Medicine and Health Sciences Commons^™

Defining County-Level Terrestrial Rabies Freedom Using The Us National Rabies Surveillance System: Surveillance Data Analysis, Amber Kunkel, Gabriella Veytsel, Sarah C. Bonaparte, Haillie Meek, Xiaoyue Ma, Amy J. Davis, Jesse Bonwitt, Ryan M. Wallace

USDA Wildlife Services: Staff Publications

Background: Rabies is a deadly zoonotic disease with nearly 100% fatality rate. In the United States, rabies virus persists in wildlife reservoirs, with occasional spillover into humans and domestic animals. The distribution of reservoir hosts in US counties plays an important role in public health decision-making, including the recommendation of lifesaving postexposure prophylaxis upon suspected rabies exposures. Furthermore, in surveillance data, it is difficult to discern whether counties have no cases reported because rabies was not present or because counties have an unreported rabies presence. These epizootics are monitored by the National Rabies Surveillance System (NRSS), to which approximately 130 …

Risk Of African Swine Fever Virus Transmission Among Wild Boar And Domestic Pigs In Poland, Kim M. Pepin, Tomasz Borowik, Maciej Frant, Kamila Plis, Tomasz Podgórski

USDA Wildlife Services: Staff Publications

Introduction

African swine fever (ASF) is a notifiable disease of swine that impacts global pork trade and food security. In several countries across the globe, the disease persists in wild boar (WB) populations sympatric to domestic pig (DP)operations, with continued detections in both sectors. While there is evidence of spillover and spillback between the sectors, the frequency of occurrence and relative importance of different risk factors for transmission at the wildlife-livestock interface remain unclear.

Methods

To address this gap, we leveraged ASF surveillance data from WB and DP across Eastern Poland from 2014–2019 in an analysis that quantified the relative …

Surveillance Of Antimicrobial Resistance In Veterinary Medicine In The United States: Current Efforts, Challenges, And Opportunities, Juliana M. Ruzante, Beth Harris, Paul Plummer, Raissa R. Raineri, John Dustin Loy, Megan Jacob, Orhan Sahin, Amanda J. Kreuder

School of Veterinary and Biomedical Sciences: Faculty Publications

Antimicrobial resistance (AMR) is a global problem facing human, animal, plant, and environmental health by threatening our ability to effectively treat bacterial infections with antimicrobials. In the United States, robust surveillance efforts exist to collect, analyze, and disseminate AMR data in human health care settings. These tools enable the development of effective infection control methods, the detection of trends, and provide the evidence needed to guide stewardship efforts to reduce the potential for emergence and further spread of AMR. However, in veterinary medicine, there are currently no known equivalent tools. This paper reviews efforts to reduce the potential for emergence …

Surveillance Of Antimicrobial Resistance In Veterinary Medicine In The United States: Current E, Juliana M. Ruzante, Beth Harris, Paul Plummer, Raissa R. Raineri, John Dustin Loy, Megan Jacob, Orhan Sahin, Amanda J. Kreuder

Nebraska Center for Virology: Faculty Publications

Antimicrobial resistance (AMR) is a global problem facing human, animal, plant, and environmental health by threatening our ability to effectively treat bacterial infections with antimicrobials. In the United States, robust surveillance efforts exist to collect, analyze, and disseminate AMR data in human health care settings. These tools enable the development of effective infection control methods, the detection of trends, and provide the evidence needed to guide stewardship efforts to reduce the potential for emergence and further spread of AMR. However, in veterinary medicine, there are currently no known equivalent tools. This paper reviews efforts to reduce the potential for emergence …

Exposure Of Egyptian Rousette Bats (Rousettus Aegyptiacus) And A Little Free-Tailed Bat (Chaerephon Pumilus) To Alphaviruses In Uganda, Rebekah C. Kading, Erin M. Borland, Eric C. Mossel, Teddy Nakayiki, Betty Nalikka, Jeremy P. Ledermann, Mary B. Crabtree, Nicholas A. Panella, Luke Nyakarahuka, Amy T. Gilbert, Julian C. Kerbis-Peterhans, Jonathan S. Towner, Brian R. Amman, Tara K. Sealy, Barry R. Miller, Julius J. Lutwama, Robert M. Kityo, Ann M. Powers

