2025 Community Health Needs Assessment by coe_cucancer

COMMUNITY HEALTH NEEDS ASSESSMENT

2025

Cover photo by Austin Hess on Unsplash

Photo by Mark Hessling on Unsplash

UNIVERSITY OF COLORADO CANCER CENTER

Mission Statement

Uniting our community to overcome cancer through innovation, discovery, prevention, early detection, multidisciplinary care, and education.

Vision Statement

Prevent and conquer cancer. Together.

LETTER FROM THE DIRECTOR

Dear Community Members,

The University of Colorado Cancer Center is delighted to share the 2025 Community Health Needs Assessment Report with you.

The CU Cancer Center stands at the forefront of cancer research and patient care in Colorado. As the state’s only National Cancer Institute (NCI)-designated Comprehensive Cancer Center, we hold a prestigious distinction that acknowledges our exceptional contributions to the fields of research, clinical trials, prevention, and cancer control. Our guiding vision is clear: “Prevent and conquer cancer. Together.” Our definition of “together” extends past our providers, researchers, and staff to include the community, our partners, and all residents of Colorado.

The CU Cancer Center is committed to equity and inclusion in the fulfillment of its mission and vision to benefit its catchment area, the state of Colorado. In that effort, we strive to understand the cancer burden, risk, and disparities that affect all Coloradans.

This 2025 Community Health Needs Assessment Report presents detailed insights into the cancer burden for various cancers in Colorado, emphasizing the unequal burden shared by counties with cancer disparities. This report shares the key areas where the CU Cancer Center will focus its efforts in the coming years, including goals around reducing the unequal cancer burden for disadvantaged communities in Colorado. Another priority is increasing collaborations between the CU Cancer Center and communities to better understand from their perspective the communities’ needs, priorities, and capacity to reduce the cancer burden in their counties and regions. These efforts at the CU Cancer Center are led by our Office of Community Outreach and Engagement.

Throughout this report, you will see that the CU Cancer Center is committed to understanding and reducing the cancer burden in Colorado through its vision to prevent and conquer cancer together.

Thank you for dedicating time to read this report. Our collective eﬀorts with communities and organizations throughout the state are indispensable to advancing health outcomes in Colorado.

Sincerely,

Richard Schulick, MD, MBA Director, University of Colorado Cancer Center Professor and Chair, University of Colorado Department of Surgery

The

Aragón/Gonzalez-Gíustí Chair

Richard Schulick, MD, MBA

MESSAGE FROM THE OFFICE OF

COMMUNITY OUTREACH & ENGAGEMENT

Dear Community Members,

The Oﬃce of Community Outreach and Engagement (COE) at the CU Cancer Center proudly presents the 2025 Community Health Needs Assessment Report. The report is a comprehensive assessment of how cancer aﬀects Coloradans, in the context of community perspectives on the cancer burden in the state.

On behalf of the CU Cancer Center, COE seeks to create synergy in its aims to minimize the adverse impact that cancer has on all Coloradans, with emphasis on those who share an unequal burden of cancer. As charged by the center’s Community Advisory Council, we prioritize efforts to benefit the medically underserved (e.g., uninsured, underinsured, low income), racial and ethnic minorities, and rural and frontier populations disproportionately affected by cancer disparities.

COE is charged with monitoring and disseminating up-to-date cancer data relevant to Colorado. To this end, we use population-based cancer statistics and engage in bidirectional communication to understand communities’ needs and priorities, including conducting a community health needs assessment across Colorado. For the 2025 Community Health Needs Assessment Report, we conducted a county-level analysis followed by countylevel key informant (KI) interviews, emphasizing counties with higher cancer disparities. The CU Cancer Center will use the report to guide and target cancer prevention and control activities that are responsive to community perspectives. To augment its impact, the report will be disseminated widely via the CU Cancer Center’s publications, website, Community Advisory Council, and community partners.

The CU Cancer Center and COE are immensely grateful to the key community members interviewed and their organizations for contributing their knowledge and experience to the Community Health Needs Assessment. We are committed to using the information shared to reduce the cancer burden in our Colorado communities.

Sincerely,

Evelinn A. Borrayo, PhD

Associate Director for Community Outreach and Engagement

University of Colorado Cancer Center

Professor, Colorado School of Public Health

CancerCure/AMC Cancer Fund Endowed Chair for Prevention and Control

Evelinn A. Borrayo, PhD

MESSAGE FROM THE OFFICE OF

ENGAGEMENT, ACCESS, & SUCCESS

Dear Community Members,

It is our pleasure to write this letter describing our profound commitment to Engagement, Access, and Success (EAS) at the University of Colorado Cancer Center. At the CU Cancer Center, we value the thoughts, perspectives, lived experiences, and backgrounds of ALL who work to facilitate our mission to overcome cancer through innovation, discovery, prevention, early detection, multidisciplinary care, and education. We are committed to the intentional development of a supportive and respectful academic community and workplace that prepares our oncology care providers, researchers and staﬀ to succeed in the war against cancer. Our oﬃce of EAS works to recruit, engage, and support exceptional individuals for the purpose of stimulating optimal research and healthcare for populations served by the CU Cancer Center.

Our commitment to engagement, access and success extends beyond the walls of our office of EAS. It is made actionable through our partnerships with the CU Cancer Center leadership, Office of Community Outreach and Engagement, Office of Cancer Research Training and Education Coordination, and communities across the state. By working together, we have the perspectives and capacity to identify health risks and gaps in cancer care delivery, and to develop solutions that can lead to better cancer outcomes for communities across Colorado. This 2025 Community Health Needs Assessment is a valuable tool to help us understand and address cancer disparities and inequities that affect our patients and their famiies. Thank you for partnering with us to promote a healthy Colorado.

For additional information regarding EAS Activities and opportunities at the CU Cancer Center, please visit our website at the QR code below.

With sincerity and appreciation,

Miria Kano, PhD (she/her/hers)

Associate Director, Engagement, Access, and Success

Morton Cohen Cancer Center Endowed Chair

The University of Colorado Cancer Center

Associate Professor of Community & Behavioral Health

Colorado School of Public Health

Curtis J. Henry, PhD (he/him/his)

Deputy Associate Director, Engagement, Access, and Success

The Margaret Turley Grohne Chair in Translational Cancer Research

The University of Colorado Cancer Center

Associate Professor of Immunology and Microbiology

Curtis J. Henry, PhD

Miria Kano, PhD

COMMUNITY OUTREACH & ENGAGEMENT

Mission Statement

COE’s mission is to provide strategic direction and planning for the CU Cancer Center to conduct focused initiatives and facilitate research that reduces the cancer burden in Colorado.

Vision Statement & Aims

Reduce Colorado’s cancer burden, risk, and disparities through the CU Cancer Center’s scientiﬁc, clinical, and community outreach and engagement endeavors. To achieve our mission and vision, COE has three aims:

1. Monitor and disseminate up-to-date data on the cancer burden, risks, and disparities in the catchment (Colorado).

2. Facilitate community-engaged research across scientiﬁc programs and clinical trials.

3. Engage communities in dissemination and implementation of interventions in cancer prevention, control, and survivorship.

Scope

As an integral component of the CU Cancer Center, COE plays a pivotal role in advancing the CU Cancer Center goal of improving cancer health equity and outcomes for all Coloradans. To achieve this goal, COE engages in education, outreach, intervention, community-engaged research, and advocacy in Colorado. Speciﬁcally, our initiatives focus on educating the public about cancer and implementing initiatives to reduce cancer incidence and mortality and improve cancer survival. To this end, COE seeks to increase access to cancer prevention, early-detection, treatment, survivorship, and research at the CU Cancer Center, including increasing underrepresented populations in clinical trials. COE also disseminates information and implements cancer prevention programs to reduce cancer risks and increase cancer’s early detection. We do this work in collaboration with community partners that represent various sectors of our society, including public health agencies, healthcare systems, schools, churches, coalitions and collaboratives, and local and state government. To augment our impact, we support policy initiatives to ease the burden of cancer for Coloradans.

Photo by Thomas Morse on Unsplash

EXECUTIVE SUMMARY

The Community Health Needs Assessment uses population-based data from the Colorado Central Cancer Registry. We analyzed data for 64 Colorado counties — 47 rural and 17 urban counties. The analysis included a Cancer Disparity Index for each county based on the incidence, mortality, and percentage of late-stage cancer diagnoses over a 10-year period. We focused the report on the 26 counties that have a higher Cancer Disparity Index. We assessed whether the counties’ cancer rates were similar, below, or above the rates of counties with non-elevated cancer disparities (non-disparity counties) and of the regional cancer rates. The goal of the assessment was to provide a picture of the cancer burden that cancer disparity counties experience.

The population-based ﬁndings were summarized in cancer snapshots using graphs and maps and shared with selected key informants (KI) from rural and urban communities across Colorado in 2022 and 2023. We then conducted KI interviews of local public health and healthcare leaders in these counties that revealed an overall minimal awareness of the cancer burden in their counties. Moreover, we found that counties with elevated cancer disparities (disparity counties) lack appropriate resources to implement cancer prevention and control measures to ease the cancer burden.

A conﬂuence of other health priorities and the impact of the COVID-19 pandemic have further taxed the healthcare system and reduced prioritization of programs to improve the prevention, early detection, or timely treatment of cancer in Colorado.

The Community Health Needs Assessment ﬁndings are described in more detail in this report. We discuss the CU Cancer Center COE’s current eﬀorts and plans to partner with communities over the next decade to improve the health landscape in Colorado to reduce the unequal burden of cancer across communities.

Visit our Exploring Cancer in Colorado (ECCO) data platform by visiting https://coe-ecco.org or scanning the QR code below for more information about the cancer burden in our state.

AT A GLANCE COLORADO

Photo by Brady Stoeltzing on Unsplash

The catchment area of the CU Cancer Center encompasses the entire state of Colorado. The catchment area represents >80% of the population that the CU Cancer Center serves through research, clinical care, and outreach and engagement initiatives. Colorado is now home to approximately 5.8 million people, and our population has grown more than 15% in the past 10 years. Colorado is the eighth largest state by land mass, covering 104,000 square miles. There are 64 counties in Colorado; of these, 47 (73%) counties are designated rural or frontier. Just over 12% of the population resides in those counties.

COLORAD O’S UNIQUE GEOGRAPHY

Altitude

Colorado is the highest contiguous state in the U.S. It is the only state that lies entirely above 1,000 meters elevation (1,300 feet). The average elevation is 6,800 feet, and about 250,000 Coloradans live at altitudes above 8,200 feet.

Utraviolet Radiation (UV)

Colorado enjoys about 300 days of sunshine each year. Because of our elevation, Coloradans are exposed to higher levels of ultraviolet (UV) radiation. UV intensity increases by approximately 10% for every 1,000 meters (~3,200 feet) in elevation. UV exposure is a risk factor for skin cancer, including melanoma.

Radon

Colorado is among the top 10 states with the highest average radon levels, due to a higher concentration of uranium in the soil. About 50% of homes tested across the state have radon levels above that recommended by the Environmental Protection Agency (4 picocuries per liter), and radon levels are higher in many mountain and rural counties. Radon is a cancer risk factor, mainly for lung cancer.

DEMOGRAPHICS

The median age of Coloradans is just over 37 years of age, with about 63% of the population between the ages of 18 and 64 years, and 15% of individuals age 65 and older.1

Race & Ethnicity

65.0% non-Hispanic White

22.5% Hispanic or Latino/a

4.6% more than one race

3.8% Black or African American

3.1% Asian

<1% American Indian or Native Hawaiian

Gender

47.2% female

52.8% male

Language (of citizens aged 18 years or older)

88.5% only speak English

11.5% speak a language other than English at home

7.3% speak Spanish

Health Insurance

7.1% no health insurance

Poverty

$80,000 median household income

10.0% living in poverty

Education

92.5% completed high school

42.8% earned at least a bachelor’s degree

CANCER BURDEN IN COLORADO

CANCER INCIDENCE

It is projected that 29,430 Coloradans will be diagnosed with cancer, and 8,480 people in the state will die from cancer, in 2024.2 The ﬁve most common cancers diagnosed in Colorado are female breast, prostate, lung, colorectal, and melanoma.3 These cancers account for over 50% of all new cancers (Figure 1).

