Cancer Center

EmailEmail    |   Bookmark Page Bookmark  |   RSS Feeds RSS  |   Print Page Print  

Cancer in Southeastern Wisconsin


Download a PDF version of this report here.

The Medical College of Wisconsin (MCW) Cancer Center’s primary catchment area consists of eight counties in southeastern Wisconsin - Milwaukee, Jefferson, Kenosha, Ozaukee, Racine, Walworth, Washington, and Waukesha (Figure 1) and over 2 million residents (Table 1).  This catchment area includes one of the most segregated metropolitan areas in the United States, and includes 83% of Wisconsin’s African American population (Figure 2), and some of the highest minority cancer mortality rates in the country.  Overall, our eight-county catchment area is home to 62% of the minority community in Wisconsin (Table 1).  Entrenched poverty, lack of health insurance options, and constrained public services create significant barriers to health care access, and further contribute to the dramatic health disparities by socioeconomic status that exist – and persist – in this area.

The catchment area is defined as the greater Milwaukee metropolitan area[1],  plus Kenosha County, due to ongoing MCW cancer activities in that county.  It does not include Dodge county, which falls within the catchment area of the University of Wisconsin Carbone Cancer Center.

Overall, the population of the catchment area is 14% Black/African American, 10% Hispanic/Latino, 72% White, and ~5% other minorities.  The City of Milwaukee is the metropolitan center of this region with approximately 595,000 residents, of whom 39% are Black/African American, 17% are Hispanic/Latino, 38% are White, and 2%[2] are Hmong.  The remainder are other racial and ethnic minority populations (Table 1).

For pediatric cancers, the catchment area is much broader, including the entire state of Wisconsin and beyond.

In addition the MCW Cancer Center has identified a growth area that includes the two Wisconsin counties (Brown and Marathon) that are future MCW community medical education focus areas (Figure 1).
 

Table 1: MCW Cancer Center Southeastern Wisconsin Catchment Area

 

 

Sex

Race and Ethnicity

County

Total Population

Male

Female

Hispanic or Latino (of any race)

White alone

Black or African American alone

American Indian and Alaska Native alone

Asian alone*

Native Hawaiian and Other Pacific Islander alone

Some other race alone

Two or more races

Milwaukee

947,941

457,942

489,999

126,273

515,620

247,658

3,766

31,895

359

680

21,690

 

 

48.30%

51.70%

13.30%

54.40%

26.10%

0.40%

3.40%

0.00%

0.10%

2.30%

Jefferson

83,708

41,629

42,079

5,594

75,876

533

78

472

0

25

1,130

 

 

49.70%

50.30%

6.70%

90.60%

0.60%

0.10%

0.60%

0.00%

0.00%

1.30%

Kenosha

166,493

82,613

83,880

19,579

129,907

11,048

441

2,526

35

203

2,754

 

 

49.60%

50.40%

11.80%

78.00%

6.60%

0.30%

1.50%

0.00%

0.10%

1.70%

Ozaukee

86,436

42,413

44,023

2,022

80,662

1,250

297

1,472

0

65

668

 

 

49.10%

50.90%

2.30%

93.30%

1.40%

0.30%

1.70%

0.00%

0.10%

0.80%

Racine

195,340

96,738

98,602

22,538

145,127

21,280

358

2,490

26

439

3,082

 

 

49.50%

50.50%

11.50%

74.30%

10.90%

0.20%

1.30%

0.00%

0.20%

1.60%

Walworth

102,457

51,412

51,045

10,558

88,582

1,081

138

683

0

326

1,089

 

 

50.20%

49.80%

10.30%

86.50%

1.10%

0.10%

0.70%

0.00%

0.30%

1.10%

Washington

131,985

65,271

66,714

3,403

124,420

1,059

116

1,461

0

11

1,515

 

 

49.50%

50.50%

2.60%

94.30%

0.80%

0.10%

1.10%

0.00%

0.00%

1.10%

Waukesha

389,899

191,182

198,717

16,204

352,855

4,799

476

10,166

18

263

5,118

 

