancer to be the most common cancer among men in the state – at 16,000 cases annually, resulting in more than 1,700 deaths, – little is proven regarding what lifestyle changes reduce the risk. Kohman said 99 percent of men who have prostate cancer, even into their 90s, don’t die from it.

Female breast cancer incidence and mortality are also lower in Fulton and Montgomery counties: Fulton’s incidence and mortality rates are 123.3 and 19.5, respectively, compared with the state’s 28.6 and 21.7, while Montgomery County’s is much lower, at 106.4 and 13.1.

Possible ways to reduce risk include drinking less alcohol, regular exercise, maintaining a healthy weight, breastfeeding for at least the baby’s first six months, and discussing with the woman’s health-care provider the risk-benefits of hormone replacement therapy. Kohman said no correlation between smoking and breast cancer has been established.