Figure 1: Number of New Cancer Cases Diagnosed Per Year in Colorado for 10 Most Common Cancers (2016-2020)

Breast (Female)

Prostate (Male)

Lymphoma

Kidney & Renal Pelvis

Uterus (Corpus & Uterus, NOS) (Female)

Data Source: State Cancer Proﬁles (2016-2020). Created by the Population Health

at the University of Colorado Cancer Center3

CANCER MORTALITY

Lung cancer remains the most common cause of cancer death in Colorado, followed by colorectal, breast, pancreatic, and prostate cancer3 (Figure 2). Incidence and mortality rates for all cancers combined are lower in Colorado compared to the U.S. average (not displayed in a ﬁgure). However, incidence rates in Colorado are slightly higher for breast cancer, and mortality rates are higher than the national average for prostate cancer and melanoma.3

Figure 2: Number of Deaths Per Year in Colorado for 10 Most Common Causes of Cancer Death (2016-2020)

Data Source: State Cancer Proﬁles (2016-2020). Created by the

CANCER DISPARITIES

Cancer incidence and mortality rates differ across racial and ethnic groups. Overall, White and Black/African American populations have similar and higher incidence rates than other racial/ethnic groups in Colorado, though Black/African Americans experience higher mortality rates. They also have higher incidence for some cancers including colorectal and prostate cancer, and higher mortality rates for breast and prostate cancer compared to all other racial/ethnic groups (Figure 3).3 With a few exceptions, the Hispanic or Latino/a population tends to have lower incidence and mortality compared to other groups. However, Hispanic or Latino/a residents in Colorado experience significantly higher incidence rates than Hispanics nationally for breast and lung cancer and higher mortality (not displayed) for colorectal, breast, and prostate cancer [CDC State Cancer Profiles].

Figure 3: Age-Adjusted Incidence Rates of Top Five Cancers in Colorado, Stratiﬁed by Race and Ethnicity (2016-2020)a

American Indian/Alaska Native

Black/African American

Non-Hispanic

American Indian/Alaska Native

Non-Hispanic

American Indian/Alaska Native

Black/African American Black/African American

Non-Hispanic

American Indian/Alaska Native

Non-Hispanic

American Indian/Alaska Native

American Black/African American

Non-Hispanic

(2016-2020).

Photo by Connor Betts on Unsplash

Cancer burden also varies by urbanicity and cancer disparity status. Overall, persons living in urban counties have higher cancer incidence and mortality rates than those living in rural and frontier counties. However, Cancer Disparity Index scores, a combined measure of cancer incidence, mortality and percent of late-stage cancer diagnoses by county (described in more detail below), are higher in several rural and frontier counties and among counties in the southeast corner of the state (Figure 4). These counties also have a higher proportion of Hispanic or Latino/a residents and persons living in poverty (Figure 5).

4: Cancer Index in Colorado

Higher cancer disparity index reﬂects greater relative cancer burden.Cancer disparity index derived from principal components analysis using crudes rates of incidence, distant stage diagnoses, and mortality for all cancer sites combined.

Data analyzed and map prepared by Amy Mellies, Population Health Shared Resource, University of Colorado Cancer Center. Incidence data was collected and provided by the Colorado Department of Public Health and Environment (CDPHE) Colorado Central Cancer Registry (CCCR) Program. CDPHE and the CCCR Program speciﬁcally disclaim responsibility for any analyses, interpretations, or conclusions they have not provided. Mortality data were obtained from the Surveillance, Epidemiology, and End Results (SEER) Program’s SEER*Stat County Mortality (1990-2018) Database.

Figure 4: Cancer Disparity Index by County in Colorado

Figure 5: Sociodemographic Characteristics for Counties in

ure 5: Characteristics for Counties in

Photo by Devonshire on Unsplash

CANCER DISPARITIES BY RURAL AND URBAN STATUS

Persons living in counties with higher Cancer Disparity Index scores, both urban and rural/frontier counties, have higher incidence and mortality than those living in non-disparity counties (Figure 6). Further, mortality rates for all cancers combined are highest among residents in rural disparity counties.

The percentage of screenable cancers that are diagnosed at late stages serves as an indicator for both sub-optimal screening and poor outcomes. Data from the Colorado Cancer Registry (Figure 7) over a 10-year period (used to produce valid estimates across smaller populated counties) show that with the exception of prostate cancer—where a greater percent of late-stage cancers are diagnosed in rural disparity counties (23.35%) compared to all other counties—the percentage of lung, breast, and colorectal cancers diagnosed at late stages is fairly similar between rural/ urban and disparity counties.

Photo by David Wirzba on Unsplash

Figure 6: Age-Adjusted Incidence and Mortality Rates in Colorado, Stratiﬁed by Urbanicity and Disparity Status Per 100,000 People (2016-2020)a

Urban Non-Disparity

Disparity Rural Non-Disparity

Disparity

Non-Disparity

a Urbanicity determined based on Rural-Urban Continuum Codes. Disparity status refers to Colorado.

b Cancer Disparity Index. Orange bars represent urban counties. Blue bars represent rural counties.

C Data Source: State Cancer Proﬁles (2016-2020). Created by the PHSR at the University of Colorado Cancer Center3

Figure 7: Percentage of Late-Stage Diagnoses for Four Screenable Cancers, Stratiﬁed by Urbanicity and Disparity Status (2007-2018)a

Urban Disparity

Rural Non-Disparity

Disparity

Urban Non-Disparity

Urban Disparity

Rural Non-Disparity

Urban Non-Disparity

Disparity Rural Disparity

Rural Non-Disparity

Urban Non-Disparity

Urban Disparity Urban Disparity

Rural Non-Disparity

Disparity

aOrange represents urban counties. Blue represents rural counties.

bData Source: Colorado Central Cancer Registry (2007-2018). Created by the Population Health Shared Resource at the University of Colorado Cancer Center4

CANCER RISK FACTORS

Health conditions and behaviors such as physical inactivity, obesity, smoking, and heavy drinking can increase the risk of developing cancer. Prevalence of these risk factors across racial/ethnic groups and by county urbanicity and cancer disparity status is presented in Figures 8 and 9.

Physical inactivity is higher among Hispanic or Latino/a (27.98%), Asian/Paciﬁc Islander (32.65%), and Black/African American residents (24.25%) compared to nonHispanic White residents (13.27%), and physical inactivity is also more prevalent in rural disparity counties (35.39%).

Obesity rates are higher among Asian/ Paciﬁc Islander (44.25%), American Indian/ Alaska Native (39.19%), and Hispanic or Latino/a residents (30.35%).

Smoking rates are higher among American Indian/Alaska Native (25.5%), Asian/Paciﬁc Islander (18.59%), and Black/African American individuals (16.49%) and are highest among residents of rural disparity counties (21.55%).

Heavy drinking is notably higher among American Indian/Alaska Native (19.7%) and Asian/Paciﬁc Islander populations (17.72%) and in rural/frontier counties for both disparity (24.01%) and non-disparity counties (26.14%).

Photo by Calvin Weibel on Unsplash

Figure 8: Prevalence of Common Risk Factors for Cancer, Stratiﬁed by

Race and Ethnicity (2022)a

American Indian/Alaska Native

American Indian/Alaska Native Black/African American Black/African American Black/African American Black/African American

aOrange represents physical inactivity; green represents obesity; blue represents current smoking; red represents heavy drinking bData Source: Colorado Behavioral Risk Factor Surveillance Survey (BRFSS) (2022). Created by the Population Health Shared Resource at the University of Colorado Cancer Center5

Figure 9: Prevalence of Common Risk Factors for Cancer, Stratiﬁed by Urbanicity and Disparity Status (2022)a

aDisparity status refers to Cancer Disparity Index. Orange represents physical inactivity; green represents obesity; blue represents current smoking; red represents heavy drinking.

CANCER SCREENING

Coloradans who are up to date (UTD) with current cancer screening recommendations include 65.54% with colorectal, 75.40% with cervical, and 71.14% with breast cancer screenings. Cancer screening rates vary by racial/ethnic group and urbanicity/ cancer disparity status as shown in Figures 10 and 11.

For colorectal cancer screening, Asian/ Paciﬁc Islander (48.57%), American Indian/ Alaska Native (55.64%), and Hispanic or Latino/a residents (55.88%) are less likely to be UTD compared to non-Hispanic White residents (68.45%). Residents of rural non-disparity counties are not UTD with colorectal cancer screenings (58.00%) compared to residents in urban nondisparity counties (65.18%).

Screening for cervical cancer is lower among Asian/Paciﬁc Islanders (66%) compared to non-Hispanic Whites (76.7%). Cervical cancer screenings are lower in rural disparity counties (68.87%) than in urban non-disparity counties (79.36%). Mammography screening rates are notably lower among American Indian/Alaska Natives (35.11%) compared to other racial/ ethnic groups and are lowest in urban disparity counties (56.56%) compared to urban non-disparity counties (73.55%).

Photo by Bea De Ros on Unsplash

Figure 10: Percentage of Coloradans Who Have Met Cancer Screening Recommendations, Stratiﬁed by Race and Ethnicity (2020*, 2022)a

American Indian/Alaska Native

Black/African American

White Non-Hispanic

Asian/Paciﬁc Islander

American Indian/Alaska Native

Black/African American

White Non-Hispanic

Asian/Paciﬁc Islander

American Indian/Alaska Native

Black/African American

White Non-Hispanic

aMost recently available data for cervical cancer screening is from 2020 Colorado Behavioral Risk Factor Surveillance Survey. All other data are from 2022 BRFSS.

bScreening recommendations for 1) breast cancer: women ages 50-75 had mammogram in last 2 years; 2) cervical cancer: women ages 21-65 had a pap smear in the last 3 years; 3) colorectal cancer: any person 45-75 meeting U.S. Preventive Services Task Force guidelines6

cData Source: Colorado Behavioral Risk Factor Surveillance Survey (2020, 2022). Created by the Population Health Shared Resource at the University of Colorado Cancer Center5

Figure 11: Percentage of Coloradans Up to Date With Cancer Screening Recommendations, Stratiﬁed by Urbanicity and Disparity Status (2020, 2022)a

Urban Non-Disparity

Urban Disparity

Rural Non-Disparity

Rural Disparity

Urban Non-Disparity

Urban Disparity

Rural Non-Disparity

Rural Disparity

Urban Non-Disparity

Urban Disparity

Rural Non-Disparity

Rural Disparity

aMost recently available data for cervical cancer screening is from 2020 Colorado Behavioral Risk Factor Surveillance Survey. All other data are from 2022 BRFSS.

cData Source: Colorado Behavioral Risk Factor Surveillance Survey (2020, 2022). Created by the Population Health Shared Resource at the University of Colorado Cancer Center5

Figure 12 illustrates the diﬀerence in mammography screening rates across the 64 counties in Colorado. Overall, rural/frontier counties outside the Front Range corridor have lower mammography screening rates. Figure 13 shows vaccination rates statewide for human papillomavirus for children age 9-13 are about 50% (not displayed) and are much lower in rural and frontier counties (10%-30%).7

12: Percent of Women Age 50+ Who Are Up to Date With Mammography Screening by County in Colorado (2020)

Met Breast Cancer Screening Recommendations

Figure

Figure 13: Percent of Teenagers Aged 13-17 Who Are Fully Up to Date With HPV

Recommendations, by County in Colorado (2020)

Data Source:

Immunization Information System7

Photo by Heyzeus Escribo on Unsplash

COLORADO’S COMMUNITY HEALTH NEEDS ASSESSMENT

On behalf of the CU Cancer Center, the COE conducted a comprehensive Community Health Needs Assessment to determine the cancer burden for each of the 64 counties in Colorado by analyzing population-based data and conducting key informant interviews with leaders across the state’s regions.

Photo by Briana Tozour on Unsplash

STATE AND COUNTY CANCER DISPARITIES METHODS

In 2020, we determined cancer disparities for Colorado’s 64 counties with a Cancer Disparity Index developed by the Colorado Department of Public Health and Environment, using the most recently available Colorado Central Cancer Registry data (2007-2016). To develop the disparity indices, we analyzed with a Principal Components Analysis (PCA) the variables of interest, including cancer incidence, mortality, and late-stage diagnosis for all cancers in the state. PCA summarizes or clusters the variables that are most alike into “components.” To calculate an index score, each component is given a weight based on how much of the data variation they explain. A higher disease disparity index (i.e., higher rank) will have a higher corresponding index score. Accordingly, each Colorado county was ranked from 1 (lesser relative cancer disparity) to 64 (greater relative cancer disparity), with a cutoﬀ Cancer Disparity Index score above 39 points, indicating counties with greater cancer disparities relative to those with a score below 39 points.