 

49.00%

51.00%

4.20%

90.50%

1.20%

0.10%

2.60%

0.00%

0.10%

1.30%

Primary Catchment Area

2,104,259

1,029,200

1,075,059

206,171

1,513,049

288,708

5,670

51,165

438

2,012

37,046

 

48.91%

51.09%

9.80%

71.90%

13.72%

0.55%

4.76%

0.21%

0.13%

1.76%

 

 

 

 

 

 

 

 

 

 

 

 

Brown

248,907

123,151

125,756

18,102

208,284

5,213

5,642

6,698

18

200

4,750

 

 

49.50%

50.50%

7.30%

83.70%

2.10%

2.30%

2.70%

0.00%

0.10%

1.90%

Marathon

134,097

67,273

66,824

3,011

120,824

434

460

7,041

18

197

2,112

 

 

50.20%

49.80%

2.20%

90.10%

0.30%

0.30%

5.30%

0.00%

0.10%

1.60%

Future Growth Area

383,004

190,424

192,580

21,113

329,108

5,647

6,102

13,739

36

397

6,862

 

49.72%

50.28%

5.51%

85.93%

2.97%

3.17%

65.07%

0.01%

7.03%

112.45%

 

 

 

 

 

 

 

 

 

 

 

 

Wisconsin

5,690,898

2,824,355

2,866,543

337,469

4,738,390

348,535

44,762

128,487

1,180

4,278

87,797

 

 

49.60%

50.40%

5.90%

83.30%

6.10%

0.80%

2.30%

0.00%

0.10%

1.50%

City of Milwaukee

595,161

284,629

310,532

103,010

223,204

230,076

2,322

21,414

331

322

14,482

 

47.80%

52.20%

17.30%

37.50%

38.70%

0.40%

3.60%

0.10%

0.10%

2.40%

Source: Population estimates from American Community Survey 2011 3-year data (http://factfinder2.census.gov).
 

Figure 2: Minority Populations in WI, Catchment Area and City of Milwaukee

 
 

Cancer Burden and Disparities in Wisconsin


Cancer is currently the leading cause of death in Wisconsin[3].  Approximately 30,000 Wisconsin residents are diagnosed with cancer each year, and more than 11,000 die from cancer. Mirroring national trends, the highest incidence cancers (age-adjusted rates per 100,000) in 2006-2010 were lung/bronchus (62.0), prostate (143.0 among men), female breast (122.5 among women), and colon/rectum (42.5)[4]

Similarly, the cancers with the highest mortality rates for Wisconsin residents in 2006-2010 are lung/bronchus (46.9), prostate (24.5 among men), female breast (21.3 among women), and colon/rectum (15.0) [5]

Of all Wisconsin counties, some of the highest cancer incidence and mortality rates are found in southeastern Wisconsin, where the MCW Cancer Center is located. Reducing cancer health disparities is a top public health priority. Cancer health disparities affect Wisconsin populations, with African Americans suffering the greatest cancer incidence and mortality disparity burden.

Although African American women are less likely to be diagnosed with breast cancer than white women in Wisconsin, they are more likely to succumb to the disease.  African Americans in Wisconsin also have significantly higher age-adjusted incidence and mortality rates per 100,000 from colorectal cancer (57.1 incidence, 23.0 mortality) and lung cancer (90.5 incidence, 70.4 mortality) than do whites (colorectal: 41.3 incidence, 14.8 mortality; lung: 59.4 incidence, 46.0 mortality). A similar pattern is observed for male prostate cancer, with African American rates (220.1 incidence, 42.1 mortality) higher than those for white populations (138.4 incidence, 24.1 mortality).  American Indians also experience disparities, with higher rates of colorectal cancer incidence (56.2) and lung cancer incidence (107.5) and mortality (85.9) than whites (Table 2).  Overall, African Americans and American Indians experience higher cancer incidence and mortality rates than all races and whites, while other racial and ethnic groups (Asian American/Pacific Islander, Hispanic/Latino) experience lower rates.[6]

