The Cleveland Department of Public Health, in cooperation with the Cuyahoga County Board of Health and the Ohio Department of Health (ODH), presents cancer incidence data for Cleveland statistical planning areas and county municipalities.

Numbers of incident primary cancer cases per area during 1998-2002 reported to the Ohio Cancer Incidence Surveillance System (OCISS) of ODH are presented. These case counts reflect all types and all sites of malignant cancer, aggregated.

Here are the summarized results:

Higher than expected numbers of primary cancer, all sites/types, aggregated

• City of Cleveland (in aggregate)
• Central, Corlett, Downtown, Euclid-Green ,Fairfax, Forest Hills, Glenville, Hough
  Kinsman, Lee-Miles, Mt. Pleasant, North Broadway, North Collinwood, Ohio City
  Puritas-Longmead, South Broadway, South Collinwood, St. Clair-Superior, Union-Miles
  West Boulevard
• Cuyahoga County (in aggregate)
• Bay Village, Beachwood, Bedford, Bedford Hts., Brookpark, Cleveland Hts.East Cleveland,
  Euclid, Fairview Park, Garfield Hts., Lakewood, Lyndhurst, Maple Hts., Mayfield Hts.
  North Olmsted, North Randall, Olmsted Falls, Olmsted Twp., Orange, Solon, South Euclid

Lower than expected numbers of primary cancer, all sites/types, aggregated

• Edgewater (statistical planning area)
• Brecksville, Highland Hills, Woodmere (municipalities)

As expected numbers of primary cancer, all sites/types, aggregated

• Brooklyn Centre, Buckeye-Shaker, Clark-Fulton, Cudell, Detroit-Shoreway, Goodrich-Kirtland Park, Industrial Valley, Jefferson, Kamms Corners, Old Brooklyn, Riverside, Stockyards, Tremont, University, Woodland Hills  (statistical planning areas)
• Bentleyville, , Berea, Bratenahl, Broadview Hts., Brooklyn, Brooklyn Hts.,
  Chagrin Falls Twp., , Chagrin Falls Village, Cuyahoga Hts., Gates Mills, Glenwillow,
  Highland Hts., Hunting Valley, Independence, Linndale, Mayfield Village, Middleburg Hts.,
  Moreland Hills, Newburgh Hts., North Royalton, Oakwood, Parma, Parma Hts.,
  Pepper Pike, Richmond Hts., Rocky River, Seven Hills, Shaker Hts., Strongsville,
  University Hts., Valley View, Walton Hills, Warrensville Hts., Westlake (municipalities)

How are these determined?

The expected number of cases are deterimined from the national age-specific rates of primary cancer for all sites and types as reported by the Surveillance Epidemiology and End Reporting (SEER) system of the National Cancer Institute.  These age-specific rates per 1,000,000 are presented for the same range of years.

Multiplying the number of age-specific cases in each local area against the age-specific national rates gives the expected number of cancer cases for each group that would be expected in the local area group.

The expected case counts are added together to derive the total number of expected cancer cases for the local area during that time period had the residents had a similar cancer experience than the US population. This sum gives the total expected number of cases for each area (SPA, municipality.) 

Next, the ratio of the observed to expected case counts provides the SIR, or standardized incidence ratio. This ratio, and a confidence interval around this ratio, allows us to determine if there are more cases observed than expected. 

                                                              Number of cases observed

                                                               in the area for the time period

SIR (Standardized Incidence ratio )  = _________________________

                                                              Number of cases expected

                                                               in the area for the time period

In general, (without considering variation in sampling)

• SIR = 1.0, when the observed and expected case counts are the same.
• SIR < 1.0 when there are fewer observed cases compared to the expected case counts.
• SIR > 1.0 when there are more observed cases compared to the expected case counts.

A confidence interval is needed since number vary naturally in any sample. This interval allows us to suspect that the ratio is big enough, or small enough, to make a reasonable conclusion that the difference in observed to expected cancer case counts vary significantly.

More specifically, when considering the confidence interval

• If the SIR confidence interval includes 1.0, we conclude that it is reasonable to conclude that the observed and expected case counts are not different. (If the interval is wide, we may not have enough cases to detect the difference between observed and expected case counts.)

How to read the tables

Let's consider this table below.

The SIR values are near 1.0, and the value of 1.0 can be found between the lower and upper interval bounds. So, we would conclude that the number of incident all sites/all types of cancer diagnoses are what would be expected had the residents in the area had similar cancer incidence to the US population.

We read the results for Brooklyn-Center as follows: For 1998-2002, Brooklyn-Center residents had between 11% less and 22% more cancer cases for all sites/types than expected. Given the variations in case counts per year, we conclude that the number of primary all site/type cancers that occurred among Brooklyn-Center residents during 1998-2002 was not different than would be expected. 

Next, let's consider this table below.

The SIR values are above 1.0, and the value of 1.0 can be found below the lower interval bound. So, we would conclude that the number of incident all sites/all types of cancer diagnoses are higher than would be expected had the residents in the area had similar cancer incidence to the US population.

We read the results for Central neighborhood as follows: For 1998-2002, Central neighborhood residents had 28.4% more primary cancer cases, between 12.2% and 46.3% more cancer cases, for all sites/types than expected.  

To download the data tables with the actual results click this link: