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Its high incidence rate, coupled with a large variation in incidence rates among counties within the state, makes North Dakota a &quot;natural" /> <meta name="twitter:image" content="http://a.academia-assets.com/images/twitter-card.jpeg" /> <meta property="fb:app_id" content="2369844204" /> <meta property="og:type" content="article" /> <meta property="og:url" content="https://www.academia.edu/54833638/An_exploration_of_colorectal_cancer_incidence_rates_in_North_Dakota_USA_via_structural_equation_modeling" /> <meta property="og:title" content="An exploration of colorectal cancer incidence rates in North Dakota, USA, via structural equation modeling" /> <meta property="og:image" content="http://a.academia-assets.com/images/open-graph-icons/fb-paper.gif" /> <meta property="og:description" content="Purpose The state of North Dakota has one of the highest incidence rates for colorectal cancer in the USA. Its high incidence rate, coupled with a large variation in incidence rates among counties within the state, makes North Dakota a &quot;natural" /> <meta property="article:author" content="https://und.academia.edu/BradleyRundquist" /> <meta name="description" content="Purpose The state of North Dakota has one of the highest incidence rates for colorectal cancer in the USA. 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false window.loswp.willEdgeCache = false; window.loswp.work = {"work":{"id":54833638,"created_at":"2021-10-02T06:33:14.965-07:00","from_world_paper_id":175624417,"updated_at":"2024-11-25T06:06:00.950-08:00","_data":{"publisher":"Springer Science and Business Media LLC","grobid_abstract":"Purpose The state of North Dakota has one of the highest incidence rates for colorectal cancer in the USA. Its high incidence rate, coupled with a large variation in incidence rates among counties within the state, makes North Dakota a \"natural laboratory\" in which to investigate environmental clues to colorectal cancer. We conducted a hypothesis-generating study to explore potential determinants of colorectal cancer in North Dakota. Methods We obtained county-specific incidence rates for North Dakota's 53 counties from the statewide cancer registry and corresponding data on county demographic, agricultural, and geophysical features from population-based sources. Candidate demographic/agricultural variables included median household income, population density, colorectal cancer screening rates, average farm size (in acres), and the percent of county fertilized. Geophysical variables included the uranium content of soil, residential radon levels, and source of drinking water (municipal or well water). Statistical analyses were performed via multivariate regression and structural equation modeling. Results Colorectal cancer incidence rates across North Dakota counties varied 3-fold. The structural equation model identified a significant role for well water use (p \u003c 0.05). This finding is consistent with studies that implicate well water in colorectal cancer. Conclusions Well water contains several agents, e.g., bacteria, disinfection by-products, and nitrates that are potent colorectal carcinogens. Studies of well water use and colorectal cancer risk at the individual level in North Dakota are warranted.","publication_name":"International Journal of Colorectal Disease","grobid_abstract_attachment_id":"71004371"},"document_type":"paper","pre_hit_view_count_baseline":null,"quality":"high","language":"en","title":"An exploration of colorectal cancer incidence rates in North Dakota, USA, via structural equation modeling","broadcastable":false,"draft":null,"has_indexable_attachment":true,"indexable":true}}["work"]; window.loswp.workCoauthors = [138386]; window.loswp.locale = "en"; window.loswp.countryCode = "SG"; window.loswp.cwvAbTestBucket = ""; window.loswp.designVariant = "ds_vanilla"; window.loswp.fullPageMobileSutdModalVariant = "full_page_mobile_sutd_modal"; window.loswp.useOptimizedScribd4genScript = false; window.loginModal = {}; window.loginModal.appleClientId = 'edu.academia.applesignon'; window.userInChina = "false";</script><script defer="" src="https://accounts.google.com/gsi/client"></script><div class="ds-loswp-container"><div class="ds-work-card--grid-container"><div class="ds-work-card--container js-loswp-work-card"><div class="ds-work-card--cover"><div class="ds-work-cover--wrapper"><div class="ds-work-cover--container"><button class="ds-work-cover--clickable js-swp-download-button" data-signup-modal="{"location":"swp-splash-paper-cover","attachmentId":71004371,"attachmentType":"pdf"}"><img alt="First page of “An exploration of colorectal cancer incidence rates in North Dakota, USA, via structural equation modeling”" class="ds-work-cover--cover-thumbnail" src="https://0.academia-photos.com/attachment_thumbnails/71004371/mini_magick20211002-29226-1nwol4b.png?1633181663" /><img alt="PDF Icon" class="ds-work-cover--file-icon" src="//a.academia-assets.com/images/single_work_splash/adobe_icon.svg" /><div class="ds-work-cover--hover-container"><span class="material-symbols-outlined" style="font-size: 20px" translate="no">download</span><p>Download Free PDF</p></div><div class="ds-work-cover--ribbon-container">Download Free PDF</div><div class="ds-work-cover--ribbon-triangle"></div></button></div></div></div><div class="ds-work-card--work-information"><h1 class="ds-work-card--work-title">An exploration of colorectal cancer incidence rates in North Dakota, USA, via