 

Table 2.  Age-Adjusted Cancer Incidence and Mortality Rates,by Race/Ethnicity in Wisconsin, 2006-2010

Site

All Races

White

African American

American Indian

Hispanic/Latino

All Cancers

Incidence

466.0

457.0

527.6

502.8

357.4

Mortality

175.6

173.4

240.1

234.4

98.2

Lung & Bronchus

Incidence

62.0

59.4

90.5

107.5

34.6

Mortality

46.9

46.0

70.4

85.9

13.8

Colorectal

Incidence

42.5

41.3

57.1

56.2

33.9

Mortality

15.0

14.8

23.0

13.7

4.8

Pancreas

Incidence

12.3

11.7

16.6

10.5

11.7

Mortality

11.2

11.1

15.9

9.6

9.0

Prostate

Incidence

143.0

138.4

220.1

123.0

114.2

Mortality

24.5

24.1

42.1

34.8

12.6

Breast

Incidence

122.5

122.6

116.5

104.3

85.2

Mortality

21.3

21.1

29.1

23.2

9.8

Cervical

Incidence

5.8

5.3

9.8

18.6

9.9

Mortality

1.6

1.4

4.0

--

--

Liver

Incidence

4.8

4.1

12.1

13.8

15.3

Mortality

3.3

3.0

8.4

6.1

8.2

             

Source: Wisconsin Cancer Reporting System, Office of Health Information, Division of Public Health, Department of Health Services, 2013.

*Rates are per 100,000 population and age-adjusted to the 2000 US standard population.

Notes: Hispanic Latino category includes all races.

Race-specific rates based on fewer than 10 cases are not presented

 

Cancer Burden in Milwaukee


A top priority of the MCW Cancer Center is to obtain a complete picture of the cancer burden in our catchment area. Below, we share a few data points which focus on Milwaukee County as an example.  Wisconsin's African American population totaled 348,353 in 2010 (6.10% of the state population). Nearly 90% of African Americans living in Wisconsin live in six southeastern Wisconsin counties (Milwaukee, Dane, Racine, Kenosha, Rock and Waukesha), with 66% of Wisconsin’s African American population living in the city of Milwaukee, comprising almost 39% of the city’s population (Table 1, Figure 2).   US Census Bureau Milwaukee County demographic data (Table 3) reveals that approximately 20.9% Milwaukee citizens live below the federal poverty level. These population demographics are significant since many population groups in Wisconsin and nationwide, often identified by race, ethnicity, socioeconomic status, and geography, experience a greater burden of cancer. Thus, to reduce the cancer burden in Wisconsin and eliminate health disparities, a focus on southeastern Wisconsin, and in particular Milwaukee County, is of the utmost importance (Figure 3)[7].

The Women’s Health Section of the Milwaukee Community Health Survey shows a decline in the number of women obtaining mammograms from 84% in 2003 to 77 percent in 2012, and a decline in the number of women obtaining pap smears from 90 percent in 2003 to 85% in 2012 (Table 4). Likewise, prostate screening rates in men have declined from 61% in 2006 to 51% in 2012 (Table 5).  Colorectal cancer screenings has seen some improvements from 2009 to 2012, with 67% reporting screening within the recommended time frame in 2012 as opposed to 61% in 2009. There was also a slight increase in the percent of individuals having a colonoscopy within the past ten years, increasing from 58% in 2009 to 61% in (Table 5). 

