An exploration of colorectal cancer incidence rates in North Dakota, USA, via structural equation modeling

Gary G. Schwartz, Marilyn G. Klug, Bradley C. Rundquist

Research output: Contribution to journalArticle

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 < 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.

Original languageEnglish (US)
Pages (from-to)1571-1576
Number of pages6
JournalInternational Journal of Colorectal Disease
Volume34
Issue number9
DOIs
StatePublished - Sep 1 2019

Fingerprint

Colorectal Neoplasms
Incidence
Water
Demography
Radon
Uranium
Structural Models
Disinfection
Population Density
Early Detection of Cancer
Drinking Water
Carcinogens
Nitrates
Registries
Soil
Bacteria
Population
Neoplasms

Keywords

  • Colorectal cancer
  • Epidemiology
  • North Dakota
  • Structural equations

ASJC Scopus subject areas

  • Gastroenterology

Cite this

An exploration of colorectal cancer incidence rates in North Dakota, USA, via structural equation modeling. / Schwartz, Gary G.; Klug, Marilyn G.; Rundquist, Bradley C.

In: International Journal of Colorectal Disease, Vol. 34, No. 9, 01.09.2019, p. 1571-1576.

Research output: Contribution to journalArticle

@article{f3dcd0286a864caa9bbbec1372355b57,
title = "An exploration of colorectal cancer incidence rates in North Dakota, USA, via structural equation modeling",
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 < 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.",
keywords = "Colorectal cancer, Epidemiology, North Dakota, Structural equations",
author = "Schwartz, {Gary G.} and Klug, {Marilyn G.} and Rundquist, {Bradley C.}",
year = "2019",
month = "9",
day = "1",
doi = "10.1007/s00384-019-03352-9",
language = "English (US)",
volume = "34",
pages = "1571--1576",
journal = "International Journal of Colorectal Disease",
issn = "0179-1958",
publisher = "Springer Verlag",
number = "9",

}

TY - JOUR

T1 - An exploration of colorectal cancer incidence rates in North Dakota, USA, via structural equation modeling

AU - Schwartz, Gary G.

AU - Klug, Marilyn G.

AU - Rundquist, Bradley C.

PY - 2019/9/1

Y1 - 2019/9/1

N2 - 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.

AB - 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.

KW - Colorectal cancer

KW - Epidemiology

KW - North Dakota

KW - Structural equations

UR - http://www.scopus.com/inward/record.url?scp=85068996705&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85068996705&partnerID=8YFLogxK

U2 - 10.1007/s00384-019-03352-9

DO - 10.1007/s00384-019-03352-9

M3 - Article

C2 - 31312891

AN - SCOPUS:85068996705

VL - 34

SP - 1571

EP - 1576

JO - International Journal of Colorectal Disease

JF - International Journal of Colorectal Disease

SN - 0179-1958

IS - 9

ER -