structural equation modeling</h1><div class="ds-work-card--work-authors ds-work-card--detail"><a class="ds-work-card--author js-wsj-grid-card-author ds2-5-body-md ds2-5-body-link" data-author-id="138386" href="https://und.academia.edu/BradleyRundquist"><img alt="Profile image of Bradley Rundquist" class="ds-work-card--author-avatar" src="//a.academia-assets.com/images/s65_no_pic.png" />Bradley Rundquist</a></div><div class="ds-work-card--detail"><p class="ds-work-card--detail ds2-5-body-sm">International Journal of Colorectal Disease</p><div class="ds-work-card--work-metadata"><div class="ds-work-card--work-metadata__stat"><span class="material-symbols-outlined" style="font-size: 20px" translate="no">visibility</span><p class="ds2-5-body-sm" id="work-metadata-view-count">…</p></div><div class="ds-work-card--work-metadata__stat"><span class="material-symbols-outlined" style="font-size: 20px" translate="no">description</span><p class="ds2-5-body-sm">6 pages</p></div><div class="ds-work-card--work-metadata__stat"><span class="material-symbols-outlined" style="font-size: 20px" translate="no">link</span><p class="ds2-5-body-sm">1 file</p></div></div><script>(async () => { const workId = 54833638; const worksViewsPath = "/v0/works/views?subdomain_param=api&work_ids%5B%5D=54833638"; const getWorkViews = async (workId) => { const response = await fetch(worksViewsPath); if (!response.ok) { throw new Error('Failed to load work views'); } const data = await response.json(); return data.views[workId]; }; // Get the view count for the work - we send this immediately rather than waiting for // the DOM to load, so it can be available as soon as possible (but without holding up // the backend or other resource requests, because it's a bit expensive and not critical). const viewCount = await getWorkViews(workId); const updateViewCount = (viewCount) => { try { const viewCountNumber = parseInt(viewCount, 10); if (viewCountNumber === 0) { // Remove the whole views element if there are zero views. document.getElementById('work-metadata-view-count')?.parentNode?.remove(); return; } const commaizedViewCount = viewCountNumber.toLocaleString(); const viewCountBody = document.getElementById('work-metadata-view-count'); if (!viewCountBody) { throw new Error('Failed to find work views element'); } viewCountBody.textContent = `${commaizedViewCount} views`; } catch (error) { // Remove the whole views element if there was some issue parsing. document.getElementById('work-metadata-view-count')?.parentNode?.remove(); throw new Error(`Failed to parse view count: ${viewCount}`, error); } }; // If the DOM is still loading, wait for it to be ready before updating the view count. if (document.readyState === "loading") { document.addEventListener('DOMContentLoaded', () => { updateViewCount(viewCount); }); // Otherwise, just update it immediately. } else { updateViewCount(viewCount); } })();</script></div><p class="ds-work-card--work-abstract ds-work-card--detail ds2-5-body-md">Purpose The state of North Dakota has one of the highest incidence rates for colorectal cancer in the USA. Its high incidence rate, coupled with a large variation in incidence rates among counties within the state, makes North Dakota a "natural laboratory" in which to investigate environmental clues to colorectal cancer. We conducted a hypothesis-generating study to explore potential determinants of colorectal cancer in North Dakota. Methods We obtained county-specific incidence rates for North Dakota's 53 counties from the statewide cancer registry and corresponding data on county demographic, agricultural, and geophysical features from population-based sources. Candidate demographic/agricultural variables included median household income, population density, colorectal cancer screening rates, average farm size (in acres), and the percent of county fertilized. Geophysical variables included the uranium content of soil, residential radon levels, and source of drinking water (municipal or well water). Statistical analyses were performed via multivariate regression and structural equation modeling. Results Colorectal cancer incidence rates across North Dakota counties varied 3-fold. The structural equation model identified a significant role for well water use (p < 0.05). This finding is consistent with studies that implicate well water in colorectal cancer. Conclusions Well water contains several agents, e.g., bacteria, disinfection by-products, and nitrates that are potent colorectal carcinogens. Studies of well water use and colorectal cancer risk at the individual level in North Dakota are warranted.</p><div class="ds-work-card--button-container"><button class="ds2-5-button js-swp-download-button" data-signup-modal="{"location":"continue-reading-button--work-card","attachmentId":71004371,"attachmentType":"pdf","workUrl":"https://www.academia.edu/54833638/An_exploration_of_colorectal_cancer_incidence_rates_in_North_Dakota_USA_via_structural_equation_modeling"}">See full PDF</button><button class="ds2-5-button ds2-5-button--secondary js-swp-download-button" data-signup-modal="{"location":"download-pdf-button--work-card","attachmentId":71004371,"attachmentType":"pdf","workUrl":"https://www.academia.edu/54833638/An_exploration_of_colorectal_cancer_incidence_rates_in_North_Dakota_USA_via_structural_equation_modeling"}"><span class="material-symbols-outlined" style="font-size: 20px" translate="no">download</span>Download PDF</button></div><div class="ds-signup-banner-trigger-container"><div