We subsequently conducted county-specific analysis using the Colorado Central Cancer Registry data (2007-2016) and the Centers for Disease Control and Prevention (CDC) National Center for Health Statistics National Vital Statistics System data (20082016). We compared a county’s cancer rates with its health statistics region and with non-disparity counties rates. We included the incidence rates for the cancers reported in the registry; the late-stage diagnosis rate of screen-detectable cancers (lung, breast, prostate, colorectal, cervical, and melanoma of the skin); ageadjusted mortality rate of the cancers reported; and the percent alive after five years of diagnosis for reported cancers in the registry. We then determined if the county’s cancer rates were similar, below, or above the regional and state rates. The findings were displayed in cancer snapshots with maps, graphs, and statistical parameters for the counties and region.

COMMUNITY READINESS & CAPACITY METHODS

We shared the cancer snapshots during key informant (KI) interviews with selected community leaders from Colorado’s rural and urban counties. The snapshots were presented to determine whether leaders and the communities they represented were aware of the cancer burden in their respective county. The presentation was followed by KI interviews of the leaders to understand the county’s level of readiness and capacity to implement cancer prevention and early detection programs in the county and region. The leaders interviewed included regional health connectors, nurse practitioners, public health nurses, healthcare system executives, directors of public health departments, directors and managers of oncology practices and hospitals, and other public health professionals, for a total of 37 interviews.

We used the Community Readiness Model (CRM)8 to guide the content of the KI interviews. The CRM is a methodology to determine a community’s level of readiness to address a health problem and to assess

capacity to implement initiatives to improve it. We utilized the CRM framework to develop and analyze the KI interviews that assessed KIs’ knowledge of established leadership, resources, and local or regional eﬀorts to address the cancer burden, in the context of relevant community awareness, climate, and health needs and priorities. We followed the CRM methodology to frame each county’s level or readiness and capacity to reduce the cancer burden and engage in cancer prevention and early detection initiatives.

KEY FINDINGS

STATE AND COUNTY CANCER DISPARITIES FINDINGS

Figure 14 illustrates the 64 counties in Colorado that are categorized as rural versus urban that were identiﬁed as cancer disparity versus non-disparity counties. The analysis found that 24 rural counties (dark blue) and 2 urban counties (light blue) had higher cancer disparities (Cancer Disparity Index of 39 points or higher), indicating high cancer incidence, mortality, and late-stage diagnoses compared to non-disparity counties. There were 23 rural non-disparity counties (dark orange) and 15 urban non-disparity counties (light orange).

Rural and Urban Disparity Counties (24 of 64 Counties)

Figure 14: Rural and Urban Disparity Counties

Consistent with COE’s aim to reduce the cancer burden in Colorado, we chose to feature key findings from the counties with higher cancer disparities from the 21 Health Statistics Regions in the state. Although we analyzed population-based data for the 64 counties and 21 regions, we only present in this report the 26 cancer disparity counties organized under their corresponding Health Statistic Region (HSR). Findings from the remaining 38 non-disparity counties can be found in the Appendix. The findings for each of the cancer disparity counties are compared to the cancer rates in their HSR and to the cancer rates of non-disparity counties. Next, we highlight the most remarkable findings to illustrate a county’s relative disadvantage.

Photo by Cody Scott Milewski on Unsplash

A. HEALTH STATISTIC REGION 1

Photo by Ian Baldwin on Unsplash

A.1 LOGAN COUNTY (DARK BLUE, FIGURE 15)

A.2 PHILLIPS COUNTY (DARK BLUE, FIGURE 16)

A.3 SEDGWICK COUNTY (DARK BLUE, FIGURE 17)

A.4 WASHINGTON COUNTY (DARK BLUE, FIGURE 18)

Cancer Snapshot

Logan County (Population 21,302)

Compared to HSR 1, Logan County has a higher incidence, late-stage diagnosis, and mortality of breast cancer, higher late-stage diagnosis and mortality of colorectal cancer, and lower 5-year survival rates for breast, prostate, lung, melanoma, and colorectal cancers.

From 2007-2018 in Logan, 1,282 people were diagnosed with cancer of any type. The four cancers with the highest rates of new cases are shown below.

Age-Adjusted Incidence Rate (per 100,000 persons)

The above red bars represent Colorado's age-adjusted incidence rates.

In comparison to rural non-disparity counties, Logan County has higher incidence, late-stage diagnosis, and mortality of lung cancer and colorectal cancer and higher mortality and late-stage diagnosis of breast cancer. Moreover, the county has lower 5-year survival rates for breast, prostate, melanoma, colorectal, and lung cancers than rural non-disparity counties. Lung

Age-Adjusted Incidence Rate (per 100,000 persons)

From 2007-2018, 607 people in Logan County were diagnosed with screenable cancers (lung and bronchus, breast, prostate, colorectal, cervical). Below are the percentages of these cancers that were diagnosed at late stage.

Diagnosis at late stage

(Age-adjusted Incidence Rate, per

stage defined as regional or distant cancer at diagnosis

The above red bars represent Colorado's percent of screenable cancers diagnosed at late stage. * County data suppressed

From 2007-2018 in Logan County, 539 people died of cancer of any type. The four cancers with the highest rates of death are shown below.

Age-Adjusted Mortality Rate (per 100,000 persons)

Age-Adjusted Incidence Rate (per 100,000 persons)

Logan HSR 1 Rural, nondisparity

* The above red bars represent Colorado's age-adjusted mortality rates.

Percentage alive 5 years after diagnosis - Top 6 most common (5-year relative survival)

HSR 1 Rural, nondisparity

* The above red bars represent Colorado's 5-year relative survivals. In Colorado, the 6 most common cancers are melanoma of the skin, breast, lung, prostate, colon, uterine cancers. The

of residents in Logan County surviving 5 years after diagnosis for each of the most common cancers are above.

* County data suppressed

Sources: Colorado Central Cancer Registry, 2007-2018. This information was compiled by the Population Health Shared Resource and the Office for Community Outreach and Engagement of the University of Colorado Cancer Center.

Disclaimer: These data were collected and provided by the Colorado Central Cancer Registry (CCCR) participating in the National Program of Cancer Registries (NPCR) of the Centers for Disease Control and Prevention (CDC). The CDC, the CCCR, and the Colorado Department of Public Health and Environment (CDPHE) specifically disclaim responsibility for any analyses, interpretations, or conclusions they have not provided. Data with too few cases for the statistic have been suppressed per source standards.

Melanoma of the Skin

Corpus and Uterus, NOS

Colon and Rectum

Lung and Bronchus

Cancer Snapshot

Phillips County (Population 4,493)

Phillips County, compared to HSR1, has a higher incidence of prostate and lung cancer, higher mortality of lung and prostate cancer, and higher percent of late-stage diagnosis for colorectal and prostate cancer.

Compared to rural non-disparity counties, Phillips County has a higher incidence of prostate and lung cancer, higher mortality of lung, prostate, and colorectal cancer, and higher percent of late-stage diagnosis of colorectal cancers. Five-year survival is lower for melanoma and colorectal cancer.

From 2007-2018 in Phillips, 309 people were diagnosed with cancer of any type. The four cancers with the highest rates of new cases are shown below.

Age-Adjusted Incidence Rate (per 100,000 persons)

From 2007-2018, 137 people in Phillips County were diagnosed with screenable cancers (lung and bronchus, breast, prostate, colorectal, cervical). Below are the percentages of these cancers that were diagnosed at late stage. * The above red bars represent Colorado's age-adjusted incidence rates.

Diagnosis at late stage

* County data suppressed

Lung and Bronchus

Colon and Rectum

Lung and Bronchus

From 2007-2018 in Phillips County, 127 people died of cancer of any type. The four cancers with the highest rates of death are shown below.

Age-Adjusted Mortality Rate (per 100,000 persons)

Age-Adjusted Incidence Rate (per 100,000 persons)

Phillips HSR 1 Rural, nondisparity

* The above red bars represent Colorado's age-adjusted mortality rates.

Percentage alive 5 years after diagnosis - Top 6 most common (5-year relative survival)

Phillips

HSR 1 Rural, nondisparity

* The above red bars represent Colorado's 5-year relative survivals. In Colorado, the 6 most common cancers are melanoma of the skin, breast, lung, prostate, colon, uterine cancers. The

of residents in Phillips County surviving 5 years after diagnosis for each of the most common cancers are above.

* County data suppressed

Prostate

Female breast

Melanoma of the Skin

Corpus and Uterus, NOS

Colon and Rectum

Lung and Bronchus

Cancer Snapshot

Sedgwick County (Population 2,391)

Compared to HSR 1, Sedgwick County has a higher incidence, late-stage diagnosis, and mortality of lung cancer, higher incidence and late-stage diagnosis of colorectal cancers, and lower 5-year survival rates of prostate cancer.

Compared to rural non-disparity counties, Sedgwick County has higher incidence of lung cancer and colorectal cancer and remarkably higher lung cancer late-stage diagnosis and mortality. The 5-year survival rates in the county for prostate cancer are lower than in other rural non-disparity counties

From 2007-2018 in Sedgwick, 175 people were diagnosed with cancer of any type. The four cancers with the highest rates of new cases are shown below.

Age-Adjusted Incidence Rate (per 100,000 persons)

From 2007-2018, 75 people in Sedgwick County were diagnosed with screenable cancers (lung and bronchus, breast, prostate, colorectal, cervical). Below are the percentages of these cancers that were diagnosed at late stage. * The above red bars represent Colorado's age-adjusted incidence rates.

Diagnosis at late

* County data suppressed

From 2007-2018 in Sedgwick County, 74 people died of cancer of any type. The four cancers with the highest rates of death are shown below.

Age-Adjusted Mortality Rate (per 100,000 persons)

Age-Adjusted Incidence Rate (per 100,000 persons)

Sedgwick HSR 1 Rural, nondisparity

* The above red bars represent Colorado's age-adjusted mortality rates.

Percentage alive 5 years after diagnosis - Top 6 most common (5-year relative survival)

Sedgwick

HSR 1 Rural, nondisparity

* The above red bars represent Colorado's 5-year relative survivals. In Colorado, the 6 most common cancers are melanoma of the skin, breast, lung, prostate, colon, uterine cancers. The

of residents in Sedgwick County surviving 5 years after diagnosis for each of the most common cancers are above.

* County data suppressed

Female breast

Melanoma of the Skin

Corpus and Uterus, NOS

Colon and Rectum

Lung and Bronchus

Cancer Snapshot

Washington County (Population 4,817)

Relative to HSR1, Washington County has a higher incidence of prostate and colorectal cancer, more late-stage diagnosis of cervical, colorectal, breast, and prostate cancers, and a higher mortality for prostate and colorectal cancer.

Compared to rural non-disparity counties, the county has higher incidence of prostate and colorectal cancer, higher mortality for prostate, colorectal, and lung cancer, and a higher percent of late-stage diagnoses for cervical, colorectal, and prostate cancer. Washington County also has a lower 5-year survival rate for prostate, breast, and uterine cancers.

From 2007-2018 in Washington, 321 people were diagnosed with cancer of any type. The four cancers with the highest rates of new cases are shown below.

Age-Adjusted Incidence Rate (per 100,000 persons)

From 2007-2018, 149 people in Washington County were diagnosed with screenable cancers (lung and bronchus, breast, prostate, colorectal, cervical). Below are the percentages of these cancers that were diagnosed at late stage.

Diagnosis at late stage

(Age-adjusted Incidence Rate,

Prostate Female breast Colon and Rectum Lung and Bronchus

Cervix Uteri

From 2007-2018 in Washington County, 132 people died of cancer of any type. The four cancers with the highest rates of death are shown below.

Age-Adjusted Mortality Rate (per 100,000 persons)

Age-Adjusted Incidence Rate (per 100,000 persons)

Washington HSR 1 Rural, nondisparity

* The above red bars represent Colorado's age-adjusted mortality rates.