USDA Wildlife Services: Staff Publications

The reservoir for zoonotic o’nyong-nyong virus (ONNV) has remained unknown since this virus was first recognized in Uganda in 1959. Building on existing evidence for mosquito bloodfeeding on various frugivorous bat species in Uganda, and seroprevalence for arboviruses among bats in Uganda, we sought to assess if serum samples collected from bats in Uganda demonstrated evidence of exposure to ONNV or the closely related zoonotic chikungunya virus (CHIKV). In total, 652 serum samples collected from six bat species were tested by plaque reduction neutralization test (PRNT) for neutralizing antibodies against ONNV and CHIKV. Forty out of 303 (13.2%) Egyptian rousettes …

Use Of A Direct, Rapid Immunohistochemical Test For Diagnosis Of Rabies Virus In Bats, Charles E. Rupprecht, Lolita Van Pelt, April D. Davis, Richard B. Chipman, David L. Bergman

USDA Wildlife Services: Staff Publications

Rabies, a zoonotic encephalitis due to transmission of a lyssavirus, such as rabies virus (RABV), has the highest case fatality of any infectious disease. A global program for the elimination of human rabies caused by dogs is proposed for realization by 2030. Sensitive, specific, and inexpensive diagnostic tests are necessary for enhanced surveillance to detect infection, inform public health and veterinary professionals during risk assessments of exposure, and support overall programmatic goals. Multiple laboratory techniques are used to confirm a suspect case of rabies. One method for the detection of lyssavirus antigens within the brain is the direct rapid immunohistochemical …

Data-Driven Management—A Dynamic Occupancy Approach To Enhanced Rabies Surveillance Prioritization, Amy J. Davis, Jordana D. Kirby, Richard B. Chipman, Kathleen M. Nelson, Amy T. Gilbert

USDA Wildlife Services: Staff Publications

Rabies lyssavirus (RABV) is enzootic in raccoons across the eastern United States. Intensive management of RABV by oral rabies vaccination (ORV) has prevented its spread westward and shown evidence of local elimination in raccoon populations of the northeastern US. The USDA, Wildlife Services, National Rabies Management Program (NRMP) collaborates with other agencies to implement broad-scale ORV and conducts extensive monitoring to measure the effectiveness of the management. Enhanced Rabies Surveillance (ERS) was initiated during 2005 and updated in 2016 to direct surveillance efforts toward higher-value specimens by assigning points to different methods of encountering specimens for collection (strange-acting, roadkill, surveillance-trapped, …

A Framework For Surveillance Of Emerging Pathogens At The Human-Animal Interface: Pigs And Coronaviruses As A Case Study, Kim M. Pepin, Ryan S. Miller, Mark Q. Wilber

USDA Wildlife Services: Staff Publications

Pigs (Sus scrofa) may be important surveillance targets for risk assessment and risk-based control planning against emerging zoonoses. Pigs have high contact rates with humans and other animals, transmit similar pathogens as humans including CoVs, and serve as reservoirs and intermediate hosts for notable human pandemics. Wild and domestic pigs both interface with humans and each other but have unique ecologies that demand different surveillance strategies. Three fundamental questions shape any surveillance program: where, when, and how can surveillance be conducted to optimize the surveillance objective? Using theory of mechanisms of zoonotic spillover and data on risk factors, …

Social Structure Defines Spatial Transmission Of African Swine Fever In Wild Boar, Kim M. Pepin, Andrew J. Golnar, Tomasz Podgórski

USDA Wildlife Services: Staff Publications

The spatial spread of infectious disease is determined by spatial and social processes such as animal space use and family group structure. Yet, the impacts of social processes on spatial spread remain poorly understood and estimates of spatial transmission kernels (STKs) often exclude social structure. Understanding the impacts of social structure on STKs is important for obtaining robust inferences for policy decisions and optimizing response plans. We fit spatially explicit transmission models with different assumptions about contact structure to African swine fever virus surveillance data from eastern Poland from 2014 to 2015 and evaluated how social structure affected inference of …

Influenza A Virus Surveillance, Infection And Antibody Persistence In Snow Geese (Anser Caerulescens), Susan A. Shriner, J. Jeffrey Root, Jeremy W. Ellis, Kevin T. Bentler, Kaci K. Vandalen, Thomas Gidlewski, Sarah N. Bevins

USDA Wildlife Services: Staff Publications

Some snow geese (Anser caerulescens) migrate between Eurasia and North America and exhibit high seroprevalence for influenza A viruses (IAVs). Hence, these birds might be expected to play a role in intercontinental dispersal of IAVs. Our objective in this manuscript was to characterize basic incidence and infection characteristics for snow geese to assess whether these birds are likely to significantly contribute to circulation of IAVs. Thus, we 1) estimated snow goose infection prevalence by summarizing > 5,000 snow goose surveillance records, 2) experimentally infected snow geese with a low pathogenic IAV (H4N6) to assess susceptibility and infection dynamics and …