class="ds-signup-banner-trigger ds-signup-banner-trigger-control"></div></div><div class="ds-signup-banner ds-signup-banner-control"><div id="ds-signup-banner-close-button"><button class="ds2-5-button ds2-5-button--secondary ds2-5-button--inverse"><span class="material-symbols-outlined" style="font-size: 20px" translate="no">close</span></button></div><div class="ds-signup-banner-ctas"><img src="//a.academia-assets.com/images/academia-logo-capital-white.svg" /><h4 class="ds2-5-heading-serif-sm">Sign up for access to the world's latest research</h4><button class="ds2-5-button ds2-5-button--inverse ds2-5-button--full-width js-swp-download-button" data-signup-modal="{"location":"signup-banner"}">Sign up for free<span class="material-symbols-outlined" style="font-size: 20px" translate="no">arrow_forward</span></button></div><div class="ds-signup-banner-divider"></div><div class="ds-signup-banner-reasons"><div class="ds-signup-banner-reasons-item"><span class="material-symbols-outlined" style="font-size: 24px" translate="no">check</span><span>Get notified about relevant papers</span></div><div class="ds-signup-banner-reasons-item"><span class="material-symbols-outlined" style="font-size: 24px" translate="no">check</span><span>Save papers to use in your research</span></div><div class="ds-signup-banner-reasons-item"><span class="material-symbols-outlined" style="font-size: 24px" translate="no">check</span><span>Join the discussion with peers</span></div><div class="ds-signup-banner-reasons-item"><span class="material-symbols-outlined" style="font-size: 24px" translate="no">check</span><span>Track your impact</span></div></div></div><script>(() => { // Set up signup banner show/hide behavior: // 1. 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In particular, the northern region of Timiskaming has the highest incidence of colorectal cancer in Ontario while the southern region of Peel displays the lowest. We aimed to identify non-nutritional modifiable environmental factors in Timiskaming that may be associated with its diverging colorectal cancer incidence rates when compared to Peel.</p><div class="ds-related-work--ctas"><button class="ds2-5-text-link ds2-5-text-link--inline js-swp-download-button" data-signup-modal="{"location":"wsj-grid-card-download-pdf-modal","work_title":"Environmental Factors in an Ontario Community with Disparities in Colorectal Cancer Incidence","attachmentId":47396300,"attachmentType":"pdf","work_url":"https://www.academia.edu/10419571/Environmental_Factors_in_an_Ontario_Community_with_Disparities_in_Colorectal_Cancer_Incidence","alternativeTracking":true}"><span class="material-symbols-outlined" style="font-size: 18px" translate="no">download</span><span class="ds2-5-text-link__content">Download free PDF</span></button><a class="ds2-5-text-link ds2-5-text-link--inline js-wsj-grid-card-view-pdf" href="https://www.academia.edu/10419571/Environmental_Factors_in_an_Ontario_Community_with_Disparities_in_Colorectal_Cancer_Incidence"><span class="ds2-5-text-link__content">View PDF</span><span class="material-symbols-outlined" style="font-size: 18px" translate="no">chevron_right</span></a></div></div><div class="ds-related-work--container js-wsj-grid-card" data-collection-position="1" data-entity-id="101972166" data-sort-order="default"><a class="ds-related-work--title js-wsj-grid-card-title ds2-5-body-md ds2-5-body-link" href="https://www.academia.edu/101972166/Geographic_determinants_of_colorectal_cancer_in_Louisiana">Geographic determinants of colorectal cancer in Louisiana</a><div class="ds-related-work--metadata"><a class="js-wsj-grid-card-author ds2-5-body-sm ds2-5-body-link" data-author-id="38787607" href="https://independent.academia.edu/LeonardiClaudia">Claudia Leonardi</a></div><p class="ds-related-work--metadata ds2-5-body-xs">Cancer Causes &amp; Control, 2022</p><p class="ds-related-work--abstract ds2-5-body-sm">Purpose Currently, rural residents in the United States (US) experience a greater cancer burden for tobacco-related cancers and cancers that can be prevented by screening. We aim to characterize geographic determinants of colorectal cancer (CRC) incidence in Louisiana due to rural residence and other known geographic risk factors, area socioeconomic status (SES), and cultural region (Acadian or French-speaking). Methods Primary colorectal cancer diagnosed among adults 30 years and older in 2008–2017 were obtained from the Louisiana Tumor Registry. Population and social and economic data were obtained from US Census American Community Survey. Rural areas were defined using US Department of Agriculture 2010 rural–urban commuting area codes. Estimates of relative risk (RR) were obtained from multilevel binomial regression models of incidence. Results The study population was 16.1% rural, 18.4% low SES, and 17.9% Acadian. Risk of CRC was greater among rural white residents (RR Women: 1....