Percentage alive 5 years after diagnosis - Top 6 most common (5-year relative survival)

Washington

HSR 1 Rural, nondisparity

* The above red bars represent Colorado's 5-year relative survivals. In Colorado, the 6 most common cancers are melanoma of the skin, breast, lung, prostate, colon, uterine cancers. The

of residents in Washington County surviving 5 years after diagnosis for each of the most common cancers are above.

* County data suppressed

Prostate

Female breast

Melanoma of the Skin

Corpus and Uterus, NOS

Colon and Rectum

Lung and Bronchus

B. HEALTH STATISTIC REGION 5

Photo by Colin Lloyd on Unsplash

B.1 CHEYENNE COUNTY (DARK BLUE, FIGURE 19)

B.2 LINCOLN COUNTY (DARK BLUE, FIGURE 20)

Cancer Snapshot

Cheyenne County (Population 1,726)

When compared to HSR 5, Cheyenne County has a higher incidence of lung cancer and colorectal cancer, higher mortality for lung, prostate, and breast cancer, and a greater percentage of late-stage diagnosis of cervical and breast cancers.

When compared to rural non-disparity counties, Cheyenne County has higher incidence of lung and colorectal cancer, higher mortality for lung, prostate, breast, and colorectal cancer, and a greater percentage of late-stage diagnosis for cervical and breast cancer. Five-year survival rates are lower in this county for prostate, breast, and melanoma skin cancers.

From 2007-2018 in Cheyenne, 127 people were diagnosed with cancer of any type. The four cancers with the highest rates of new cases are shown below.

Age-Adjusted Incidence Rate (per 100,000 persons)

From 2007-2018, 54 people in Cheyenne County were diagnosed with screenable cancers (lung and bronchus, breast, prostate, colorectal, cervical). Below are the percentages of these cancers that were diagnosed at late stage. * The above red bars represent Colorado's age-adjusted incidence rates. Late stage defined as regional or distant cancer at diagnosis

* The above red bars represent Colorado's percent of screenable cancers diagnosed at late stage.

* County data suppressed Cheyenne Cheyenne HSR 5 HSR 5 Rural, nondisparity Rural, non-disparity

Diagnosis at late stage

(Age-adjusted Incidence Rate,

Cervix Uteri

From 2007-2018 in Cheyenne County, 56 people died of cancer of any type. The four cancers with the highest rates of death are shown below.

Age-Adjusted Mortality Rate (per 100,000 persons)

Age-Adjusted Incidence Rate (per 100,000 persons)

Cheyenne HSR 5 Rural, nondisparity

* The above red bars represent Colorado's age-adjusted mortality rates.

Percentage alive 5 years after diagnosis - Top 6 most common (5-year relative survival)

HSR 5 Rural, nondisparity

* The above red bars represent Colorado's 5-year relative survivals. In Colorado, the 6 most common cancers are melanoma of the skin, breast, lung, prostate, colon, uterine cancers. The

of residents in Cheyenne County surviving 5 years after diagnosis for each of the most common cancers are above.

* County data suppressed

Prostate Female breast Melanoma of the Skin

Colon and Rectum Lung and Bronchus

Cheyenne

Cancer Snapshot

Lincoln County (Population 5,583)

Relative to HSR 5, the county has higher incidence, late-stage diagnosis, and mortality of lung cancer and higher percentage of late-stage diagnosis for breast and prostate cancer.

Compared to rural non-disparity counties, Lincoln County has higher incidence of lung and colorectal cancer, higher mortality and late-stage diagnosis for lung cancer, and a greater percentage of late-stage diagnosis for breast cancer. Five-year survival rates are lower for melanoma.

From 2007-2018 in Lincoln, 326 people were diagnosed with cancer of any type. The four cancers with the highest rates of new cases are shown below.

Age-Adjusted Incidence Rate (per 100,000 persons)

From 2007-2018, 150 people in Lincoln County were diagnosed with screenable cancers (lung and bronchus, breast, prostate, colorectal, cervical). Below are the percentages of these cancers that were diagnosed at late stage. * The above red bars represent Colorado's age-adjusted incidence rates.

Diagnosis at late stage, screenable cancers (Percent of screenable cancers diagnosed at late stage)

Diagnosis at late stage

(Age-adjusted Incidence Rate, per 100,000 persons)

From 2007-2018 in Lincoln County, 125 people died of cancer of any type. The four cancers with the highest rates of death are shown below.

Age-Adjusted Mortality Rate (per 100,000 persons)

Age-Adjusted Incidence Rate (per 100,000 persons)

Lincoln HSR 5 Rural, nondisparity

* The above red bars represent Colorado's age-adjusted mortality rates.

Percentage alive 5 years after diagnosis - Top 6 most common (5-year relative survival)

Lincoln

HSR 5 Rural, nondisparity

* The above red bars represent Colorado's 5-year relative survivals. In Colorado, the 6 most common cancers are melanoma of the skin, breast, lung, prostate, colon, uterine cancers. The

of residents in Lincoln County surviving 5 years after diagnosis for each of the most common cancers are above.

* County data suppressed

Prostate

Female breast

Melanoma of the Skin

Corpus and Uterus, NOS

Colon and Rectum

Lung and Bronchus

C. HEALTH STATISTIC REGION 6

Photo by Dayne Topkin on Unsplash

C.1 BACA COUNTY (DARK BLUE, FIGURE 21)

C.2 BENT COUNTY (DARK BLUE, FIGURE 22)

C.3 HUERFANO COUNTY (DARK BLUE, FIGURE 23)

C.4 KIOWA COUNTY (DARK BLUE, FIGURE 24)

C.5 LAS ANIMAS COUNTY (DARK BLUE, FIGURE 25)

C.6 OTERO COUNTY (DARK BLUE, FIGURE 26)

C.7 PROWERS COUNTY (DARK BLUE, FIGURE 27)

Cancer Snapshot

Baca County (Population 3,496)

Relative to HSR 6, Baca County has higher incidence and mortality of breast and lung cancer and higher mortality and late-stage diagnosis of prostate cancer.

Relative to non-disparity counties, Baca County also has a higher incidence of lung and colorectal cancer, higher mortality for all four top cancers, and 5-year survival for colorectal cancer.

From 2007-2018 in Baca, 282 people were diagnosed with cancer of any type. The four cancers with the highest rates of new cases are shown below.

Age-Adjusted Incidence Rate (per 100,000 persons)

From 2007-2018, 138 people in Baca County were diagnosed with screenable cancers (lung and bronchus, breast, prostate, colorectal, cervical). Below are the percentages of these cancers that were diagnosed at late stage. * The above red bars represent Colorado's age-adjusted incidence rates.

Diagnosis at late stage

(Age-adjusted Incidence Rate, per

stage defined as regional or distant cancer at diagnosis * The above red bars represent Colorado's percent of screenable cancers diagnosed at late stage.

* County data suppressed

From 2007-2018 in Baca County, 148 people died of cancer of any type. The four cancers with the highest rates of death are shown below.

Age-Adjusted Mortality Rate (per 100,000 persons)

Age-Adjusted Incidence Rate (per 100,000 persons)

Baca HSR 6 Rural, nondisparity

* The above red bars represent Colorado's age-adjusted mortality rates.

Percentage alive 5 years after diagnosis - Top 6 most common (5-year relative survival)

HSR 6 Rural, nondisparity

* The above red bars represent Colorado's 5-year relative survivals. In Colorado, the 6 most common cancers are melanoma of the skin, breast, lung, prostate, colon, uterine cancers. The

of residents in Baca County surviving 5 years after diagnosis for each of the most common cancers are above.

* County data suppressed

Prostate

Female breast

Melanoma of the Skin

Corpus and Uterus, NOS

Colon and Rectum

Lung and Bronchus

Baca

Cancer Snapshot

Bent County (Population 5,561)

Compared to HSR 6, Bent County has more late-stage diagnosis and higher mortality of lung cancer higher mortality of breast and colorectal cancer, and higher percent of late-stage diagnosis for cervical and breast cancer.

Compared to rural non-disparity counties, Bent County has higher incidence of lung and colorectal cancer, higher mortality for all four top cancers, and greater percent of late-stage diagnosis for lung, cervical, and breast cancer. Five-year survival is lower for breast, colorectal, and lung cancer

From 2007-2018 in Bent, 299 people were diagnosed with cancer of any type. The four cancers with the highest rates of new cases are shown below.

Age-Adjusted Incidence Rate (per 100,000 persons)

From 2007-2018, 149 people in Bent County were diagnosed with screenable cancers (lung and bronchus, breast, prostate, colorectal, cervical). Below are the percentages of these cancers that were diagnosed at late stage. * The above red bars represent Colorado's age-adjusted incidence rates.

Diagnosis at late stage

* County data suppressed

Prostate Female breast

Lung and Bronchus

Colon and Rectum

Lung and Bronchus

From 2007-2018 in Bent County, 168 people died of cancer of any type. The four cancers with the highest rates of death are shown below.

Age-Adjusted Mortality Rate (per 100,000 persons)

Age-Adjusted Incidence Rate (per 100,000 persons)

* The above red bars represent Colorado's age-adjusted mortality rates.

Percentage alive 5 years after diagnosis - Top 6 most common (5-year relative survival)

Bent HSR 6 Rural, nondisparity Bent

HSR 6 Rural, nondisparity

* The above red bars represent Colorado's 5-year relative survivals. In Colorado, the 6 most common cancers are melanoma of the skin, breast, lung, prostate, colon, uterine cancers. The

of residents in Bent County surviving 5 years after diagnosis for each of the most common cancers are above.

* County data suppressed

Prostate

Female breast

Melanoma of the Skin

Corpus and Uterus, NOS

Colon and Rectum

Lung and Bronchus

Cancer Snapshot

Huerfano County (Population 6,896)

In comparison to HSR 6, Huerfano County has higher incidence and mortality of breast cancer, higher incidence of prostate and colorectal cancer, higher percent of late-stage cervical cancer, and lower 5-year survival of prostate, breast, melanoma, and colorectal cancer.

Compared to rural non-disparity counties, Huerfano County has higher incidence of breast, colorectal and lung cancer, higher mortality for all four top cancers, greater percent of late-stage diagnosis for breast cancer, and lower 5-year survival rates for prostate, breast, melanoma, and colorectal cancer.

From 2007-2018 in Huerfano, 609 people were diagnosed with cancer of any type. The four cancers with the highest rates of new cases are shown below.

Age-Adjusted Incidence Rate (per 100,000 persons)

From 2007-2018, 266 people in Huerfano County were diagnosed with screenable cancers (lung and bronchus, breast, prostate, colorectal, cervical). Below are the percentages of these cancers that were diagnosed at late stage. * The above red bars represent Colorado's age-adjusted incidence rates.

Diagnosis at late stage

(Age-adjusted Incidence Rate,

stage defined as regional or distant cancer at diagnosis * The above red bars represent Colorado's percent of screenable cancers diagnosed at late stage.

* County data suppressed Huerfano Huerfano HSR 6 HSR 6 Rural, nondisparity Rural, non-disparity

From 2007-2018 in Huerfano County, 245 people died of cancer of any type. The four cancers with the highest rates of death are shown below.

Age-Adjusted Mortality Rate (per 100,000 persons)

Age-Adjusted Incidence Rate (per 100,000 persons)

Huerfano HSR 6 Rural, nondisparity

* The above red bars represent Colorado's age-adjusted mortality rates.

Percentage alive 5 years after diagnosis - Top 6 most common (5-year relative survival)

Huerfano

HSR 6 Rural, nondisparity

* The above red bars represent Colorado's 5-year relative survivals. In Colorado, the 6 most common cancers are melanoma of the skin, breast, lung, prostate, colon, uterine cancers. The

of residents in Huerfano County surviving 5 years after diagnosis for each of the most common cancers are above.

* County data suppressed

Corpus and Uterus, NOS

Colon and Rectum

Lung and Bronchus

Cancer Snapshot

Kiowa County (Population 1,347)

When compared to HSR 6 and rural non-disparity counties, Kiowa County has higher incidence and mortality for breast, lung, and colorectal cancers, and higher percent of late-stage cervical and colorectal cancers. Five-year survival is lower for prostate and melanoma skin cancer.

