Lung Cancer Morbidity Rates in US: Baltimore City vs Chicago



Lung Cancer Morbidity Rates in US: Baltimore City vs ChicagoGroup 3Promise Okafor AmadiCalandra DysonLyliane MbahMonique VeneyCoppin State UniversityNURS 520 EpidemiologyDr. Robin Warren-DorseyMarch 25, 2015Lung Cancer Morbidity Rates in US: Baltimore City vs ChicagoTremendous advances in health care and technology have paved the way for a healthier, longer living American population. According to CDC data, in the last 40 years alone since 1970, the life expectancy of the average United States citizen has risen 11% to 78.7 years from 70.8 years (Centers for Disease Control and Prevention [CDC], 2013). Although health disparities and life expectancy differences still exist between races, the perspective seen is an overall improvement in the nation’s health. However, despite living in an era in which we are universally living longer than our fore parents could have even imagined, a significant portion of the population are becoming sick from and dying from seemingly preventable illnesses such as heart disease, diabetes and various types of cancers. The most recent available statistics from 2009 and 2010 list heart disease and malignant cancers as the leading causes of death among all Americans of all ages and races. These top two diseases alone are accountable for nearly half of all deaths combined (National Center for Health Statistics. [NCHS], 2013); however, the remainder of this discussion will focus primarily on the morbidity associated with lung cancer, particularly in Baltimore City, Maryland and Chicago, Illinois. Lung cancer continues to be the leading cause of all cancer deaths in the United States of America. According to the Centers for Disease Control and Prevention, in 2011, “207,339 people in the United States were diagnosed with [morbidity] lung cancer, including 110,322 men and 97,017 women” and “156,953 people in the United States died from lung cancer [mortality], including 86,736 men and 70,217 women” (Centers for Disease Control and Prevention: Lung Cancer website, 2014, para. 1). Lung cancer is a disease in which cancer cells grow out of control in the lung tissue. Lung cancers are usually grouped into two main types: small cell and non-small cell. The categories refer to what the cancer cells look like under a microscopic examination. Non-small cell lung cancer is more common that small cell lung cancer (Centers for Disease Control and Prevention [CDC], 2014). The risk factors for lung cancer include smoking, second-hand smoke, radon, personal or family history of lung cancer and radiation therapy to the chest. Smoking is the number one risk factor for lung cancer. In the U.S., smoking is linked to 90% of lung cancers. Second hand smoke or smoke inhalation from other people’s cigarettes, pipes or cigars also can cause lung cancer (CDC, 2014). Radon is a naturally occurring gas that comes from rocks and dirt that gets trapped in houses and buildings. Although this gas cannot be seen, tasted, or smelled, it also has been linked to lung cancer. Asbestos fiber is another cause of lung cancer. This material contains a silicate fiber that lines the lungs of the exposed person for almost the life time of the carrier. This mode of infection is very common in work places where the substance is utilized to insulate acoustic insulation and thermal pipes. In some parts of the United States the use of asbestos has since been prohibited (CDC, 2014). One factor that cannot been controlled, genetics or family history is also a risk factor for developing lung cancer. Your risk for developing lung cancer may be higher if your parents, brothers, sisters or children have had lung cancer. If you are a lung cancer survivor, there is a risk that you may develop another lung cancer at another time. Additionally, cancer survivors who have had radiation therapy to the chest are at a higher risk of lung cancer (CDC, 2014).Identification of lung cancer usually depends on identification of symptoms and then further diagnostic testing. Some symptoms of lung cancer include coughing that gets worse or doesn’t go away, chest pain, shortness of breath, wheezing, coughing up blood, extreme fatigue or feeling very tired all the time and unintentional weight loss (CDC, 2014). There are no recommended screening intervals or protocols established for detecting lung cancer. However, the recommended screening test for lung cancer is low-dose computed tomography (low-dose CT scan). This test is done by allowing an X-ray machine to scan body and using low doses of radiation to take detailed pictures of the lungs. Candidates for screening include people who have a history of heavy smoking, currently smoke or have quit smoking within the past 15 years and are between 55 and 80 years old (CDC, 2014).If lung cancer is diagnosed, testing is done to find out how far it has spread through the lungs, lymph nodes and the rest of the body. Testing includes MRI, PET scan, CT scan, radionuclide bone scan, pulmonary function test, endoscopic ultrasound, mediastinoscopy, anterior mediastinotomy, lymph node biopsy and bone marrow aspiration and biopsy (National Cancer Institute at the National Institutes of Health, 2014).According to the American Lung Association (ALA), treatment approach will depend on the type of lung cancer, stage of the cancer, other present health issues, and patient preferences (ALA, 2015). The main treatment approach for either Non-Small Lung Cancer (NSCLC) or Small Cell Lung Cancer (SCLC) will include; surgery, radiation, chemotherapy, and laser therapy (2015).? With surgical approach, the cancer cell or affected lobe or the entire lung maybe removed (ALA, 2015). Radiation is usually done in combination with surgery or chemotherapy, and in some cases both (ALA, 2015). Another approach for treatment is chemotherapy, which is done to control the progression and spread of cancer (ALA, 2015). Other than the side effects of chemotherapy, the main concern is that it only a small number of people can be cured with this approach (ALA, 2015). With laser therapy, a highly focused beam of light is used