</p><div class="ds-related-work--ctas"><button class="ds2-5-text-link ds2-5-text-link--inline js-swp-download-button" data-signup-modal="{"location":"wsj-grid-card-download-pdf-modal","work_title":"Geographic determinants of colorectal cancer in Louisiana","attachmentId":102363478,"attachmentType":"pdf","work_url":"https://www.academia.edu/101972166/Geographic_determinants_of_colorectal_cancer_in_Louisiana","alternativeTracking":true}"><span class="material-symbols-outlined" style="font-size: 18px" translate="no">download</span><span class="ds2-5-text-link__content">Download free PDF</span></button><a class="ds2-5-text-link ds2-5-text-link--inline js-wsj-grid-card-view-pdf" href="https://www.academia.edu/101972166/Geographic_determinants_of_colorectal_cancer_in_Louisiana"><span class="ds2-5-text-link__content">View PDF</span><span class="material-symbols-outlined" style="font-size: 18px" translate="no">chevron_right</span></a></div></div><div class="ds-related-work--container js-wsj-grid-card" data-collection-position="2" data-entity-id="115286896" data-sort-order="default"><a class="ds-related-work--title js-wsj-grid-card-title ds2-5-body-md ds2-5-body-link" href="https://www.academia.edu/115286896/Geographic_variation_in_the_incidence_of_colorectal_cancer_in_the_United_States_1998_2001">Geographic variation in the incidence of colorectal cancer in the United States, 1998–2001</a><div class="ds-related-work--metadata"><a class="js-wsj-grid-card-author ds2-5-body-sm ds2-5-body-link" data-author-id="64954623" href="https://independent.academia.edu/ClutterGayle">Gayle Clutter</a></div><p class="ds-related-work--metadata ds2-5-body-xs">Cancer, 2006</p><p class="ds-related-work--abstract ds2-5-body-sm">BACKGROUND. This study examined the incidence rates and risk factors for colorectal cancer in 9 geographic divisions in the United States. METHODS. The colorectal cancer cases were diagnosed between 1998 and 2001 in 39 states and the District of Columbia (grouped into 9 geographic divisions in the United States). The association between colorectal cancer and geographic division was analyzed using the Poisson regression model controlling for demographics and ecologic measures of education, behavioral factors and colorectal cancer screening data extracted from the Behavioral Risk Factor Surveillance System. RESULTS. The age-adjusted incidence rates of colorectal cancer were highest in the Middle Atlantic division, followed by New England division, East and West North Central divisions, East South Central and South Atlantic divisions, West South Central and Pacific divisions, with the lowest rate observed in the Mountain division. Old age, male gender, black race, less than a twelfth-grade education, smoking, and no physical activity were significantly associated with higher incidence rates of colorectal cancer, whereas having sigmoidoscopy/colonoscopy in the past 5 years, fecal occult blood test in the past year, and obesity were associated with lower incidence rates of colorectal cancer. The relative ranking of incidence rates of colorectal cancer across divisions changed after adjusting for these factors. CONCLUSIONS. Significant geographic variation in colorectal cancer exists in the United States. Risk factors, including demographics, education, behavior, and screening use, can only partially explain the differences across geographic divisions.</p><div class="ds-related-work--ctas"><button class="ds2-5-text-link ds2-5-text-link--inline js-swp-download-button" data-signup-modal="{"location":"wsj-grid-card-download-pdf-modal","work_title":"Geographic variation in the incidence of colorectal cancer in the United States, 1998–2001","attachmentId":111737957,"attachmentType":"pdf","work_url":"https://www.academia.edu/115286896/Geographic_variation_in_the_incidence_of_colorectal_cancer_in_the_United_States_1998_2001","alternativeTracking":true}"><span class="material-symbols-outlined" style="font-size: 18px" translate="no">download</span><span class="ds2-5-text-link__content">Download free PDF</span></button><a class="ds2-5-text-link ds2-5-text-link--inline js-wsj-grid-card-view-pdf" href="https://www.academia.edu/115286896/Geographic_variation_in_the_incidence_of_colorectal_cancer_in_the_United_States_1998_2001"><span class="ds2-5-text-link__content">View PDF</span><span class="material-symbols-outlined" style="font-size: 18px" translate="no">chevron_right</span></a></div></div><div class="ds-related-work--container js-wsj-grid-card" data-collection-position="3" data-entity-id="125170928" data-sort-order="default"><a class="ds-related-work--title js-wsj-grid-card-title ds2-5-body-md ds2-5-body-link" href="https://www.academia.edu/125170928/County_level_cumulative_environmental_quality_associated_with_cancer_incidence">County-level cumulative environmental quality associated with cancer incidence</a><div class="ds-related-work--metadata"><a class="js-wsj-grid-card-author ds2-5-body-sm ds2-5-body-link" data-author-id="308713563" href="https://independent.academia.edu/ShannonGrabich">Shannon Grabich</a></div><p class="ds-related-work--metadata ds2-5-body-xs">Cancer, 2017</p><p class="ds-related-work--abstract ds2-5-body-sm">Individual environmental exposures are associated with cancer development; however, environmental exposures occur simultaneously. The Environmental Quality Index (EQI) is a county-level measure of cumulative environmental exposures that occur in 5 domains. The EQI was linked to county-level annual age-adjusted cancer incidence rates from the Surveillance, Epidemiology, and End Results (SEER) Program state cancer profiles. All-site cancer and the top 3 site-specific cancers for male and female subjects were considered. Incident rate differences (IRDs; annual rate difference per 100,000 persons) and 95% confidence intervals (CIs) were estimated using fixed-slope, random intercept multilevel linear regression models. Associations were assessed with domain-specific indices and analyses were stratified by rural/urban status. Comparing the highest quintile/poorest environmental quality with the lowest quintile/best environmental quality for overall EQI, all-site county-level cancer incide...