From 2007-2018 in Kiowa, 113 people were diagnosed with cancer of any type. The four cancers with the highest rates of new cases are shown below.

Age-Adjusted Incidence Rate (per 100,000 persons)

From 2007-2018, 47 people in Kiowa County were diagnosed with screenable cancers (lung and bronchus, breast, prostate, colorectal, cervical). Below are the percentages of these cancers that were diagnosed at late stage. * The above red bars represent Colorado's age-adjusted incidence rates.

Diagnosis at late stage

(Age-adjusted Incidence Rate, per 100,000 persons)

Kiowa HSR 6 HSR 6 Rural, nondisparity Rural, non-disparity

stage defined as regional or distant cancer at diagnosis * The above red bars represent Colorado's percent of screenable cancers diagnosed at late stage.

* County data suppressed

From 2007-2018 in Kiowa County, 61 people died of cancer of any type. The four cancers with the highest rates of death are shown below.

Age-Adjusted Mortality Rate (per 100,000 persons)

Age-Adjusted Incidence Rate (per 100,000 persons)

Kiowa HSR 6 Rural, nondisparity

* The above red bars represent Colorado's age-adjusted mortality rates.

Percentage alive 5 years after diagnosis - Top 6 most common (5-year relative survival)

Kiowa

HSR 6 Rural, nondisparity

* The above red bars represent Colorado's 5-year relative survivals. In Colorado, the 6 most common cancers are melanoma of the skin, breast, lung, prostate, colon, uterine cancers. The

of residents in Kiowa County surviving 5 years after diagnosis for each of the most common cancers are above.

* County data suppressed

Prostate Female breast Melanoma of the Skin

Colon and Rectum

Lung and Bronchus

Cancer Snapshot

Las Animas County (Population 14,422)

Compared to HSR 6, Las Animas County has higher late-stage diagnosis of prostate, cervical, and colorectal cancer and lower 5-year survival rates for uterine and lung cancer.

When compared to rural non-disparity counties, the county has higher incidence and mortality of lung and colorectal cancer, higher percent of late-stage diagnosis for colorectal and cervical cancer, and lower 5-year survival rates of lung, colorectal, melanoma, and uterine cancer.

From 2007-2018 in Las Animas, 957 people were diagnosed with cancer of any type. The four cancers with the highest rates of new cases are shown below.

Age-Adjusted Incidence Rate (per 100,000 persons)

From 2007-2018, 458 people in Las Animas County were diagnosed with screenable cancers (lung and bronchus, breast, prostate, colorectal, cervical). Below are the percentages of these cancers that were diagnosed at late stage. * The above red bars represent Colorado's age-adjusted incidence rates.

Diagnosis at late stage

* County data suppressed

Bronchus Colon and Rectum

Bronchus

From 2007-2018 in Las Animas County, 423 people died of cancer of any type. The four cancers with the highest rates of death are shown below.

Age-Adjusted Mortality Rate (per 100,000 persons)

Age-Adjusted Incidence Rate (per 100,000 persons)

Las Animas HSR 6 Rural, nondisparity

* The above red bars represent Colorado's age-adjusted mortality rates.

Percentage alive 5 years after diagnosis - Top 6 most common (5-year relative survival)

Las Animas

HSR 6 Rural, nondisparity

* The above red bars represent Colorado's 5-year relative survivals. In Colorado, the 6 most common cancers are melanoma of the skin, breast, lung, prostate, colon, uterine cancers. The

of residents in Las Animas County surviving 5 years after diagnosis for each of the most common cancers are above.

* County data suppressed

Corpus and Uterus, NOS

Colon and Rectum

Lung and Bronchus

Cancer Snapshot

Otero County (Population 18,580)

Compared to HSR 6, Otero County has higher incidence of prostate and colorectal cancer, higher percent of late-stage lung cancer, and lower 5-year survival rates of prostate, melanoma, uterine, and colorectal cancer.

When compared to rural non-disparity counties, the county has higher incidence of colorectal and lung cancers, more late-stage diagnosis of lung and breast cancers, higher mortality of prostate, colorectal, and lung cancers, and a lower 5-year survival of prostate, breast, melanoma, uterine, and colorectal cancer.

From 2007-2018 in Otero, 1,172 people were diagnosed with cancer of any type. The four cancers with the highest rates of new cases are shown below.

Age-Adjusted Incidence Rate (per 100,000 persons)

From 2007-2018, 526 people in Otero County were diagnosed with screenable cancers (lung and bronchus, breast, prostate, colorectal, cervical). Below are the percentages of these cancers that were diagnosed at late stage.

* The above red bars represent Colorado's age-adjusted incidence rates. Late stage defined as regional or distant cancer at diagnosis

* The above red bars represent Colorado's percent of screenable cancers diagnosed at late stage.

* County data suppressed

Diagnosis at late stage

(Age-adjusted Incidence Rate, per

Otero Otero HSR 6 HSR 6 Rural, nondisparity Rural, non-disparity

Bronchus

From 2007-2018 in Otero County, 487 people died of cancer of any type. The four cancers with the highest rates of death are shown below.

Age-Adjusted Mortality Rate (per 100,000 persons)

Age-Adjusted Incidence Rate (per 100,000 persons)

Otero HSR 6 Rural, nondisparity

* The above red bars represent Colorado's age-adjusted mortality rates.

Percentage alive 5 years after diagnosis - Top 6 most common (5-year relative survival)

HSR 6 Rural, nondisparity

* The above red bars represent Colorado's 5-year relative survivals. In Colorado, the 6 most common cancers are melanoma of the skin, breast, lung, prostate, colon, uterine cancers. The

of residents in Otero County surviving 5 years after diagnosis for each of the most common cancers are above.

* County data suppressed

Melanoma of the Skin

Corpus and Uterus, NOS

Colon and Rectum

Lung and Bronchus

Otero

Cancer Snapshot

Prowers County (Population 11,968)

When compared to HSR 6, Prowers County has a higher incidence of prostate, lung, and colorectal cancers, higher late-stage diagnosis of prostate, breast, colorectal, and cervical cancers, higher mortality of prostate, lung, and colorectal cancers, and a lower 5-year survival rate of prostate, breast, and melanoma skin cancer.

Prowers County, compared to rural non-disparity counties, has higher incidence and mortality of prostate, lung, and colorectal cancer, higher late-stage diagnosis of colorectal and breast cancer, and a lower 5-year survival of prostate, breast, and melanoma skin cancer.

From 2007-2018 in Prowers, 726 people were diagnosed with cancer of any type. The four cancers with the highest rates of new cases are shown below.

Age-Adjusted Incidence Rate (per 100,000 persons)

The above red bars represent Colorado's age-adjusted incidence rates.

From 2007-2018, 356 people in Prowers County were diagnosed with screenable cancers (lung and bronchus, breast, prostate, colorectal, cervical). Below are the percentages of these cancers that were diagnosed at late stage.

Diagnosis at late stage

(Age-adjusted Incidence Rate, per

stage defined as regional or distant cancer at diagnosis

The above red bars represent Colorado's percent of screenable cancers diagnosed at late stage. * County data suppressed

From 2007-2018 in Prowers County, 335 people died of cancer of any type. The four cancers with the highest rates of death are shown below.

Age-Adjusted Mortality Rate (per 100,000 persons)

Age-Adjusted Incidence Rate (per 100,000 persons)

Prowers HSR 6 Rural, nondisparity

* The above red bars represent Colorado's age-adjusted mortality rates.

Percentage alive 5 years after diagnosis - Top 6 most common (5-year relative survival)

Prowers

HSR 6 Rural, nondisparity

* The above red bars represent Colorado's 5-year relative survivals. In Colorado, the 6 most common cancers are melanoma of the skin, breast, lung, prostate, colon, uterine cancers. The

of residents in Prowers County surviving 5 years after diagnosis for each of the most common cancers are above.

* County data suppressed

Melanoma of the Skin

Corpus and Uterus, NOS

Colon and Rectum

Lung and Bronchus

D. HEALTH STATISTIC REGION 7

Photo by AV Media on Unsplash

D.1 PUEBLO COUNTY (DARK BLUE, FIGURE 28) 65

Cancer Snapshot

Pueblo County (Population 168,135)

Compared to urban non-disparity counties, Pueblo County has a higher incidence of lung and colorectal cancers, a higher mortality for all 4 top cancers, greater percent of late-stage diagnoses of lung, cervical, and colorectal cancer, and lower 5-year survival rates of melanoma, breast, colorectal, and lung cancer.

From 2007-2018 in Pueblo, 10,489 people were diagnosed with cancer of any type. The four cancers with the highest rates of new cases are shown below.

Age-Adjusted Incidence Rate (per 100,000 persons)

non-disparity

* The above red bars represent Colorado's age-adjusted incidence rates.

From 2007-2018, 4,894 people in Pueblo County were diagnosed with screenable cancers (lung and bronchus, breast, prostate, colorectal, cervical). Below are the percentages of these cancers that were diagnosed at late stage.

Diagnosis at late stage, screenable cancers (Percent

Lung and Bronchus

Late stage defined as regional or distant cancer at diagnosis

* The above red bars represent Colorado's percent of screenable cancers diagnosed at late stage.

* County data suppressed

Diagnosis at late stage (Age-adjusted Incidence Rate, per 100,000

non-disparity

From 2007-2018 in Pueblo County, 4,141 people died of cancer of any type. The four cancers with the highest rates of death are shown below.

Age-Adjusted Mortality Rate (per 100,000 persons)

Age-Adjusted Incidence Rate (per 100,000 persons)

Urban, non-disparity

* The above red bars represent Colorado's age-adjusted mortality rates.

Percentage alive 5 years after diagnosis - Top 6 most common (5-year relative survival)

Urban, non-disparity

* The above red bars represent Colorado's 5-year relative survivals. In Colorado, the 6 most common cancers are melanoma of the skin, breast, lung, prostate, colon, and uterine cancers. The percentage of residents in Pueblo County surviving 5 years after diagnosis for each of the most common cancers are above.

Melanoma of the Skin

Female breast

Prostate

Corpus and Uterus, NOS

Colon and Rectum

Lung and Bronchus

Pueblo

E. HEALTH STATISTIC REGION 8

Photo by Joe Dudeck on Unsplash

E.1 CONEJOS COUNTY (DARK BLUE, FIGURE 29)

E.2 COSTILLA COUNTY (DARK BLUE, FIGURE 30)

E.3 MINERAL COUNTY (DARK BLUE, FIGURE 31)

E.4 SAGUACHE COUNTY (DARK BLUE, FIGURE 32) 69 73 71 75

Cancer Snapshot

Conejos County (Population 7,553)

Relative to HSR 8, the county has higher late-stage diagnosis of cervical, lung, colorectal, and prostate cancer and lower 5-year survival rates of prostate, breast, and melanoma skin cancer.

Relative to rural non-disparity counties, Conejos County has higher incidence of colorectal cancer, higher percent of late-stage diagnosis for cervical and lung cancer, and higher mortality rates for prostate cancer. This county also has lower 5-year survival rates for prostate, breast, and melanoma skin cancer.

From 2007-2018 in Conejos, 382 people were diagnosed with cancer of any type. The four cancers with the highest rates of new cases are shown below.

Age-Adjusted Incidence Rate (per 100,000 persons)

The above red bars represent Colorado's age-adjusted incidence rates.

From 2007-2018, 166 people in Conejos County were diagnosed with screenable cancers (lung and bronchus, breast, prostate, colorectal, cervical). Below are the percentages of these cancers that were diagnosed at late stage.

Diagnosis at late stage

Cervix Uteri

From 2007-2018 in Conejos County, 166 people died of cancer of any type. The four cancers with the highest rates of death are shown below.

Age-Adjusted Mortality Rate (per 100,000 persons)

Age-Adjusted Incidence Rate (per 100,000 persons)

Conejos HSR 8 Rural, nondisparity

* The above red bars represent Colorado's age-adjusted mortality rates.

Percentage alive 5 years after diagnosis - Top 6 most common (5-year relative survival)

HSR 8 Rural, nondisparity

* The above red bars represent Colorado's 5-year relative survivals. In Colorado, the 6 most common cancers are melanoma of the skin, breast, lung, prostate, colon, uterine cancers. The

of residents in Conejos County surviving 5 years after diagnosis for each of the most common cancers are above.