to kill the cancer cell (ALA, 2015).? Other treatment approaches specific for NSCLC includes: watchful waiting, targeted therapy, photodynamic therapy, cryosurgery, and electrocautery (ALA, 2015). The doctor can watch the patient closely and treatment is initiated once the patient starts to show symptoms or experience changes (ALA, 2015). Watchful waiting is used only in some rare cases of lung cancer (ALA, 2015).?In target therapy, medications such as a tyrosine kinase inhibitor are used to block cancer cell growth (ALA, 2015).? The photodynamic therapy consists of the use of medicine and a particular light to treat the cancer (ALA, 2015). Cryosurgery will freeze and destroy the lung tumor (ALA, 2015). The electrocautery approach uses a low-voltage electrical charge to destroy the cancerous tumors (ALA, 2015). Lung cancer has been a major killer and has constituted a heavy burden to United States population and healthcare as a whole. The morbidity and mortality rates have declined, however, in the last decade because of efforts made through awareness and education by the governmental and advocacy agencies and authorities. Cigarette smoking is the major cause of lung cancer in United States. People that smoke about 3 packs of cigarette per year have an increased risk of getting lung cancer. The more packs you smoke, the higher the risk becomes. Passive smoking is when you are exposed to and inhale cigarette smoke from the environment. Chances of getting lung disease in this way is about 24%. Studies have shown that a lot of United States citizen have died as result of second hand smoke inhalation. For this reason, various states have introduced laws to protect citizens from this disease by introducing smoke free regulations in all public places and about 50 feet away from public buildings (World Health Organization, 2003). The burden associated with lung cancer disease not only includes morbidity, but also encompasses mortality rate, loss of?revenue in treating these patient and loss of income from the family of the patient affected. This has a direct impact on national productivity figures, so much so, that the federal government is spending enormous resources in combating its effects including giving incentives to pharmaceutical companies and educating the public on the danger associated with smoking and second hand smoke (CDC, 2014). Notwithstanding, lung cancer still poses a major concern for our nation as a whole as the number one cancer killer of all Americans. For illustration purposes, a comparison of the effects of lung cancer morbidity in two major U.S. urban cities Baltimore, MD and Chicago, IL, will be evaluated.United States Census Bureau statistics from 2010, the last year available, lists the population of Baltimore City at 620,961 down from 651,154 in the decade prior. Likewise, the population of Chicago was noted to be 620, 961 in 2010, a 21% decline from more than 2 million residents in 2000 population count (U.S. Census Bureau, 2000, 2010). Both Baltimore and Chicago are considered to major urban metropolitan cities with similar population figures, as recorded by the 2010 census. However, based on surveillance data obtained from both city health departments, the morbidity rate from lung cancer in each city is remarkably different. While Baltimore City carries an 823/100,000 residents or 0.82% lung cancer morbidity rate, Chicago’s rate is 2.57% (2,572/100,000 residents) (Center for Disease Control, 2015Illinois Department of Public Health, 2015). The difference between these two similarly populated cities is a staggering 31%.Knowing the morbidity and mortality rates for specific disease processes, such as lung cancer, in specific cities and regions of the country allows research and prevention efforts to be geared or target toward those specific regions or populations. This in turn will ultimately help to further eradicate fatal diseases, increase national productivity, decrease healthcare costs, increase longevity and improve the nation’s overall health.ReferencesAmerican Lung Association (ALA), 2015. Lung cancer: Making Treatment decision. Retrieved on March 18, 2015 from Center for Cancer Surveillance and Control Maryland Department of Health and Mental Hygiene. Retrieved on March 18, 2015 from Centers for Disease Control and Prevention. (2013). How did cause of death contribute to racial differences in life expectancy in the United States in 2010? (NCHS Data Brief Number 125). Washington, DC: Government Printing Office.Division of Cancer Prevention and Control, Centers for Disease Control and Prevention. (2014). How is Lung Cancer Diagnosed and Treated? Retrieved from Division of Cancer Prevention and Control, Centers for Disease Control and Prevention. (2014). What are the Risk Factors? Retrieved from Division of Cancer Prevention and Control, Centers for Disease Control and Prevention. (2014). What Screening Tests are There? Retrieved from Division of Cancer Prevention and Control, Centers for Disease Control and Prevention. (2014). What are the Symptoms? Retrieved from Division of Cancer Prevention and Control, Centers for Disease Control and Prevention. (2014). What is Lung Cancer? Retrieved from Heron, M. (2013). Deaths: Leading causes for 2010 (National Vital Statistics Reports Vol 62 No 6). Retrieved from National Vital Statistics Reports: Department of Public Health. Cancer in Illinois Statistics. Retrieved on March 20, 2015 from National Cancer Institute at the National Institutes of Health. (2014). Non-Small Cell Lung Cancer Treatment. Retrieved from United States Census Bureau. (2000). General Population and Housing Characteristics, Baltimore City. Retrieved from United States Census Bureau. (2010). General Population and Housing Characteristics, Baltimore City. Retrieved from United States Census Bureau. (2000). General Population and Housing Characteristics, Chicago. Retrieved from United States Census Bureau. (2010). General Population and Housing Characteristics, Chicago. Retrieved from World Health Organization [WHO]. (2003). Lung Cancer. ................
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