From Field To Film: Mosquito Surveillance And Survey Of Us Adults' Knowledge And Attitudes Towards Arthropod-Borne Disease Vectors, Justine Laviolette

Department of Entomology: Dissertations, Theses, and Student Research

Mosquito-borne disease is a public health challenge that warrants an active surveillance program for the identification of mosquito populations and the education of the public for prevention and protection against disease-transmitting arthropods. The communication of science to the public is necessary to prevent disease, change behavior, and promote a dialog between scientists and the public.

People are accustomed to high quality entertainment, which begs the question, “If we made science more entertaining, would the public be more interested?”

To address these issues, the objectives of this study are: 1) identify mosquito species and abundance at the US Meat Animal Research …

Not All Surveillance Data Are Created Equal—A Multi‐Method Dynamic Occupancy Approach To Determine Rabies Elimination From Wildlife, Amy J. Davis, Jordona D. Kirby, Richard B. Chipman, Kathleen M. Nelson, Tatiana Xifara, Colleen T. Webb, Ryan Wallace, Amy T. Gilbert, Kim M. Pepin

USDA Wildlife Services: Staff Publications

1. A necessary component of elimination programmes for wildlife disease is effective surveillance. The ability to distinguish between disease freedom and non‐detection can mean the difference between a successful elimination campaign and new epizootics. Understanding the contribution of different surveillance methods helps to optimize and better allocate effort and develop more effective surveillance programmes.

2. We evaluated the probability of rabies virus elimination (disease freedom) in an enzootic area with active management using dynamic occupancy modelling of 10 years of raccoon rabies virus (RABV) surveillance data (2006–2015) collected from three states in the eastern United States. We estimated detection probability …

Improving Risk Assessment Of The Emergence Of Novel Influenza A Viruses By Incorporating Environmental Surveillance, Kim M. Pepin, Matthew W. Hopken, Susan A. Shriner, Erica Spackman, Zaid Abdo, Colin Parrish, Steven Steven, James O. Lloyd-Smith, Antoinette J. Piaggio

USDA Wildlife Services: Staff Publications

Reassortment is an evolutionary mechanism by which influenza A viruses (IAV) generate genetic novelty. Reassortment is an important driver of host jumps and is widespread according to retrospective surveillance studies.However, predicting the epidemiological risk of reassortant emergence in novel hosts from surveillance data remains challenging. IAV strains persist and cooccur in the environment, promoting co-infection during environmental transmission. These conditions offer opportunity to understand reassortant emergence in reservoir and spillover hosts. Specifically, environmental RNA could provide rich information for understanding the evolutionary ecology of segmented viruses, and transform our ability to quantify epidemiological risk to spillover hosts. However, significant challenges …

Mosquito Host Choices On Livestock Amplifiers Of Rift Valley Fever Virus In Kenya, David P. Tchouassi, Robinson O. Okiro, Rosemary Sang, Lee W. Cohnstaedt, D. Scott Mcvey, Baldwyn Torto

School of Veterinary and Biomedical Sciences: Faculty Publications

Background: Animal hosts may vary in their attraction and acceptability as components of the host location process for assessing preference, and biting rates of vectors and risk of exposure to pathogens. However, these parameters remain poorly understood for mosquito vectors of the Rift Valley fever (RVF), an arboviral disease, and for a community of mosquitoes.

Methods: Using three known livestock amplifiers of RVF virus including sheep, goat and cattle as bait in enclosure traps, we investigated the host-feeding patterns for a community of mosquitoes in Naivasha, an endemic area of Rift Valley fever (RVF), in a longitudinal study for six …

Annual Report To The Nation On The Status Of Cancer, 1975-2008, Featuring Cancers Associated With Excess Weight And Lack Of Sufficient Physical Activity, Christie Eheman, S. Jane Henley, Rachel Ballard-Barbash, Eric J. Jacobs, Maria J. Schymura, Anne-Michelle Noone, Liping Pan, Robert N. Anderson, Janet E. Fulton, Betsy A. Kohler, Ahmedin Jemal, Elizabeth Ward, Marcus Plescia, Lynn A. G. Ries, Brenda K. Edwards

Public Health Resources

BACKGROUND: Annual updates on cancer occurrence and trends in the United States are provided through collaboration between the American Cancer Society (ACS), the Centers for Disease Control and Prevention (CDC), the National Cancer Institute (NCI), and the North American Association of Central Cancer Registries (NAACCR). This year’s report highlights the increased cancer risk associated with excess weight (overweight or obesity) and lack of sufficient physical activity (<150 minutes of physical activity per week).