* County data suppressed

Prostate Female breast

Melanoma of the Skin

Corpus and Uterus, NOS

Colon and Rectum

Lung and Bronchus

Conejos

Cancer Snapshot

Costilla County (Population 3,534)

In comparison to HSR 8 and rural non-disparity counties, Costilla County has higher incidence of colorectal cancer, more late-stage diagnosis for lung, cervical, and colorectal cancer, higher mortality rates of breast and colorectal cancer, and lower 5-year survival rates for prostate, melanoma, and colorectal cancer.

From 2007-2018 in Costilla, 212 people were diagnosed with cancer of any type. The four cancers with the highest rates of new cases are shown below.

Age-Adjusted Incidence Rate (per 100,000 persons)

From 2007-2018, 91 people in Costilla County were diagnosed with screenable cancers (lung and bronchus, breast, prostate, colorectal, cervical). Below are the percentages of these cancers that were diagnosed at late stage. * The above red bars represent Colorado's age-adjusted incidence rates.

Diagnosis at late stage

(Age-adjusted Incidence Rate, per

stage defined as regional or distant cancer at diagnosis * The above red bars represent Colorado's percent of screenable cancers diagnosed at late stage. * County data suppressed

From 2007-2018 in Costilla County, 83 people died of cancer of any type. The four cancers with the highest rates of death are shown below.

Age-Adjusted Mortality Rate (per 100,000 persons)

Age-Adjusted Incidence Rate (per 100,000 persons)

Costilla HSR 8 Rural, nondisparity

* The above red bars represent Colorado's age-adjusted mortality rates.

Percentage alive 5 years after diagnosis - Top 6 most common (5-year relative survival)

* The above red bars represent Colorado's 5-year relative survivals. In Colorado, the 6 most common cancers are melanoma of the skin, breast, lung, prostate, colon, uterine cancers. The

of residents in Costilla County surviving 5 years after diagnosis for each of the most common cancers are above.

* County data suppressed HSR 8 Rural, nondisparity

Prostate

Female breast

Melanoma of the Skin

Corpus and Uterus, NOS

Colon and Rectum

Lung and Bronchus

Costilla

Cancer Snapshot

Mineral County (Population 794)

Compared to HSR 8 and rural non-disparity counties, Mineral County has higher incidence of breast and colorectal cancer, greater percent of late-stage diagnosis for lung cancer, and much higher mortality for colorectal cancers.

From 2007-2018 in Mineral, 54 people were diagnosed with cancer of any type. The four cancers with the highest rates of new cases are shown below.

Age-Adjusted Incidence Rate (per 100,000 persons)

From 2007-2018, 20 people in Mineral County were diagnosed with screenable cancers (lung and bronchus, breast, prostate, colorectal, cervical). Below are the percentages of these cancers that were diagnosed at late stage.

Diagnosis at late stage

(Age-adjusted Incidence Rate, per 100,000 persons)

County data suppressed

From 2007-2018 in Mineral County, 17 people died of cancer of any type. The four cancers with the highest rates of death are shown below.

Age-Adjusted Mortality Rate (per 100,000 persons)

Age-Adjusted Incidence Rate (per 100,000 persons)

* The above red bars represent Colorado's age-adjusted mortality rates.

Percentage alive 5 years after diagnosis - Top 6 most common (5-year relative survival)

HSR 8 Rural, nondisparity Mineral HSR 8 Rural, nondisparity Mineral

* The above red bars represent Colorado's 5-year relative survivals. In Colorado, the 6 most common cancers are melanoma of the skin, breast, lung, prostate, colon, uterine cancers. The percentage of residents in Mineral County surviving 5 years after diagnosis for each of the most common cancers are above.

* County data suppressed

Prostate Female breast Melanoma of the Skin

Colon and Rectum

Lung and Bronchus

Cancer Snapshot

Saguache County (Population 6,454)

Relative to HSR 8, Saguache County has a higher incidence of lung cancer, a greater percent of late-stage lung, cervical, colorectal, and prostate cancer, and higher mortality of lung cancer. Five-year survival rates are lower for prostate, melanoma, and uterine cancer.

Compared to rural non-disparity counties, Saguache County has higher late-stage diagnosis of lung, cervical, and colorectal cancers and lower 5-year survival rates of prostate, melanoma, uterine, and lung cancer.

From 2007-2018 in Saguache, 336 people were diagnosed with cancer of any type. The four cancers with the highest rates of new cases are shown below.

Age-Adjusted Incidence Rate (per 100,000 persons)

From 2007-2018, 158 people in Saguache County were diagnosed with screenable cancers (lung and bronchus, breast, prostate, colorectal, cervical). Below are the percentages of these cancers that were diagnosed at late stage. * The above red bars represent Colorado's age-adjusted incidence rates.

Diagnosis at late stage

* County data suppressed

Bronchus Colon and Rectum

Bronchus

From 2007-2018 in Saguache County, 128 people died of cancer of any type. The four cancers with the highest rates of death are shown below.

Age-Adjusted Mortality Rate (per 100,000 persons)

Age-Adjusted Incidence Rate (per 100,000 persons)

Saguache HSR 8 Rural, nondisparity

* The above red bars represent Colorado's age-adjusted mortality rates.

Percentage alive 5 years after diagnosis - Top 6 most common (5-year relative survival)

HSR 8 Rural, nondisparity

* The above red bars represent Colorado's 5-year relative survivals. In Colorado, the 6 most common cancers are melanoma of the skin, breast, lung, prostate, colon, uterine cancers. The

of residents in Saguache County surviving 5 years after diagnosis for each of the most common cancers are above.

* County data suppressed

Melanoma of the Skin

Corpus and Uterus, NOS

Colon and Rectum

Lung and Bronchus

Saguache

F. HEALTH STATISTIC REGION 9

Photo by Justin Wang on Unsplash

F.1 MONTEZUMA COUNTY (DARK BLUE, FIGURE 33) 79

Cancer Snapshot

Montezuma County (Population 26,070)

Compared to HSR 9, Montezuma County has a higher incidence of lung cancer, more late-stage diagnosis of prostate cancer, and higher mortality of lung and prostate cancer. Five-year survival is lower for prostate, uterine, and lung cancer.

Relative to rural non-disparity counties, the county has higher incidence of lung cancer, more late-stage prostate cancer, and higher mortality of lung and prostate cancer. Five-year survival rates are lower for prostate and lung cancer.

From 2007-2018 in Montezuma, 1,611 people were diagnosed with cancer of any type. The four cancers with the highest rates of new cases are shown below.

Age-Adjusted Incidence Rate (per 100,000 persons)

The above red bars represent Colorado's age-adjusted incidence rates.

From 2007-2018, 690 people in Montezuma County were diagnosed with screenable cancers (lung and bronchus, breast, prostate, colorectal, cervical). Below are the percentages of these cancers that were diagnosed at late stage.

Diagnosis at late stage

Incidence Rate,

* County data suppressed

Prostate

Female breast

Lung and Bronchus

Colon and Rectum

Lung and Bronchus Colon and Rectum Cervix

From 2007-2018 in Montezuma County, 652 people died of cancer of any type. The four cancers with the highest rates of death are shown below.

Age-Adjusted Mortality Rate (per 100,000 persons)

Age-Adjusted Incidence Rate (per 100,000 persons)

Montezuma HSR 9 Rural, nondisparity

* The above red bars represent Colorado's age-adjusted mortality rates.

Percentage alive 5 years after diagnosis - Top 6 most common (5-year relative survival)

HSR 9 Rural, nondisparity

* The above red bars represent Colorado's 5-year relative survivals. In Colorado, the 6 most common cancers are melanoma of the skin, breast, lung, prostate, colon, uterine cancers. The

of residents in Montezuma County surviving 5 years after diagnosis for each of the most common cancers are above.

* County data suppressed

Corpus and Uterus, NOS

Colon and Rectum

Lung and Bronchus

Montezuma

G. HEALTH STATISTIC REGION 10

Photo by Jonathan Speek on Unsplash

G.1 DELTA COUNTY (DARK BLUE, FIGURE 34)

G.2 MONTROSE COUNTY (DARK BLUE, FIGURE 35) 83 85

Cancer Snapshot

Delta County (Population 31,173)

Compared to HSR 10, Delta County has higher incidence of prostate, lung, and colorectal cancer, greater percent of late-stage diagnosis for cervical cancer, and higher mortality of lung, prostate, and colorectal cancer. Five-year survival is lower for prostate, breast, melanoma, and lung cancer.

Compared to rural non-disparity counties, Delta County has higher incidence of lung and colorectal cancer, greater percent of late-stage diagnosis for cervical and prostate cancer, and higher mortality of lung, prostate, breast, and colorectal cancer. Five-year survival is lower for prostate, breast, and melanoma skin cancer.

From 2007-2018 in Delta, 2,304 people were diagnosed with cancer of any type. The four cancers with the highest rates of new cases are shown below.

Age-Adjusted Incidence Rate (per 100,000 persons)

From 2007-2018, 1,030 people in Delta County were diagnosed with screenable cancers (lung and bronchus, breast, prostate, colorectal, cervical). Below are the percentages of these cancers that were diagnosed at late stage.

Diagnosis at late stage

(Age-adjusted Incidence Rate,

stage defined as regional or distant cancer at diagnosis

The above red bars represent Colorado's percent of screenable cancers diagnosed at late stage. * County data suppressed

Cervix Uteri

The above red bars represent Colorado's age-adjusted incidence rates.

From 2007-2018 in Delta County, 1,003 people died of cancer of any type. The four cancers with the highest rates of death are shown below.

Age-Adjusted Mortality Rate (per 100,000 persons)

Age-Adjusted Incidence Rate (per 100,000 persons)

* The above red bars represent Colorado's age-adjusted mortality rates.

Percentage alive 5 years after diagnosis - Top 6 most common (5-year relative survival)

HSR 10 Rural, nondisparity Delta HSR 10 Rural, nondisparity

* The above red bars represent Colorado's 5-year relative survivals. In Colorado, the 6 most common cancers are melanoma of the skin, breast, lung, prostate, colon, uterine cancers. The

of residents in Delta County surviving 5 years after diagnosis for each of the most common cancers are above.

* County data suppressed

Corpus and Uterus, NOS

Colon and Rectum

Lung and Bronchus

Cancer Snapshot

Montrose County (Population 42,823)

Compared to HSR 10, Montrose County has higher incidence of breast and lung cancer, more late-stage diagnosis of cervical and lung cancer, and higher mortality of lung, breast, and prostate cancer. Five-year survival is lower for breast, uterine, and lung cancer.

Compared to rural non-disparity counties, Montrose County has a higher incidence of breast and lung cancer, greater percent of late-stage diagnosis for cervical and prostate cancer, and higher mortality for lung, breast, and prostate cancer. Five-year survival is lower for breast cancer.

From 2007-2018 in Montrose, 2,704 people were diagnosed with cancer of any type. The four cancers with the highest rates of new cases are shown below.

Age-Adjusted Incidence Rate (per 100,000 persons)

The above red bars represent Colorado's age-adjusted incidence rates.

From 2007-2018, 1,193 people in Montrose County were diagnosed with screenable cancers (lung and bronchus, breast, prostate, colorectal, cervical). Below are the percentages of these cancers that were diagnosed at late stage.

Diagnosis at late stage

Cervix Uteri

From 2007-2018 in Montrose County, 1,056 people died of cancer of any type. The four cancers with the highest rates of death are shown below.

Age-Adjusted Mortality Rate (per 100,000 persons)

Age-Adjusted Incidence Rate (per 100,000 persons)

Montrose HSR 10 Rural, nondisparity

* The above red bars represent Colorado's age-adjusted mortality rates.

Percentage alive 5 years after diagnosis - Top 6 most common (5-year relative survival)

HSR 10 Rural, nondisparity

* The above red bars represent Colorado's 5-year relative survivals. In Colorado, the 6 most common cancers are melanoma of the skin, breast, lung, prostate, colon, uterine cancers. The

of residents in Montrose County surviving 5 years after diagnosis for each of the most common cancers are above.

