Important details about PCIST methods and how to read CCIR reports are available under “Why PCIST?”

As you read and interpret your CCIR, the following points can also serve as a general guide.  Like any epidemiological tool, PCIST has both strengths and weaknesses.

1. The main part of the CCIR report provides the percents that the annual average crude cancer incidence rates are elevated as compared with the U.S. national, PA state, and county rates. We only list cancers where an elevation of more than 10% was found.  

A 50% elevation is equivalent to a rate of 1.5 times the comparison population; 100% to 2 times; 200% to 3 times etc.

The percent elevations are provided for the total population, all females, all males, children aged 0-19, youth aged 0-29, and adults aged 20+.  We provide these breakdowns, in addition to our total population analysis, because children and adults, and men and women, have different physiologies.  Gendered and age differences in exposures are also a factor. 

2. Because rates of cancer are strongly affected by age, Community Cancer Incidence Reports (CCIR) always include the median age of each reference population and an informational chart that provides the average age of onset of each type of cancer. This information aids interpretation and the identification of true “hot spots” with elevated community cancer incidence, as opposed to situations where a significantly older population might explain the elevations.

3. Like all epidemiological tools, PCIST numbers are most powerful and accurate when dealing with larger communities. The tool was specifically designed, however, to provide urgently needed and otherwise unavailable information on cancer incidence for smaller towns and boroughs. Here it is it most helpful to think of elevated numbers as “cancer signals” rather than absolute incidence rates.  With a small community, the percent elevation will jump much more (up and down) due to even a few more or few less cases, especially for rarer types of cancer. Since all pediatric cancers are rare, percent elevations in the high hundreds and thousands should be understood as a positive signal that there is an elevation, without undue attention to and concern about the specific value.

It is also very helpful to explore what your community’s cancer profile looks like as compared with neighboring communities.  If the rate of a rare cancer (like laryngeal in adults or any type of cancer in children) is consistently elevated in towns near your own, this finding cannot reasonably be explained away as “random chance”. It is extremely improbable that the exact same cancers (out of 23 possibilities) are elevated in adjoining communities unless there is a shared underlying factor.  A strength of PCIST is its all-inclusive, comprehensive scope, which allows for such comparative interpretations of the data. 

PCIST ultimately prioritizes providing PA communities with information about what has actually occurred in terms of cancer cases, rather than prioritizing abstract statistical standards of what constitutes a “good number”.  We do not believe that it is ethical to dismiss or erase the significance of cases of cancer in small communities where statistical priorities can never be realized. Arguably, doing so for decades has cost us an accurate understanding of Pennsylvanians’ lived health experiences, and has especially left our most vulnerable communities feeling invalidated.  Ours is a call to put people, rather than statistical principles, first.

For any questions or further assistance in reading and assessing your community’s CCIR report, please contact PCIST@pm.me.

We are always happy to discuss, explain, collaborate, partner and help. Maps and other visual representations of PCIST findings are also forthcoming.