METHODS: Data on cancer incidence were obtained from the CDC, NCI, and NAACCR; data on cancer deaths were obtained from the CDC’s National Center for Health Statistics. Annual percent changes in …

Cancer In American Indian And Alaska Native Young Adults (Ages 20–44 Years): Us, 1999–2004, Hannah K. Weir, Melissa Jim, Loraine D. Marrett, Temeika L. Fairley

Public Health Resources

BACKGROUND. An examination of cancer incidence patterns in American Indians and Alaska Native (AI/AN) young adults may provide insight into their present and future cancer burden.

METHODS. To reduce racial misclassification, incidence data were linked with the Indian Health Service (IHS) patient services database. Age-adjusted cancer incidence rates per 100,000 (AAR) and corresponding rate ratios (RR) for young adults (ages 20-44 years) were compared across IHS regions and for selected cancers within Contract Health Service Delivery Area counties by race (AI/AN vs non-Hispanic whites [NHW]) and sex.

RESULTS. The all-sites cancer incidence rate was lower for AI/ANs …

Gastric Cancer Among American Indians And Alaska Natives In The United States, 1999–2004, Charles Wiggins, David G. Perdue, Jeffrey A. Henderson, Michael G. Bruce, Anne P. Lanier, Janet J. Kelly, Brenda F. Seals, David K. Espey

Public Health Resources

BACKGROUND. Gastric cancer incidence rates for American Indians and Alaska Natives (AI/ANs) historically have exceeded those for non-Hispanic whites (NHWs). Previous reports may have underestimated the true burden of gastric cancer in AI/AN populations because of misclassification of AI/AN race in cancer registries.

METHODS. Population-based cancer registry data from 1999 through 2004 were used to describe gastric cancer incidence in AI/ANs and NHWs in the US. To address misclassification of race, registry data were linked with Indian Health Service administrative records, and analyses were restricted to residents of Contract Health Service Delivery Areas (CHSDA). Disease patterns were assessed …

Regional Differences In Cervical Cancer Incidence Among American Indians And Alaska Natives, 1999–2004, Thomas M. Becker, David K. Espey, Herschel W. Lawson, Mona Saraiya, Melissa A. Jim, Alan G. Waxman

Public Health Resources

BACKGROUND. Reports from limited geographic regions indicate higher rates of cervical cancer incidence in American Indian and Alaska Native (AI/AN) women than in women of other races. However, accurate determinations of cervical cancer incidence in AI/AN women have been hampered by racial misclassification in central cancer registries.

METHODS. The authors linked data from cancer registries participating in the National Program of Cancer Registries (NPCR) and the Surveillance, Epidemiology, and End Results (SEER) Program with Indian Health Service (IHS) enrollment records to improve identification of AI/AN race. NPCR and SEER data were combined to estimate annualized age-adjusted rates (expressed …

Gallbladder Cancer Incidence Among American Indians And Alaska Natives, Us, 1999–2004, Shannon M. Lemrow, David G. Perdue, Sherri L. Stewart, Lisa C. Richardson, Melissa Jim, Helen T. French, Judith Swan, Brenda K. Edwards, Charles Wiggins, Lois Dickie, David K. Espey

Public Health Resources

BACKGROUND. Gallbladder cancer (GBC) is rare; however, it disproportionately affects the American Indian and Alaska Natives (AI/AN) population. The purpose of the study was to characterize GBC among AI/AN in the US population.

METHODS. Cases of GBC diagnosed between 1999 and 2004 and collected by state-based cancer registries were included. Registry records were linked with Indian Health Service (IHS) administration records to decrease race misclassification of AI/AN. GBC rates and/or percent distributions for AI/AN and non-Hispanic whites (NHW) were calculated by sex, IHS region, age, and stage for all US counties and IHS Contract Health Service Delivery Area …

Lung Cancer Incidence Among American Indians And Alaska Natives In The United States, 1999–2004, Anne Bliss, Nathaniel Cobb, Teshia Solomon, Kym Cravatt, Melissa A. Jim, Latisha Marshall, Janis Campbell

Public Health Resources

BACKGROUND. Lung cancer incidence rates among American Indians and Alaska Natives (AI/ANs) in the United States have not been described well, primarily because of race misclassification and, until the 1990s, incomplete coverage of their population by cancer registries. Smoking, the predominant cause of lung cancer, is particularly prevalent among this population.