</p><div class="ds-related-work--ctas"><button class="ds2-5-text-link ds2-5-text-link--inline js-swp-download-button" data-signup-modal="{"location":"wsj-grid-card-download-pdf-modal","work_title":"County-level cumulative environmental quality associated with cancer incidence","attachmentId":119261495,"attachmentType":"pdf","work_url":"https://www.academia.edu/125170928/County_level_cumulative_environmental_quality_associated_with_cancer_incidence","alternativeTracking":true}"><span class="material-symbols-outlined" style="font-size: 18px" translate="no">download</span><span class="ds2-5-text-link__content">Download free PDF</span></button><a class="ds2-5-text-link ds2-5-text-link--inline js-wsj-grid-card-view-pdf" href="https://www.academia.edu/125170928/County_level_cumulative_environmental_quality_associated_with_cancer_incidence"><span class="ds2-5-text-link__content">View PDF</span><span class="material-symbols-outlined" style="font-size: 18px" translate="no">chevron_right</span></a></div></div><div class="ds-related-work--container js-wsj-grid-card" data-collection-position="4" data-entity-id="110363979" data-sort-order="default"><a class="ds-related-work--title js-wsj-grid-card-title ds2-5-body-md ds2-5-body-link" href="https://www.academia.edu/110363979/Assessment_of_Pediatric_Cancer_and_Its_Relationship_to_Environmental_Contaminants_An_Ecological_Study_in_Idaho">Assessment of Pediatric Cancer and Its Relationship to Environmental Contaminants: An Ecological Study in Idaho</a><div class="ds-related-work--metadata"><a class="js-wsj-grid-card-author ds2-5-body-sm ds2-5-body-link" data-author-id="118051440" href="https://independent.academia.edu/Kolokalan">alan Kolok</a></div><p class="ds-related-work--metadata ds2-5-body-xs">GeoHealth, 2022</p><p class="ds-related-work--abstract ds2-5-body-sm">The primary aim of this study was to determine the degree to which a multivariable principal component model based on several potentially carcinogenic metals and pesticides could explain the county‐level pediatric cancer rates across Idaho. We contend that human exposure to environmental contaminants is one of the reasons for increased pediatric cancer incidence in the United States. Although several studies have been conducted to determine the relationship between environmental contaminants and carcinogenesis among children, research gaps exist in developing a meaningful association between them. For this study, pediatric cancer data was provided by the Cancer Data Registry of Idaho, concentrations of metals and metalloids in groundwater were collected from the Idaho Department of Water Resources, and pesticide use data were collected from the United States Geological Survey. Most environmental variables were significantly intercorrelated at an adjusted P‐value &lt;0.01 (97 out of ...</p><div class="ds-related-work--ctas"><button class="ds2-5-text-link ds2-5-text-link--inline js-swp-download-button" data-signup-modal="{"location":"wsj-grid-card-download-pdf-modal","work_title":"Assessment of Pediatric Cancer and Its Relationship to Environmental Contaminants: An Ecological Study in Idaho","attachmentId":108203896,"attachmentType":"pdf","work_url":"https://www.academia.edu/110363979/Assessment_of_Pediatric_Cancer_and_Its_Relationship_to_Environmental_Contaminants_An_Ecological_Study_in_Idaho","alternativeTracking":true}"><span class="material-symbols-outlined" style="font-size: 18px" translate="no">download</span><span class="ds2-5-text-link__content">Download free PDF</span></button><a class="ds2-5-text-link ds2-5-text-link--inline js-wsj-grid-card-view-pdf" href="https://www.academia.edu/110363979/Assessment_of_Pediatric_Cancer_and_Its_Relationship_to_Environmental_Contaminants_An_Ecological_Study_in_Idaho"><span class="ds2-5-text-link__content">View PDF</span><span class="material-symbols-outlined" style="font-size: 18px" translate="no">chevron_right</span></a></div></div><div class="ds-related-work--container js-wsj-grid-card" data-collection-position="5" data-entity-id="54138548" data-sort-order="default"><a class="ds-related-work--title js-wsj-grid-card-title ds2-5-body-md ds2-5-body-link" href="https://www.academia.edu/54138548/Thyroid_Cancer_Incidence_Rates_in_North_Dakota_are_Associated_with_Land_and_Water_Use">Thyroid Cancer Incidence Rates in North Dakota are Associated with Land and Water Use</a><div class="ds-related-work--metadata"><a class="js-wsj-grid-card-author ds2-5-body-sm ds2-5-body-link" data-author-id="50455792" href="https://independent.academia.edu/GarySchwartz13">Gary Schwartz</a></div><p class="ds-related-work--metadata ds2-5-body-xs">International Journal of Environmental Research and Public Health</p><p class="ds-related-work--abstract ds2-5-body-sm">Objective: The increasing rate of thyroid cancer diagnoses in the U.S. reflects the increasing use of ultrasonography and of specialist medical care. North Dakota is a rural state with limited access to specialist care, yet its incidence of thyroid cancer is significantly greater than that of the U.S. overall. We sought to identify factors responsible for the high incidence of thyroid cancer in North Dakota. Methods: We examined county-specific incidence rates for thyroid cancer in North Dakota in relation to demographic and geographic factors, including median household income, percent of land fertilized, cattle density per capita, and source of drinking water (city or well water), using structural equation modeling. We included county level data on residential radon levels and estimates of radioactive iodine in milk following nuclear weapons testing in the 1950s. Results: Thyroid cancer incidence rates were significantly associated with median income (p &lt; 0.05); percent of land...