Table 3. Source: Milwaukee County Census Data; US Census Bureau www.factfinder2.census.gov

Demographics  2008-2012 American Community Survey 5-Year Estimates

 

Milwaukee County

State of Wisconsin 

Education level of adults 25 years or older

Less than high school degree

14.5%

9.9%

High school degree

29.1%

33.1%

Some college/associates

28.7%

30.7%

Bachelor’s degree or higher

27.7%

26.4%

Percent of those ages 16 or older who are unemployed

10.6%

7.5%

Median Household Income

$43,599

$49,001

Percent below poverty

20.9%

15.3%

Language spoken at home

English

84.1%

91.4%

Spanish or Spanish creole

10.0%

4.5%

Indo-European

3.0%

2.2%

Asian and Pacific Island

2.3%

1.6%

Other Languages

0.8%

0.3%

Housing

Owner Occupied

51.9%

68.6%

Renter Occupied

48.1%

31.4%

 

Table 4.  Source: Milwaukee Community Health Survey 2012-2013 http://mkehcp.org/publications/

Milwaukee Community Health Survey

Women's Health

2003

2006

2009

2012

Mammogram (50+; within past 2 years)

84.0%

78.0%

78.0%

77.0%

Bone Density Scan (65 and older)

 

67.0%

73.0%

71.0%

Pap Smear (18-65; within past 3 years)

91.0%

90.0%

89.0%

86.0%

 

Other Research: (2010)

WI

US

Mammogram (50+; within past 2 years)

80.0%

78.0%

Pap Smear (18+; within past 3 years)

85.0%

81.0%

           
 

Table 5.  Source: Milwaukee Community Health Survey 2012-2013

Milwaukee Community Health Survey

Men's Health (40 and Older)

 

2006

2009

2012

Prostate Cancer Screening Within Past 2 Years

 

61.0%

64.0%

51.0%

Colorectal Cancer Screenings (50 and older men and women)

2003

2006

2009

2012

Blood Stool Test (within past year)

36.0%

23.0%

 

14.0%

Sigmoidoscopy (within past 5 years)

 

 

10.0%

10.0%

Colonoscopy (within past 10 years)

 

 

58.0%

61.0%

Screening in Recommended Time Frame

 

 

61.0%

67.0%

Cigarette Use (men and women)

2003

2006

2009

2012

Current Smokers (past 30 days)

26.0%

26.0%

25.0%

24.0%

Other Tobacco Products

 

 

 

6.0%

Quite Smoking at least 1 Day or More in past Year:

 

 

 

 

Because Trying to Quit

51.0%

54.0%

53.0%

64.0%

Saw a Health Care professional and Advised to Quit

 

77%

72%

80%

Other Research (men and women)

 

 

WI

US

Current Smokers (2010)

 

 

19.0%

17.0%

Tried to Quit (2005)

 

 

49.0%

56.0%

 

[1] The Office of Management and Budget (OMB) in February 2013 issued new delineations of metropolitan areas.  As of February 2013, the Milwaukee-Waukesha-West Allis metropolitan statistical area includes Milwaukee, Ozaukee, Washington and Waukesha counties. The Milwaukee-Racine-Waukesha Combined Statistical Area includes in addition Dodge, Racine, Jefferson, and Walworth counties.

[2] Population estimate for Hmong in Milwaukee city is from US Decennial Census 2010 (http://factfinder2.census.gov).

[3] Wisconsin Caner Facts & Figures 2013-2014. American Cancer Society. www.wicancer.org/

[4] Wisconsin Cancer Reporting System, Office of Health Information, Division of Public Health, Department of Health Services, 2013.

[5] National Center for Health Statistics. Wisconsin mortality data file 1995-2010, compiled from data provided through the Vital Statistics Cooperative Program, 2013.

[6] Wisconsin Cancer Reporting System, Office of Health Information, Division of Public Health, Department of Health Services, 2013.

[7] *Additional Sources:

Wisconsin Department of Health Services. African Americans in Wisconsin. 2012; Available at: http://www.dhs.wisconsin.gov/health/minorityhealth/mhpop/africanameripop2009.htm. Accessed September 17, 2013.

Jones NR, Williamson A, Foote M, Creswell P, Strickland R, Remington P, Cleary J, Adams A. Cancer Health Disparities Persist among African Americans in Wisconsin. WMJ 2010 October; 109(5): 267–273.

 

 

webmaster@mcw.edu
© 2014 Medical College of Wisconsin
Page Updated 06/11/2014