METHODS. Data from the National Program of Cancer Registries and the Surveillance, Epidemiology, and End Results Program were combined to estimate age adjusted incidence rates of lung cancer during 1999 through 2004. Cases were linked to Indian Health Service (IHS) registration databases to identify AI/ANs whose race …

Methods For Improving Cancer Surveillance Data In American Indian And Alaska Native Populations, David K. Espey, Charles Wiggins, Melissa A. Jim, Barry A. Miller, Christopher J. Johnson, Tom M. Becker

Public Health Resources

BACKGROUND. The misclassification of race decreases the accuracy of cancer incidence data for American Indians and Alaska Natives (AI/ANs) in some central cancer registries. This article describes the data sources and methods that were used to address this misclassification and to produce the cancer statistics used by most of the articles in this supplement.

METHODS. Records from United States cancer registries were linked with Indian Health Service (IHS) records to identify AI/AN cases that were misclassified as non-AI/AN. Data were available from 47 registries that linked their data with IHS, met quality criteria, and agreed to participate. Analyses …

Prostate Cancer Incidence Among American Indian And Alaska Native Men, Us, 1999–2004, Jeffrey A. Henderson, David K. Espey, Melissa Jim, Robert R. German, Kate M. Shaw, Richard M. Hoffman

Public Health Resources

BACKGROUND. American Indian and Alaska Native (AI/AN) men experience lower incidence of prostate cancer than other race/ethnic populations in the US, but racial misclassification of AI/AN men threatens the validity of these estimates. To the authors’ knowledge, little is known concerning prostate-specific antigen (PSA) testing in AI/AN men.

METHODS. The authors linked cancer registry data with Indian Health Service enrollment records to improve race classification. Analyses comparing cancer incidence rates and stage at diagnosis for AI/AN and non-Hispanic white (NHW) men for 6 geographic regions focused on counties known to have less race misclassification. The authors also used …

Surveillance For Health Behaviors Of American Indians And Alaska Natives—Findings From The Behavioral Risk Factor Surveillance System, 2000–2006, C. Brooke Steele, Cheryll J. Cardinez, Lisa C. Richardson, Lillian Tom-Orme, Kate M. Shaw

Public Health Resources

BACKGROUND. The authors compared estimates for cancer risk factors, use of cancer screening tests, health status indicators, and access to care for American Indians and Alaska Natives (AI/ANs) and non-Hispanic whites (NHWs) in the US and for AI/ANs in 6 Indian Health Service regions.

METHODS. Behavioral Risk Factor Surveillance System data were aggregated from the years 2000 through 2006 and were used to calculate weighted prevalence estimates by gender for key variables except demographic variables.

RESULTS. Compared with NHWs, AI/ANs had lower prevalence estimates for income, educational attainment, insurance coverage, and access to personal healthcare providers. AI/ANs …

Using Population-Based Cancer Registry Data To Assess The Burden Of Human Papillomavirus-Associated Cancers In The United States: Overview Of Methods, Meg Watson, Mona Saraiya, Faruque Ahmed, Cheryll J. Cardinez, Marsha E. Reichman, Hannah K. Weir, Thomas B. Richards

Public Health Resources

Increased attention to human papillomavirus (HPV)-associated cancers in light of the recent release of an HPV vaccine, as well as increased availability of cancer registry data that now include reporting from a large proportion of the US population, prompted the current assessment of HPV-associated cancers. This article describes methods used to assess the burden of HPV-associated cervical, vulvar, vaginal, penile, anal, and oral cavity/oropharyngeal cancers in the United States during 1998 through 2003 using cancer registry data, and it provides a brief overview of the epidemiology of these cancers.

Persistent infection with the human papillomavirus (HPV) is considered to be …

Cancer Among American Indians And Alaska Natives In The United States, 1999–2004, Charles Wiggins, David K. Espey, Phyllis A. Wingo, Judith S. Kaur, Robin Taylor Wilson, Judith Swan, Barry A. Miller, Melissa Jim, Janet J. Kelly, Anne P. Lanier

Public Health Resources

BACKGROUND. Cancer incidence rates vary among American Indian and Alaska Native (AI/AN) populations and often differ from rates among non-Hispanic whites (NHWs). However, the misclassification of race for AI/AN cancer cases in central cancer registries may have led to underestimates of the AI/AN cancer burden in previous reports.

