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Utah has the lowest overall cancer rate in the nation, thanks mostly to the small percentage of smokers in the state.

The Utah Cancer Registry has completed a report analyzing the incidence rates for the 10 most common malignant cancers during the 10-year period 1978-87. The report compares the overall state cancer incident rate to the national rate as well as individual county rates to the state and national rates. It is the first time the Utah Cancer Registry has compiled 10-year comparative data on a county-by-county basis, said Dr. William P. McWhorter, director."It shows in general that it is good health habits that are responsible for lower overall cancer rates, particularly smoking," McWhorter said. "We can see the results of this even on a county level."

The report is being sent to physicians throughout the state, and will be submitted to the National Cancer Institute. Data in the study is based on number of cases per 100,000 people per year; all rates have been age-adjusted. Comparisons to the national average have a 95 percent confidence rate; state comparisons have an 85 percent confidence rate.

Utah's overall cancer incidence rate is 17 percent below the national average. In six of the 10 categories of cancer the state average is significantly lower than the national average. Twenty-eight of the 29 counties in Utah have overall cancer rates below the national rate.

"The statewide data shows Utah has low cancer incidence in general compared to the rest of the country," McWhorter said. "It has the lowest overall cancer rate of any state I know of."

Utah and Cache counties have statistically significant lower overall cancer rates than both the state and national averages. McWhorter found no consistent geographical patterns for any of the 10 cancers.

Low smoking rates are by far the biggest reason for the state's low cancer rates, McWhorter said. Utah lung cancer rates are less than half the national average - 26.9 compared to 54.5. And, the rates for two other types of cancer associated with smoking - bladder and cervix - are also below national averages.

Two Utah counties _ Grand and Piute _ have significantly high rates of cervical cancer. Piute County's cervical cancer rate is 43.7 compared with the state rate of 6.8 and the national rate of 7.9.; Grand County's rate is 23.6.

Utah ranked higher than the national average in prostate and melanoma cancers, McWhorter said. The statewide rate for prostate cancer is 106 compared to 81.3 nationwide; Utah's rate for melanoma is 11.9 compared to the nation's rate of 9.5.

"Prostate is an enigma in terms of what causes it, the natural history of it," McWhorter said. "No one has been able to find a large factor that causes it."

The prostate cancer rate was higher than both state and national averages in Cache, Emery, Rich, Sanpete and Sevier counties. County rates were higher than national rates in Box Elder, Davis, Garfield, Iron, Millard, Morgan, Salt Lake, Summit, Tooele, Utah, Washington and Weber counties.

However, McWhorter said there are good clues as to why the melanoma rate is high in Utah. Melanoma is a skin cancer that commonly occurs in moles. It is the most dangerous of skin cancers; it spreads quickly and is hard to cure, often resulting in death. Unlike many other skin cancers, melanoma occurs more frequently in young people.

Utah's population is composed largely of light-skinned people, many of whom tend to have moles, McWhorter said. The state's high altitude and the outdoor lifestyle of Utahns result in high levels of sun exposure.

"This is a cancer that can be avoided by avoiding severe sun exposure," McWhorter said. "For that reason I'm glad the sun-tanning fad appears to be peaking, and that people are using lotions, hats and covering up."


(Chart 1)

How Utah compares

Type of Cancer Utah rate National rate*

Lung 26.9 54.5

Breast 83.0 95.7

Prostate 106.0 81.3

Colon 36.5 51.0

Bladder 11.1 17.3

Uterus 23.8 24.2

Cervix 6.8 7.9

Lymphomas 13.1 15.1

Leukemias 9.9 10.0

Melanoma 11.9 9.5

*Provided by the National Cancer Institute's Surveillance, Epidemiology and End Results network of nine population-based registries around the country. *****

(Chart 2)

County by county

Cancer incidence rates (per 100,000) by county:

Beaver 302

Box Elder 289

Cache 278

Carbon 323+

Daggett 288

Davis 288

Duchesne 324

Emery 345+

Garfield 345

Grand 323

Iron 323

Juab 341

Kane 265

Millard 282

Morgan 350

Piute 384+

Rich 283

Salt Lake 310+

San Juan 215-

Sanpete 313

Sevier 301

Summit 307

Tooele 321

Uintah 297

Utah 274

Wasatch 322

Washington 294

Wayne 275

Weber 291

State of Utah 298

U.S. 354

Note: + or - indicates rates that are statistically significantly higher or lower than the state rate. Some higher or lower rates are not noted because a rate based on very few cases may not be statistically significant.