* County data suppressed

Melanoma of the Skin

Corpus and Uterus, NOS

Colon and Rectum

Lung and Bronchus

Montrose

H. HEALTH STATISTIC REGION 11

Photo by Katie Moum on Unsplash

H.1 JACKSON COUNTY (DARK BLUE, FIGURE 36) 89

Cancer Snapshot

Jackson County (Population 1,440)

Compared to HSR 11, Jackson County has higher late-stage diagnosis of colorectal and breast cancer and higher mortality of prostate cancer. Five-year survival rates across cancers are suppressed for the county due to a low number of reported cases.

Compared to rural, non-disparity counties, this county has more late-stage colorectal, lung, and breast cancer, and higher mortality for prostate cancer.

From 2007-2018 in Jackson, 80 people were diagnosed with cancer of any type. The four cancers with the highest rates of new cases are shown below.

Age-Adjusted Incidence Rate (per 100,000 persons)

From 2007-2018, 37 people in Jackson County were diagnosed with screenable cancers (lung and bronchus, breast, prostate, colorectal, cervical). Below are the percentages of these cancers that were diagnosed at late stage.

* The above red bars represent Colorado's age-adjusted incidence rates. Late stage defined as regional or distant cancer at diagnosis

* The above red bars represent Colorado's percent of screenable cancers diagnosed at late stage.

* County data suppressed

Diagnosis at late stage

(Age-adjusted Incidence Rate, per

From 2007-2018 in Jackson County, 34 people died of cancer of any type. The four cancers with the highest rates of death are shown below.

Age-Adjusted Mortality Rate (per 100,000 persons)

Age-Adjusted Incidence Rate (per 100,000 persons)

Jackson HSR 11 Rural, nondisparity

* The above red bars represent Colorado's age-adjusted mortality rates.

Percentage alive 5 years after diagnosis - Top 6 most common (5-year relative survival)

Jackson

HSR 11 Rural, nondisparity

* The above red bars represent Colorado's 5-year relative survivals. In Colorado, the 6 most common cancers are melanoma of the skin, breast, lung, prostate, colon, uterine cancers. The percentage of residents in Jackson County surviving 5 years after diagnosis for each of the most common cancers are above.

* County data suppressed

Prostate Lung and Bronchus Colon and Rectum Female breast

Prostate

Female breast

Melanoma of the Skin

Corpus and Uterus, NOS

Colon and Rectum

Lung and Bronchus

I. HEALTH STATISTIC REGION 13

Photo by Austin Henckel on Unsplash

I.2 CUSTER COUNTY DARK BLUE, FIGURE 38) 93 97 95

I.1 CHAFFEE COUNTY (DARK BLUE, FIGURE 37)

I.3 FREMONT COUNTY (DARK BLUE, FIGURE 39)

Cancer Snapshot

Chaffee County (Population 19,564)

In comparison to HSR 13, Chaffee County has higher incidence and mortality of breast and prostate cancer and lower 5-year survival for prostate, breast, and lung cancer.

Compared to rural non-disparity counties, Chaffee County has higher incidence and mortality rates of breast and prostate cancer, higher mortality of colorectal cancer, and lower 5-year survival rates of breast and lung cancer.

From 2007-2018 in Chaffee, 1,404 people were diagnosed with cancer of any type. The four cancers with the highest rates of new cases are shown below.

Age-Adjusted Incidence Rate (per 100,000 persons)

From 2007-2018, 554 people in Chaffee County were diagnosed with screenable cancers (lung and bronchus, breast, prostate, colorectal, cervical). Below are the percentages of these cancers that were diagnosed at late stage. * The above red bars represent Colorado's age-adjusted incidence rates.

Diagnosis at late stage

(Age-adjusted Incidence Rate, per

County data suppressed

From 2007-2018 in Chaffee County, 514 people died of cancer of any type. The four cancers with the highest rates of death are shown below.

Age-Adjusted Mortality Rate (per 100,000 persons)

Age-Adjusted Incidence Rate (per 100,000 persons)

Chaffee HSR 13 Rural, nondisparity

* The above red bars represent Colorado's age-adjusted mortality rates.

Percentage alive 5 years after diagnosis - Top 6 most common (5-year relative survival)

HSR 13 Rural, nondisparity

* The above red bars represent Colorado's 5-year relative survivals. In Colorado, the 6 most common cancers are melanoma of the skin, breast, lung, prostate, colon, uterine cancers. The

of residents in Chaffee County surviving 5 years after diagnosis for each of the most common cancers are above.

* County data suppressed

Melanoma of the Skin

Corpus and Uterus, NOS

Colon and Rectum

Lung and Bronchus

Chaffee

Cancer Snapshot

Custer County (Population 4,885)

Compared to HSR 13, Custer County has higher incidence of prostate and colorectal cancer, more late-stage diagnosis of lung and breast cancer, and lower 5-year survival of uterine and colorectal cancer.

Compared to rural non-disparity counties, the county has higher incidence of breast, colorectal and prostate cancer, more late-stage lung and breast cancer, higher mortality of lung, prostate and colorectal cancer, and lower 5-year survival of uterine and colorectal cancer.

From 2007-2018 in Custer, 390 people were diagnosed with cancer of any type. The four cancers with the highest rates of new cases are shown below.

Age-Adjusted Incidence Rate (per 100,000 persons)

From 2007-2018, 169 people in Custer County were diagnosed with screenable cancers (lung and bronchus, breast, prostate, colorectal, cervical). Below are the percentages of these cancers that were diagnosed at late stage. * The above red bars represent Colorado's age-adjusted incidence rates.

at late stage, screenable

Diagnosis at late stage

* County data suppressed

Colon and Rectum

Lung and Bronchus

Bronchus

From 2007-2018 in Custer County, 143 people died of cancer of any type. The four cancers with the highest rates of death are shown below.

Age-Adjusted Mortality Rate (per 100,000 persons)

Age-Adjusted Incidence Rate (per 100,000 persons)

Custer HSR 13 Rural, nondisparity

* The above red bars represent Colorado's age-adjusted mortality rates.

Percentage alive 5 years after diagnosis - Top 6 most common (5-year relative survival)

HSR 13 Rural, nondisparity

* The above red bars represent Colorado's 5-year relative survivals. In Colorado, the 6 most common cancers are melanoma of the skin, breast, lung, prostate, colon, uterine cancers. The

of residents in Custer County surviving 5 years after diagnosis for each of the most common cancers are above.

* County data suppressed

Melanoma of the Skin

Corpus and Uterus, NOS

Colon and Rectum

Lung and Bronchus

Custer

Cancer Snapshot

Fremont County (Population 49,107)

Relative to HSR 13, Fremont County has higher incidence of breast, lung, and colorectal cancer, greater percent of late-stage diagnosis of cervical cancer, higher mortality of lung cancer, and lower 5-year survival rates of uterine cancer.

Compared to rural non-disparity counties, Fremont County has higher incidence of breast, lung, and colorectal cancer, higher mortality of lung, breast, prostate, and colorectal cancer, and lower 5-year survival rates of melanoma and uterine cancer.

From 2007-2018 in Fremont, 3,543 people were diagnosed with cancer of any type. The four cancers with the highest rates of new cases are shown below.

Age-Adjusted Incidence Rate (per 100,000 persons)

The above red bars represent Colorado's age-adjusted incidence rates.

From 2007-2018, 1,616 people in Fremont County were diagnosed with screenable cancers (lung and bronchus, breast, prostate, colorectal, cervical). Below are the percentages of these cancers that were diagnosed at late stage.

Diagnosis at late stage

* County data suppressed

From 2007-2018 in Fremont County, 1,386 people died of cancer of any type. The four cancers with the highest rates of death are shown below.

Age-Adjusted Mortality Rate (per 100,000 persons)

Age-Adjusted Incidence Rate (per 100,000 persons)

Fremont HSR 13 Rural, nondisparity

* The above red bars represent Colorado's age-adjusted mortality rates.

Percentage alive 5 years after diagnosis - Top 6 most common (5-year relative survival)

HSR 13 Rural, nondisparity

* The above red bars represent Colorado's 5-year relative survivals. In Colorado, the 6 most common cancers are melanoma of the skin, breast, lung, prostate, colon, uterine cancers. The

of residents in Fremont County surviving 5 years after diagnosis for each of the most common cancers are above.

* County data suppressed

Corpus and Uterus, NOS

Colon and Rectum

Lung and Bronchus

Fremont

J. HEALTH STATISTIC REGION 19

Photo by Josh Smith on Unsplash

J.1 MESA COUNTY (DARK BLUE, FIGURE 40)

Cancer Snapshot

Mesa County (Population 156,131)

Relative to urban non-disparity counties, Mesa has higher incidence of lung cancer, and colorectal cancer, more late-stage prostate cancer, higher mortality for lung and prostate cancer, and lower 5-year survival of melanoma, colorectal, and lung cancer.

From 2007-2018 in Mesa, 9,241 people were diagnosed with cancer of any type. The four cancers with the highest rates of new cases are shown below.

Age-Adjusted Incidence Rate (per 100,000 persons)

The above red bars represent Colorado's age-adjusted incidence rates.

From 2007-2018, 4,227 people in Mesa County were diagnosed with screenable cancers (lung and bronchus, breast, prostate, colorectal, cervical). Below are the percentages of these cancers that were diagnosed at late stage.

Diagnosis

at late stage (Age-adjusted Incidence Rate, per 100,000 persons)

From 2007-2018 in Mesa County, 3,529 people died of cancer of any type. The four cancers with the highest rates of death are shown below.

Age-Adjusted Mortality Rate (per 100,000 persons)

Age-Adjusted Incidence Rate (per 100,000 persons)

* The above red bars represent Colorado's age-adjusted mortality rates.

Percentage alive 5 years after diagnosis - Top 6 most common (5-year relative survival)

non-disparity

* The above red bars represent Colorado's 5-year relative survivals. In Colorado, the 6 most common cancers are melanoma of the skin, breast, lung, prostate, colon, and uterine cancers. The percentage of residents in Mesa County surviving 5 years after diagnosis for each of the most common cancers are above.

Melanoma of the Skin

Female breast

Prostate

Corpus and Uterus, NOS

Colon and Rectum

Lung and Bronchus

Photo by Caleb Jack on Unsplash

KEY INFORMANT INTERVIEWS

We interviewed 19 key informants from rural counties in 2021 and 18 key informants from urban counties in 2022. The 37 KI interviewees represented 33 counties from 15 of the 21 Health Statistics Regions, with six regions represented in the interviews of counties in the Denver Metro area and Colorado’s Front Range.

The ﬁndings suggest that the public health sector and communities have limited knowledge of the cancer burden and risks in their home counties. Further, healthcare administrative leadership and front-end providers face limitations addressing cancer in the context of competing health priorities and needs and with very scarce resources.

We also learned that communities do not have sustainable cancer prevention and control programs. Three key themes emerged from the KI interviews that illustrate communities’ level of readiness to take action and their capacity to reduce the cancer burden. We illustrated the themes from a few cancer disparity counties with quotes from various KI interviewees.

Quotes have been edited to remove verbal pauses to increase readability.

1. Lack of Awareness. A clear theme was lack of awareness about the cancer disparities that aﬀect counties and regions among local leaders, community members, and health professionals. They lacked awareness about cancer risks and lacked programs to prevent or detect cancer early to improve survival. Community members also lack awareness of their cancer risks and seek care only when a serious health problem is suspected, which may partially explain a county’s high number of late-stage cancer diagnoses. The following KIs’ quotes illustrate that awareness of the cancer burden is generally vague to very low:

Phillips County (HSR 1)

“Without knowledge … knowledge is key. And I think we can educate the community [about cancer]. That might help. As of now, if it’s not broke, don’t ﬁx it, or people really aren’t aware.”

Pueblo County (HSR 7)

“A while ago [we] did some work with patients as well as providers, trying to understand the value or how people thought about preventive care, which [cancer] screening sort of falls underneath. And for the most part, what was learned was that people do not seek preventive care, including a primary care doctor, unless it’s really necessary, so unless they start to experience health issues.”

Costilla County (HSR 8)

“Right now, maybe two or three, if it’s on a scale [from 1 through 10, with 1 being lowest awareness and 10 being highest awareness], it’s pretty low. The data [cancer snapshots] that you guys presented was … that tells a lot we didn’t know. I didn’t even know that.”