</p><div class="ds-related-work--ctas"><button class="ds2-5-text-link ds2-5-text-link--inline js-swp-download-button" data-signup-modal="{"location":"wsj-grid-card-download-pdf-modal","work_title":"Thyroid Cancer Incidence Rates in North Dakota are Associated with Land and Water Use","attachmentId":70647784,"attachmentType":"pdf","work_url":"https://www.academia.edu/54138548/Thyroid_Cancer_Incidence_Rates_in_North_Dakota_are_Associated_with_Land_and_Water_Use","alternativeTracking":true}"><span class="material-symbols-outlined" style="font-size: 18px" translate="no">download</span><span class="ds2-5-text-link__content">Download free PDF</span></button><a class="ds2-5-text-link ds2-5-text-link--inline js-wsj-grid-card-view-pdf" href="https://www.academia.edu/54138548/Thyroid_Cancer_Incidence_Rates_in_North_Dakota_are_Associated_with_Land_and_Water_Use"><span class="ds2-5-text-link__content">View PDF</span><span class="material-symbols-outlined" style="font-size: 18px" translate="no">chevron_right</span></a></div></div><div class="ds-related-work--container js-wsj-grid-card" data-collection-position="6" data-entity-id="58642934" data-sort-order="default"><a class="ds-related-work--title js-wsj-grid-card-title ds2-5-body-md ds2-5-body-link" href="https://www.academia.edu/58642934/Colorectal_Cancer_Incidence_Rates_in_the_Louisiana_Acadian_Parishes_Demonstrated_to_be_Among_the_Highest_in_the_United_States">Colorectal Cancer Incidence Rates in the Louisiana Acadian Parishes Demonstrated to be Among the Highest in the United States</a><div class="ds-related-work--metadata"><a class="js-wsj-grid-card-author ds2-5-body-sm ds2-5-body-link" data-author-id="35098446" href="https://independent.academia.edu/ElizabethFontham">Elizabeth Fontham</a></div><p class="ds-related-work--metadata ds2-5-body-xs">Clinical and Translational Gastroenterology, 2014</p><p class="ds-related-work--abstract ds2-5-body-sm">OBJECTIVES: Determine whether colorectal cancer (CRC) rates are disproportionately high in the French-Acadian region (population 1.2 million) of Louisiana, home of the Cajuns, a founder population. METHODS: 2005-2009 cancer incidence rates were stratified by age/race/gender in the 18 Acadian parish region and 9-parish subgroup with higher proportions of French speakers and compared with Louisiana and United States rates. Parishes were identified through language census data. A total of 3,288 CRC cases were identified in the Acadian region and 11,737 in Louisiana. RESULTS: CRC rates in whites and white males in the 18 parishes were statistically significantly higher than both Louisiana and US rates. In the 9 parishes, rates increased further; whites had an incidence of 56.1/100,000, 13% higher than Louisiana (Po0.0003) and 23% higher than US rates (Po0.0001). In white males, incidence was 72.6/100,000, 19% higher than Louisiana (Po0.0002) and 37% higher than US rates (Po0.0001). If the 9-parish regions were considered a "state," white males would have the highest CRC incidence in the United States by 11% (Po0.0175) compared with other white male populations. CONCLUSIONS: CRC rates are among the highest in the United States, increasing with the proportion of French speakers, a marker for the Cajun population. This appears to be the first study identifying a high rate of cancer in a large, regional, US founder population, raising the possibility of a genetic predisposition. Alternatively, an unidentified, robust environmental risk factor may be present. Future studies are needed to identify genetic and/or other risk factors in this population.</p><div class="ds-related-work--ctas"><button class="ds2-5-text-link ds2-5-text-link--inline js-swp-download-button" data-signup-modal="{"location":"wsj-grid-card-download-pdf-modal","work_title":"Colorectal Cancer Incidence Rates in the Louisiana Acadian Parishes Demonstrated to be Among the Highest in the United States","attachmentId":72953991,"attachmentType":"pdf","work_url":"https://www.academia.edu/58642934/Colorectal_Cancer_Incidence_Rates_in_the_Louisiana_Acadian_Parishes_Demonstrated_to_be_Among_the_Highest_in_the_United_States","alternativeTracking":true}"><span class="material-symbols-outlined" style="font-size: 18px" translate="no">download</span><span class="ds2-5-text-link__content">Download free PDF</span></button><a class="ds2-5-text-link ds2-5-text-link--inline js-wsj-grid-card-view-pdf" href="https://www.academia.edu/58642934/Colorectal_Cancer_Incidence_Rates_in_the_Louisiana_Acadian_Parishes_Demonstrated_to_be_Among_the_Highest_in_the_United_States"><span class="ds2-5-text-link__content">View PDF</span><span class="material-symbols-outlined" style="font-size: 18px" translate="no">chevron_right</span></a></div></div><div class="ds-related-work--container js-wsj-grid-card" data-collection-position="7" data-entity-id="9313673" data-sort-order="default"><a class="ds-related-work--title js-wsj-grid-card-title ds2-5-body-md ds2-5-body-link" href="https://www.academia.edu/9313673/Rural_Urban_Differences_in_Colon_Cancer_Risk_in_Blacks_and_Whites_The_North_Carolina_Colon_Cancer_Study">Rural-Urban Differences in Colon Cancer Risk in Blacks and Whites: The North Carolina Colon Cancer Study</a><div