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© 1996 Oxford University Press

research-article

Urbanicity-Related Trends in Lung Cancer Mortality in US Counties: White Females and White Males, 1970–1987

KAREN KAFADAR*, LAURENCE S FREEDMAN**, COLIN R GOODALL{dagger} and JOHN W TUKEY{ddagger}

*Department of Mathematics, Box 170, University of Colorando-Denver Denver, Colorando, 80217-3364, USA.
**Biometry Branch, Division of Cancer Prevention and Control National Cancer Institute Bethesda, Maryland, USA.
{dagger}Department of Statistics, The Pennsylvania State University University Park, Pennsylvania, USA.
{ddagger}Department of Statistics, Princeton University Princeton, New Jersey, USA.

Kafadar K (Derpartment of Mathematics. Box 170. University of Colorada-Denver. PO Box 173364, Danver CO 80217-3364, USA), Freedman L S, Goodall CR and Tukey J W Urbanicity-related trends in lung cancer mortality in US conties: white females and white males, 1970–1987.International journal of Epidemiology 1996; 25: 918–932.

BACKGROUND: The effect of urbanization on age-adjusted lung cancer mortality rates in US countries is investagated. The data come from National Cancer Institute, and urban trends are estimated in time periods 1970–1979 aand 1980–1987, for both white males and white females. To account for possibly different gradients in different parts of the country, the 48 contiguous states are divided into seven regions.

METHODS: A measure of urbannes, urbanicity, is defined and is used to stratify counties. A multiplicative model is proposed that relates county mortality raters to urbanicity. The residuals from this multiplicative model serve as age and urban-adjusted rates.

RESULTS: Urban-rural gradients are significant for nearly all regions for both white males and white females, diminishing slightly in the latter time period for white males but becoming stronger for whito females.

CONCLUSIONS: The age and urban-adjusted rates may be used in mapping to investigate geographical patterns that remain after removal of the urban factor.

Keywords geographical epidemiology, urbanicity, smoothing, Poisson, exploratory data analysis

Revised 1 March 1996


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