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CANCER IN KITSAP COUNTY BACKGROUND Cancer is complex, can have many possible causes, and is common in the U.S. 1 in 2 males and 1 in 3 females is at risk of developing cancer in their lifetime; 1 in 4 males and 1 in 5 females is at risk of dying from cancer in their lifetime. Risk factors for cancer include genetic factors, lifestyle factors -- tobacco use, diet, physical activity -- certain infections, and environmental exposures to different chemicals and radiation.* Two important factors to consider: the time between exposure or other cause(s) and cancer diagnosis can be quite long; access to health care services influences cancer screening frequency, detection, and treatment. NEW CASES OF CANCER (INCIDENCE) During 2011-2013 on average each year, 1,683 Kitsap residents were diagnosed with cancer.^ The rate of cancer incidence is statistically unchanged over time in WA State, Kitsap County and in all areas of the county. The rates of cancer incidence in all areas of the county are not statistically different compared to the county average. The most commonly diagnosed types of cancer are listed in table 1. in order of the number of Kitsap residents diagnosed on average each year from 2011 to 2013. Figure 1. Age-Adjusted Cancer Incidence Rate per 100,000 Source: WA State Dept. of Health, Cancer Registry, Accessed in CHAT. Trend assessed using JoinPoint Regression Program 4.3.1.0. Age Adjusted Rate per 100,000 Population Kitsap and WA trends over time statistically unchanged 600 Table 1. Diagnosis Group Breast Prostate Skin Lung and Bronchus Urinary System (includes bladder and kidney) 550 500 450 400 350 1996-1998 1999-2001 2002-2004 WA State 2005-2007 2008-2010 2011-2013 Kitsap County KITSAP CANCER INCIDENCE RATES PER 100,000 BY SUBGROUP Table 2. Sub-county regions BAINBRIDGE ISLAND BREMERTON CENTRAL KITSAP NORTH KITSAP SOUTH KITSAP 1996-98 515 556 562 488 558 2011-13 541 519 551 562 545 TREND ------ Compared to Kitsap same same same same same 2011-13 Figure 2. Female Male Figure 3. Figure 4. 517 584 * http://www.cancer.org/cancer/cancerbasics/lifetime-probability-of-developing-or-dying-from-cancer ^ Cancer Registry, WA State Dept. of Health, accessed in CHAT. Average # per Year 268 243 192 181 124 CANCER DEATHS (MORTALITY) Cancer is the second most common cause of death among WA State and Kitsap County residents accounting for about 1 in 4 deaths.^ Cancer is the most common cause of premature death (death before age 65). In 2015, 497 Kitsap residents died from cancer and cancer contributed to the deaths of an additional 45 residents. The rate of cancer deaths is statistically decreasing over time in WA State, Kitsap County, and in the all areas of the county as shown in figure 5 and table 4 below. The rates of cancer mortality in all areas of the county are not statistically different compared to the county average, except for Bainbridge which was statistically lower than the county average in 2013-15. The most common types of cancer deaths are listed in table 3 in order of the number of Kitsap residents who died on average each year from 2013 to 2015.^ Figure 5. Age-Adjusted Cancer Death Rate per 100,000 (primary cause) Table 3. Diagnosis Group Source: WA State Dept. of Health, Death Certificate Database, Accessed in CHAT. Trend assessed using JoinPoint Regression Program 4.3.1.0. Age Adjusted Rate per 100,000 Population Kitsap and WA trends over time statistically decreasing Lung and Bronchus Pancreas Breast Prostate Urinary System (includes bladder and kidney) 230 210 190 170 150 WA State 130 Kitsap County 110 Average # per Year 90 70 50 1992-1994 1995-1997 1998-2000 2001-2003 2004-2006 2007-2009 2010-2012 2013-2015 KITSAP CANCER DEATH RATES PER 100,000 BY SUBGROUP Table 4. Sub-county Regions BAINBRIDGE ISLAND BREMERTON CENTRAL KITSAP NORTH KITSAP SOUTH KITSAP 1992-94 197 212 210 204 245 2013-15 106 170 145 143 173 Compared TREND to Kitsap lower same same same same 2013-15 Figure 6. Female Figure 7. White Black/African-American 127 103 American Indian/Alaskan Native 165 Asian 141 Pacific Islander Male 179 Prepared by: Kitsap Public Health District, 11/4/16 ^ Cancer Registry, WA State Dept. of Health, accessed in CHAT. Figure 8. 152 343 Multi-Race 98 Hispanic 94 127 35 34 29 28