Direct Age Standardization of Cancer Rates:

HOMEWORK #1 – Direct Age Standardization of Cancer Rates:

First, download and save the two blank Excel worksheets that I have provided: “Incidence.xlsx” and “Mortality.xlsx”; you will need these to enter age-specific rates and calculate age-adjusted rates. Next, go to http://www.kcr.uky.edu , which is the Kentucky Cancer Registry website. By default (without asking for it), you will see a map of the counties in Kentucky showing age-adjusted cancer incidence/mortality rates for all races and both sexes combined during 2015-2019.

Click on “Cancer Incidence Rates in Kentucky” to get started. For this assignment, you are to obtain age-specific case counts for white males, white females, black males, and black females, and enter them into the Excel worksheets (“Incidence.xlsx”). By doing so, you will generate age-specific rates, crude rates, and [directly] age-adjusted rates for all four race / sex groups (see below). You will need to reset sex and race four times to get data for each of the four race / sex groups. Leave “Display Geography” set to “County”, leave “Cancer Site” set to “All Sites”, but change the “Starting” and “Ending” years to “2015 and “2019”. [Use the 2000 U.S Standard Million Population].

Leave the window that says “Invasive Cancer Incidence” as it is. To get data for a specific race / sex subgroup, change the “Sex” and “Race / Ethnicity” settings, then click the “Redraw” button, and wait for the map to change. Next, click the first of the five buttons (“State Data”) at the bottom of the table generated to create a data table with population at risk, total cases, crude rates, and age-adjusted rates for each year from 2015 through 2019; then click the second of four buttons (top of table; counting from the left) to generate a table of “ age-specific rates”.

The last column on the right shows age-specific rates for the 19 age groups during 2015-2019; just to the left of that column is the column listing age-specific case counts for 2015-2019. Copy these case counts, entering zeroes for any that were “suppressed” [blanked-out due to small numbers to protect confidentiality], into the appropriate (orange) column of the Excel worksheet called “Incidence.xlsx”. The age-specific, crude, and age-adjusted rates will be calculated for you.

(There is a separate spreadsheet page for each race / sex group; click the race / sex tab at the bottom of the worksheet to turn the page as needed.) Change race and / or sex in the windows on the website, then click “Redraw” again, and click the appropriate icons again to generate a new data table; repeat until you have data for all four subgroups. (You can print each table for future reference by clicking the printer icon above the table.)

Save “Incidence.xlsx” when finished with it; then open “Mortality.xlsx”. You will have to change to “Cancer Mortality” in the window on the website that says, “Invasive Cancer incidence”, and then you can access death counts the same way you accessed incident case counts. Fill in the death counts on the mortality worksheets, entering zeroes for any values that were “suppressed” [blanked-out due to small numbers to protect confidentiality], and the age-specific, crude, and age-adjusted mortality rates will be calculated automatically, same as for incidence.

Submit responses to these questions and excel files using “EX1” tab on Blackboard.

QUESTIONS

1. Which race/gender recorded the highest number of new cases of cancer between 2015 and 2019?

2. Which race/gender recorded the lowest number of deaths between 2015 and 2019?

3. Comment on the differences between white males and black males in terms of their crude and age-adjusted cancer incidence rates.

4. Why is the crude death rate different from the age-adjusted death rate in all the groups?

5. The group with the lowest age-adjusted incidence rate also had the lowest age-adjusted death rate; True or False?