class="ds-related-work--metadata"><a class="js-wsj-grid-card-author ds2-5-body-sm ds2-5-body-link" data-author-id="21491503" href="https://independent.academia.edu/AnitaCarolina5">Anita Carolina</a></div><p class="ds-related-work--metadata ds2-5-body-xs">Journal of Rural Health, 2006</p><p class="ds-related-work--abstract ds2-5-body-sm">ABSTRACT: Context: Geographic and racial variations in cancer incidence have been observed. Studies of colorectal carcinoma indicate a higher incidence and mortality rate for blacks than for whites in the United States. Purpose: We evaluated the effect of rural versus urban residence on colon cancer risk and stage of disease at diagnosis in blacks and whites. Methods: Interviews were conducted with 558 colon cancer cases and 952 controls enrolled in the North Carolina Colon Cancer Study, a population-based case-control study of blacks and whites residing in 33 contiguous counties. Findings: Residence in a rural area was associated with increased colon cancer risk (odds ratio, 1.4; 95% confidence interval, 1.1-1.8). This association was no longer significant after controlling for recent use of colorectal cancer screening tests (odds ratio, 1.2; 95% confidence interval, 0.9-1.6). Risk estimates were not modified by race nor were they markedly different for extent of disease at diagnosis. However, colorectal cancer screening rates were lower for blacks than for whites. Conclusion: Our findings suggest that rural blacks and whites are at increased risk of colon cancer regardless of stage of disease at diagnosis than their urban counterparts; this relationship may be mediated by screening behavior.</p><div class="ds-related-work--ctas"><button class="ds2-5-text-link ds2-5-text-link--inline js-swp-download-button" data-signup-modal="{"location":"wsj-grid-card-download-pdf-modal","work_title":"Rural-Urban Differences in Colon Cancer Risk in Blacks and Whites: The North Carolina Colon Cancer Study","attachmentId":47826058,"attachmentType":"pdf","work_url":"https://www.academia.edu/9313673/Rural_Urban_Differences_in_Colon_Cancer_Risk_in_Blacks_and_Whites_The_North_Carolina_Colon_Cancer_Study","alternativeTracking":true}"><span class="material-symbols-outlined" style="font-size: 18px" translate="no">download</span><span class="ds2-5-text-link__content">Download free PDF</span></button><a class="ds2-5-text-link ds2-5-text-link--inline js-wsj-grid-card-view-pdf" href="https://www.academia.edu/9313673/Rural_Urban_Differences_in_Colon_Cancer_Risk_in_Blacks_and_Whites_The_North_Carolina_Colon_Cancer_Study"><span class="ds2-5-text-link__content">View PDF</span><span class="material-symbols-outlined" style="font-size: 18px" translate="no">chevron_right</span></a></div></div><div class="ds-related-work--container js-wsj-grid-card" data-collection-position="8" data-entity-id="72362348" data-sort-order="default"><a class="ds-related-work--title js-wsj-grid-card-title ds2-5-body-md ds2-5-body-link" href="https://www.academia.edu/72362348/Delineating_colorectal_cancer_distribution_interaction_and_risk_prediction_by_environmental_risk_factors_and_serum_trace_elements">Delineating colorectal cancer distribution, interaction, and risk prediction by environmental risk factors and serum trace elements</a><div class="ds-related-work--metadata"><a class="js-wsj-grid-card-author ds2-5-body-sm ds2-5-body-link" data-author-id="21671424" href="https://ukm-my.academia.edu/AzmawatiNawi">Azmawati Nawi</a></div><p class="ds-related-work--metadata ds2-5-body-xs">Scientific Reports</p><p class="ds-related-work--abstract ds2-5-body-sm">The burden of colorectal cancer (CRC) is increasing worldwide especially in developing countries. This phenomenon may be attributable to lifestyle, dietary and environmental risk factors. We aimed to determine the level of 25 trace elements, their interaction with environmental risk factors, and subsequently develop a risk prediction model for CRC (RPM CRC). For the discovery phase, we used a hospital-based case–control study (CRC and non-CRC patients) and in the validation phase we analysed pre-symptomatic samples of CRC patients from The Malaysian Cohort Biobank. Information on the environmental risk factors were obtained and level of 25 trace elements measured using the ICP-MS method. CRC patients had lower Zn and Se levels but higher Li, Be, Al, Co, Cu, As, Cd, Rb, Ba, Hg, Tl, and Pb levels compared to non-CRC patients. The positive interaction between red meat intake ≥ 50 g/day and Co ≥ 4.77 µg/L (AP 0.97; 95% CI 0.91, 1.03) doubled the risk of CRC. A panel of 24 trace elements...</p><div class="ds-related-work--ctas"><button class="ds2-5-text-link ds2-5-text-link--inline js-swp-download-button" data-signup-modal="{"location":"wsj-grid-card-download-pdf-modal","work_title":"Delineating colorectal cancer distribution, interaction, and risk prediction by environmental risk factors and serum trace elements","attachmentId":81318116,"attachmentType":"pdf","work_url":"https://www.academia.edu/72362348/Delineating_colorectal_cancer_distribution_interaction_and_risk_prediction_by_environmental_risk_factors_and_serum_trace_elements","alternativeTracking":true}"><span class="material-symbols-outlined" style="font-size: 18px" translate="no">download</span><span class="ds2-5-text-link__content">Download free PDF</span></button><a class="ds2-5-text-link ds2-5-text-link--inline js-wsj-grid-card-view-pdf" href="https://www.academia.edu/72362348/Delineating_colorectal_cancer_distribution_interaction_and_risk_prediction_by_environmental_risk_factors_and_serum_trace_elements"><span