Physical Activity-related Cancers in Mississippi, 2003-2019

Lack of physical activity is a modifiable risk factor that increases the risk of developing certain cancers. According to data from the Behavioral Risk Factor Surveillance System for 2020, 70.0% of Mississippi adults over age 18 reported participating in any physical activity over the past month. Mississippi has the second lowest rate in the nation for participation in physical activity.¹ Lack of physical activity is associated with developing cancers of the colon and uterus, as well as, development of breast cancer after menopause.³ Below are graphs of the trends in physical activity-related cancers over the period 2003 to 2019 by race and sex with a description of the trends occurring in each group both for the full time period and for the most recent period between 2015 and 2019. All analysis was done using SEER*Stat software².

While colon cancer is associated with lack of physical activity, it also associated with other modifiable risk factors, tobacco use, alcohol use, and obesity. Black males had significantly higher rates of colon cancer than white females for all years. Black males had significantly higher rates than black females in 2003, 2008, 2009 and from 2011 to 2019. Black males also had significantly higher rates of colon cancer than white males for 2003 and for the time period from 2006 to 2018. The rate for white females was significantly lower than for white males except for 2009 and 2018 and was significantly lower than for black females all years except 2019. White males, black males, and black females had statistically significant decreasing trends for the full-time period from 2003 to 2019. For white males, the decrease was 1.53% annually, and for black males, the decrease was 0.91% annually. Black females had a decrease of 2.14% annually. White females experienced a significant annual decrease of 2.10% between 2003 and 2013 followed by an observed annual increase of 1.32% between 2013 and 2019.

For the latest five-year time period between 2015 and 2019, only black females had a statistically significant change which was a 3.88% decrease annually. White males and black males both had decreasing trends for this time period. The annual decrease for white males was 1.95% and for black males was 1.08%. For white females, the trend was increasing at an observed rate of 0.80% annually. The combination of this observed increasing trend in white females and the decreasing trends in white males and black females closed the disparity between the rates for white females and both white males and black females in 2017.

Post-menopausal breast cancer is defined as breast cancer diagnosed in women ages 50 and older. Besides lack of physical activity, post-menopausal breast cancer is also associated with obesity. Additionally, female breast cancer, regardless of age, is associated with another modifiable risk factor, alcohol use. The rates of post-menopausal breast cancer by race were very similar over time. The rates of post-menopausal breast cancer between 2003 and 2019 increased significantly by 0.96% annually. The annual percent change for white females was a significant 0.78% and for black females was a significant 1.39%. For the most recent five-year time from 2015 to 2019, white females experienced a significant annual increase of 1.51%. Black females also experienced an annual significant increase over the period of 2013 to 2019 of 2.35%.

While uterine cancer is associated with lack of physical activity, it is also associated with another modifiable risk factor, obesity. Uterine cancer rates increased significantly between 2003 and 2019. The annual percent change over that period of time was 1.94%. Black females experienced a significant increase of 1.73% annually, and white females experienced a significant increase of 1.94%. The trend over the latest five-year period from 2015 to 2019 for black females was an annual increase of 0.89% which was not statistically significant. For white females, there was a decrease of 1.55% annually in contrast to the increase over the full time period. Though black females have rates that are observed to be higher than white females for all years except 2013, these differences are only statistically significant for years 2004, 2008, 2011, 2014, 2016, and 2019.

Definitions

Age Adjusting: A statistical method that allows comparisons of populations that take into account age-distribution differences between the populations. The 2000 U.S. standard population is used and applied to all of the time periods being considered. This assures that the rates do not reflect differences in the age distribution of the population.

Annual Percent Change (APC): The average annual percent change over several years. It is used to measure the change in rates over time. Calculating the APC involves fitting a straight line to the natural logarithm of the data when it is displayed by calendar year.

Statistical Significance: This is a mathematical measure of the difference between groups. A difference is said to be statistically significant if it is greater than what might be expected to happen by chance alone 95% of the time. Rate ratios were used to assess the statistical significance between groups.

Citations

¹Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Division of Population Health. BRFSS Prevalence & Trends Data [online]. 2020. [accessed Apr 25, 2020]. URL: https://www.cdc.gov/brfss/brfssprevalence/.

²Surveillance Research Program, National Cancer Institute SEER*Stat software (seer.cancer.gov/seerstat) version 8.3.9.1.

³National Program of Cancer Registries and Surveillance, Epidemiology and End Results Program SEER*Stat Database: NPCR and SEER Incidence - U.S. Cancer Statistics Public Use Research Database, 2021 Submission (2001-2019). United States Department of Health and Human Services, Centers for Disease Control and Prevention and National Cancer Institute. Released June 2022. Accessed at www.cdc.gov/cancer/uscs/public-use.

Source of Data: SEER*Stat Database: MS0219. Created on 11/30/2021. Mississippi Cancer Registry 2021 Submission (2002-2019) to Centers for Disease Control and Prevention, National Program of Cancer Registries.

Acknowledgement

We acknowledge the Centers for Disease Control and Prevention for their financial support under a cooperative agreement awarded to the Mississippi Cancer Registry.