METHODS. Cases diagnosed during 1999 through 2004 were identified from population- based cancer registries in the United States. Age-adjusted rates were calculated for the 25 most common sites for AI/ANs and NHWs. To minimize the misclassification of race, cancer registry records were linked with patient registration files from the Indian …

Breast Cancer Incidence Among American Indian And Alaska Native Women: Us, 1999–2004, Phyllis A. Wingo, Jessica King, Judith Swan, Steven S. Coughlin, Judith S. Kaur, Julie A. Erb-Alvarez, Jeannette Jackson-Thompson, Teshia G. Arambula Solomon

Public Health Resources

BACKGROUND. Breast cancer is a leading cause of cancer morbidity and mortality among American Indian and Alaska Native (AI/AN) women. Although published studies have suggested that breast cancer rates among AI/AN women are lower than those among other racial and ethnic populations, accurate determinations of the breast cancer burden have been hampered by misclassification of AI/AN race.

METHODS. Cancer incidence data from the National Program of Cancer Registries and the Surveillance, Epidemiology, and End Results Program were combined to estimate age-adjusted rates for the diagnosis years 1999 through 2004. Several steps were taken to reduce the misclassification of …

Annual Report To The Nation On The Status Of Cancer, 1975–2004, Featuring Cancer In American Indians And Alaska Natives, David K. Espey, Xiao-Cheng Wu, Judith Swan, Charles Wiggins, Melissa A. Jim, Elizabeth Ward, Phyllis A. Wingo, Holly L. Howe, Lynn A. G. Ries, Barry A. Miller, Ahmedin Jemal, Faruque Ahmed, Nathaniel Cobb, Judith S. Kaur, Brenda K. Edwards

Public Health Resources

BACKGROUND. The American Cancer Society, the Centers for Disease Control and Prevention, the National Cancer Institute, and the North American Association of Central Cancer Registries collaborate annually to provide updated information on cancer occurrence and trends in the U.S. The 2007 report features a comprehensive compilation of cancer information for American Indians and Alaska Natives (AI/AN).

METHODS. Cancer incidence data were available for up to 82% of the U.S. population. Cancer deaths were available for the entire U.S. population. Long-term (1975 through 2004) and fixed-interval (1995 through 2004) incidence and mortality trends were evaluated by annual percent change …

Annual Report To The Nation On The Status Of Cancer, 1973-1999, Featuring Implications Of Age And Aging On U.S. Cancer Burden, Brenda K. Edwards, Holly L. Howe, Lynn A. G. Ries, Michael J. Thun, Harry M. Rosenberg, Rosemary Yancik, Phyllis A. Wingo, Ahmedin Jemal, Ellen G. Feigal

Public Health Resources

BACKGROUND. The American Cancer Society, the National Cancer Institute, the North American Association of Central Cancer Registries (NAACCR), the National Institute on Aging (NIA), and the Centers for Disease Control and Prevention, including the National Center for Health Statistics (NCHS) and the National Center for Chronic Disease Prevention and Health Promotion, collaborated to provide an annual update on cancer occurrence and trends in the United States. This year’s report contained a special feature focusing on implications of age and aging on the U.S. cancer burden.

METHODS. For 1995 through 1999, age-specific rates and age-adjusted rates were calculated for …

The Annual Report To The Nation On The Status Of Cancer, 1973– 1997, With A Special Section On Colorectal Cancer, Lynn A. G. Ries, Phyllis A. Wingo, Daniel S. Miller, Holly L. Howe, Hannah K. Weir, Harry M. Rosenberg, Sally W. Vernon, Kathleen Cronin, Brenda K. Edwards

Public Health Resources

BACKGROUND. This annual report to the nation addresses progress in cancer prevention and control in the U.S. with a special section on colorectal cancer. This report is the joint effort of the American Cancer Society, the National Cancer Institute (NCI), the North American Association of Central Cancer Registries (NAACCR), and the Centers for Disease Control and Prevention (CDC), including the National Center for Health Statistics (NCHS).

METHODS. Age-adjusted rates were based on cancer incidence data from the NCI and NAACCR and underlying cause of death as compiled by NCHS. Joinpoint analysis was based on NCI Surveillance, Epidemiology, and …