class="ds2-5-text-link__content">View PDF</span><span class="material-symbols-outlined" style="font-size: 18px" translate="no">chevron_right</span></a></div></div><div class="ds-related-work--container js-wsj-grid-card" data-collection-position="9" data-entity-id="18532564" data-sort-order="default"><a class="ds-related-work--title js-wsj-grid-card-title ds2-5-body-md ds2-5-body-link" href="https://www.academia.edu/18532564/Rurality_and_Other_Determinants_of_Early_Colorectal_Cancer_Diagnosis_in_Nebraska_A_6_Year_Cancer_Registry_Study_1998_2003">Rurality and Other Determinants of Early Colorectal Cancer Diagnosis in Nebraska: A 6-Year Cancer Registry Study, 1998-2003</a><div class="ds-related-work--metadata"><a class="js-wsj-grid-card-author ds2-5-body-sm ds2-5-body-link" data-author-id="38564065" href="https://independent.academia.edu/JayashriSankaranarayanan">Jayashri Sankaranarayanan</a></div><p class="ds-related-work--metadata ds2-5-body-xs">The Journal of Rural Health, 2009</p><p class="ds-related-work--abstract ds2-5-body-sm">There are no studies of rurality, and other determinants of colorectal cancer (CRC) stage at diagnosis with population-based data from the Midwest. This retrospective study identified, incident CRC patients, aged 19 years and older, from 1998-2003 Nebraska Cancer Registry (NCR) data. Using federal Office of Management and Budget classifications, we grouped patients by residence in metropolitan, micropolitan nonmetropolitan, or rural nonmetropolitan counties (non-core based statistical areas). In univariate and multivariate logistic regression analyses, we examined the association of the county classification and of other determinants with early (in situ/local) versus late (regional/distant) stage at CRC diagnosis. Of the 6,561 CRC patients identified, 45% were from metropolitan counties, 24% from micropolitan nonmetropolitan counties and 31% from rural nonmetropolitan counties, with 32%, 38%, and 33%, respectively, being diagnosed at an early stage. Multivariate analysis showed micropolitan nonmetropolitan residents were significantly more likely than rural nonmetropolitan residents to be diagnosed at an early stage (adjusted OR, 1.22; 95% CI: 1.05-1.42, P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; .05). However, rural nonmetropolitan and metropolitan residents did not significantly differ in the likelihood of early diagnosis. Residents with Medicare rather than those with private insurance (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; .0001), married rather than unmarried residents (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; .01), and residents with rectal cancer rather than those with colon cancer (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; .0001) were more likely to be diagnosed at an early stage. Early CRC diagnosis needs to be increased in rural (non-core) non-metropolitan residents, unmarried residents, and those with private insurance.</p><div class="ds-related-work--ctas"><button class="ds2-5-text-link ds2-5-text-link--inline js-swp-download-button" data-signup-modal="{"location":"wsj-grid-card-download-pdf-modal","work_title":"Rurality and Other Determinants of Early Colorectal Cancer Diagnosis in Nebraska: A 6-Year Cancer Registry Study, 1998-2003","attachmentId":42160808,"attachmentType":"pdf","work_url":"https://www.academia.edu/18532564/Rurality_and_Other_Determinants_of_Early_Colorectal_Cancer_Diagnosis_in_Nebraska_A_6_Year_Cancer_Registry_Study_1998_2003","alternativeTracking":true}"><span class="material-symbols-outlined" style="font-size: 18px" translate="no">download</span><span class="ds2-5-text-link__content">Download free PDF</span></button><a class="ds2-5-text-link ds2-5-text-link--inline js-wsj-grid-card-view-pdf" href="https://www.academia.edu/18532564/Rurality_and_Other_Determinants_of_Early_Colorectal_Cancer_Diagnosis_in_Nebraska_A_6_Year_Cancer_Registry_Study_1998_2003"><span class="ds2-5-text-link__content">View PDF</span><span class="material-symbols-outlined" style="font-size: 18px" translate="no">chevron_right</span></a></div></div></div></div><div class="ds-sticky-ctas--wrapper js-loswp-sticky-ctas hidden"><div class="ds-sticky-ctas--grid-container"><div class="ds-sticky-ctas--container"><button class="ds2-5-button js-swp-download-button" data-signup-modal="{"location":"continue-reading-button--sticky-ctas","attachmentId":71004371,"attachmentType":"pdf","workUrl":null}">See full PDF</button><button class="ds2-5-button ds2-5-button--secondary js-swp-download-button" data-signup-modal="{"location":"download-pdf-button--sticky-ctas","attachmentId":71004371,"attachmentType":"pdf","workUrl":null}"><span class="material-symbols-outlined" style="font-size: 20px" translate="no">download</span>Download PDF</button></div></div></div><div class="ds-below-fold--grid-container"><div class="ds-work--container js-loswp-embedded-document"><div class="attachment_preview" data-attachment="Attachment_71004371" style="display: none"><div class="js-scribd-document-container"><div class="scribd--document-loading js-scribd-document-loader" style="display: block;"><img alt="Loading..." src="//a.academia-assets.com/images/loaders/paper-load.gif" /><p>Loading Preview</p></div></div><div style="text-align: center;"><div class="scribd--no-preview-alert js-preview-unavailable"><p>Sorry, preview is currently unavailable. 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