Cheyenne County (HSR 5)

“I think in part because the information is not out there. When I do see these old patients, it’s like the mentality needs to change. People aren’t coming into visits until they’re 70. And prior to that, they’re just coming in for med reﬁlls, and that’s all. And then you’re trying to tell these 70-year-olds we can do a cancer screening for lung cancer or younger than that. And they’re like, ‘No, I would just rather not know.’”

Conejos County (HSR 8)

“I don’t know if all of them [public health leaders] have seen these numbers [cancer snapshots] that you just showed me today. They may not be aware of how serious it is in our rural communities. So, I think we’re supportive. I think all the leaders want to do something diﬀerent, but I don’t think they realize what the impact is right now.”

Photo by Clay Banks on Unsplash

2. Competing Health Priorities and Needs. Across cancer disparity counties, a common theme was the confluence of health priorities and needs that have strained the ability of healthcare and public health agencies to effectively address the cancer burden. The leaders talked about pressing health priorities that also negatively affect communities, such as other chronic diseases, mental health problems, and substance misuse. Social determinants that impact health, such as inadequate housing, food insecurity, and a lack of health insurance, are needs that take priority, making cancer almost irrelevant. For example, local public health agencies did not include cancer in their latest 2023 Community Health Improvement Plans. During the COVID-19 pandemic, healthcare resources were less available, furthering the shortage of cancer prevention and early detection programs.

Prowers County (HSR 6)

“We do health fairs every year. Obviously, 2020, we didn’t do anything. And so, I think that that will be very concerning for some of the cancers. … The hospital has been shut down twice during COVID and not doing any mammograms.”

Costilla County (HSR 8)

“It’s probably pretty low right now [cancer as a priority]. There are too many that [are dealing with drug substance abuse]. That’s the biggest [concern]. Conejos and Costilla [counties], they are red when you look at opioid use. So…there’s huge eﬀorts in that area.”

Routt County (HSR 11)

“We’ve got so many barriers, such as housing and transportation. All of these factors that screening for cancers, is probably not the top of mind for a lot of our residents right now.”

Chaﬀee County (HSR 13)

“There’s probably a moderate level of understanding and knowledge for those that truly care about their health. I think there’s also so many other competing priorities, like aﬀordable housing or juggling three jobs or childcare. I think that at any given point we have to look at what that balance is between seeking out healthcare services versus all the other social determinants of health.”

Huerfano County (HSR 6)

“They’re probably aware [cancer prevention or early detection] is not one of their top priorities. They have so many other issues [social determinants of health] that they have to deal with prior to accessing healthcare”.

Montezuma County (HSR9)

“We have a high Hispanic population here, and a lot of them are not insured. In the last four years, it has become even more scary for them to seek healthcare. And we’ve seen that here. So I think that’s probably an inaccessible area or it has been.”

Custer County (HSR 13)

“Diabetes is a big thing down here. We have a lot of diabetics. That’s one of our top disparities. There’s a lot of focus on caring for diabetics and providing education about prevention of diabetes. We also have a massive opioid crisis down here. And so behavioral health is also a big deal down here to try to work on addictions. There are some real concerns down here that go way out of the realm of cancer care. Opioids will kill somebody way faster than cancer.”

3. Lack of resources and geographic Isolation. A common theme among cancer disparity counties is the lack of resources and capacity to reduce cancer risks through prevention measures such as tobacco cessation programs or to improve uptake of the HPV vaccine. Programs to detect cancer in its early stages are also lacking or less easily accessible to low-income residents from rural areas, which contributes to late-stage cancer diagnoses. For example, colonoscopies for colorectal cancer screening are diﬃcult to access due to cost or long-distance travel. Several KIs noted that the few cancer prevention and early detection programs have been terminated due to funding cuts, aﬀecting their capacity to sustainably reduce the cancer burden in their counties and regions.

Washington County (HSR 1)

“We just don’t have a lot of the resources out here [rural areas] to provide those screenings. Of course … we’re big supporters of the HPV vaccine … it’s just really hard to do that without there being any providers in our area and folks having to travel. [Lowincome areas] don’t have the transportation or the money to take their kids or themselves to the dentist. So that is a huge problem. That just adds more stress to our families and [makes them] very reluctant to get a screening or to really receive the information because their hands are tied to have any results.”

Cheyenne County (HSR 5)

“I think we don’t have a good, robust system in place. We’re trying to ramp up our Medicare preventative visits because I think our cancer prevention is weak and that it’s sporadic in targeting patients. There is no education out there for our communities. Nothing.”

Delta County (HSR 10)

“The doctor and I have discussed a lot of these cancers that we see. They are typically pretty advanced stages by the time we see them. We’ve got a farming, ranching, immigrant, low-income community that doesn’t really do well seeking healthcare and following up, so typically that’s what we see, these late-stage cancers.”

Lincoln County (HSR 5)

“The hospital and clinics struggle to get that awareness out. And so, if they’re not coming to the health care clinics or hospitals, they really don’t know, and the reason it’s diﬃcult for them [due to distance] to get them in. A good number of their community members are farmers and ranchers, so they don’t have time, again many of them don’t qualify for health insurance. So having those discussion about how we get creative around getting folks to do surveys and to get them to be aware of screenings, you have to get to them.”

Mineral County (HSR 8)

“Medicaid pays for cessation stuff. Patches and gum. But you have to go to Walmart, which is 90 miles away, to get it, and you have to buy it first. Then turn your receipt in to get paid back. So, if you don’t have the money to drive and you don’t have a car and you don’t even have the money to buy the stuff, it doesn’t matter If you get reimbursed, you’re not going to get it.”

Jackson County (HSR 11)

“One of the biggest barriers to us having actual big programs or things like that, we don’t have a mammogram machine. We don’t have anyone in town locally, we don’t have a surgery center, so you can’t get colonoscopies [in Jackson County]. People have to travel a minimum of 65 miles to get those services, and so that that makes it diﬃcult to provide those services and to do those screenings and follow up on those just because of the distance that people have to go, because a lot of people don’t want to travel.”

Photo by Andrew W on Unsplash

IMPROVING THE HEALTH

AND

HEALTHCARE LANDSCAPES IN COLORADO TO REDUCE THE UNEQUAL BURDEN OF CANCER

The Community Health Needs Assessment (CHNA) population-based data and interviews with key community leaders provide a comprehensive understanding of the unequal burden of cancer in Colorado. The CHNA’s goal was to assess geographic cancer disparities to gain a broad picture of how cancer affects all populations in the state. Subsequently, we created this report to discuss how the CHNA can assist in strengthening the landscape in Colorado to improve cancer outcomes in counties with higher disparities. Next, we discuss COE’s efforts to strengthen communities’ capacity to implement cancer prevention and control programs, especially among disadvantaged populations that lack access and experience overall worse health outcomes. More specifically, the CU Cancer Center is particularly keen to reduce cancer disparities that affect medically underserved (e.g., uninsured, underinsured, low income), racial and ethnic minorities, and rural and frontier populations residing in counties with high cancer disparities across the state.

CANCER DISPARITIES, PRIORITIES, AND NEEDS

The CHNA population-based ﬁndings unequivocally demonstrate that rural and frontier counties bear an unequal burden of cancer in Colorado. Of the 47 rural and frontier counties, 24 (over 50%) have a high Cancer Disparity Index (>39 points); 19 have 15% of the population living in poverty; and 10 counties have about 25% of residents who are Hispanic or Latino/a. Thus, rural and frontier cancer disparity counties are socioeconomically disadvantaged, and most are in the east and south regions of Colorado. Although population cancer rates vary by county, a consistent pattern of disparities emerged. Compared to counties in their region and to non-disparity counties, cancer disparity counties have higher mortality overall, and the majority have higher mortality for the top-incident cancers (lung, prostate, breast, and colorectal).

While cancer disparities disproportionately aﬀect rural and frontier counties and a few urban counties, the communities in these counties are mostly unaware

of such disparities, lack resources to support cancer prevention and early detection programs, and are focused on other competing health priorities and needs. Since a large majority of residents in cancer disparity counties are socioeconomically disadvantaged, their immediate concerns include inadequate housing, food insecurity, and a lack of health insurance. Similarly, cancer disparity counties have competing health priorities such as other chronic diseases, mental health problems, and substance use. Cancer was not considered a priority by public health or healthcare leaders from either rural and frontier or urban counties, conﬁrmed by the fact that none of the local public health agencies across counties included cancer in their Community Health Improvement Plans. In addition, resources in disparity counties to address community health priorities and needs are scarce and almost nonexistent for cancer prevention or early detection to deter high cancer mortality and low survival rates.

Photo

ENGAGING COMMUNITIES

Engaging communities aﬀected by the populationbased cancer disparities we uncovered was essential in understanding community drivers of the cancer burden in their counties. The public health and healthcare leaders interviewed were keenly interested in learning about and explaining the disparities, but also in discussing possible actions to improve the landscape in their communities to reduce cancer disparities. We used the Community Readiness Model’s8 strategies framework in the execution of COE’s follow-up actions and for engaging communities in sustainable cancer prevention and control initiatives.

Key informants observed that leaders and community members lacked awareness of the higher incidence, mortality, late-stage diagnosis, and low 5-year survival cancer rates in their counties and regions. Thus, it is of utmost importance to engage communities in educational activities that increase their awareness and knowledge of the disparities, but more importantly to move them to implement measures to prevent and detect cancer in its early stages. Key informants

recommended that education must begin with local public health and healthcare leaders: “I think we’re supportive. I think all the leaders want to do something different, but I don’t think they realize what the impact is right now” (Conejos County, HSR 8). Engaging with leaders one-on-one during KI interviews was the CU Cancer Center’s first step toward bringing awareness and gauging their desire to engage in actions to remedy the cancer burden in their community. Subsequently, with support from NCI,9 COE partnered with the Colorado Cancer Coalition to convene leaders across counties and regions to form Regional Cancer Networks (RCNs). The goal of the RCNs is to engage counties with the CU Cancer Center and the Coalition’s efforts to reduce Colorado’s cancer burden. We shared the CHNA findings with the RCNs leads and convened local community organizations to create awareness and enlist partnerships that sustainably engage their communities. We plan to work with the RCN to organize cancer education events and build capacity for cancer prevention and control programs.

Photo by Connor Betts on Unsplash

Key informants also emphasized the need to educate community members about cancer: “Knowledge is key. I think we can educate the community [about cancer]. That might help” (Philips County, HSR 1). The leaders interviewed indicated that residents who are not aware of their cancer risks are less likely to engage in cancer prevention or screening, which may also explain the higher incidence and mortality from cancers that are detected at a late stage. Finding the best outlets to educate the community at large through trusted health sources is likely to improve community members’ readiness to learn about cancer and engage in preventive health behaviors. To this end, in 2023 COE participated in the 9Health Fairs (later 365 Health Fairs) and other community-sponsored events in underserved areas of the state to provide cancer education on risk factors and free screenings to community members to improve cancer awareness and early detection for certain cancers. COE attended 36 community health fairs across the state to engage individuals in cancer prevention. We distributed 172 home kits to detect radon, a lung cancer risk factor, and 650 fecal immunochemical test (FIT) kits to screen for colorectal cancer, navigating underserved individuals with negative ﬁndings to radon mitigation services or to colonoscopy. COE also sponsored 19 skin cancer prevention workshops in mountain regions, engaging 725 residents who received sunscreen, SPF lip balm, sun hats, and sunglasses. The CU Cancer Center will continue to engage community partners to disseminate cancer education and encourage cancer screenings, focusing on cancer disparity counties and other disadvantaged populations.

The lack of resources and geographic isolation are barriers to engaging communities in cancer disparity counties in sustainable cancer prevention and control activities. Although capacity is limited, a few state-funded cancer screening programs exist that reach populations statewide, including isolated rural and frontier populations. The Women’s Wellness Connection (WWC) oﬀers free breast and cervical cancer screenings at more than 100 clinics across Colorado to those who qualify as medically underserved (e.g., low-income, uninsured, underinsured). In 2023, the CU Cancer Center established a partnership with WWC to improve access to cancer care for patients diagnosed with breast and cervical cancer who do not qualify for the state’s Breast and Cervical Cancer Program. These are often uninsured Hispanic or Latina women. COE oﬀers these and other uninsured patients free navigation to cancer treatment, preferably at locations closer to home to remove geographic barriers when possible. This WWW-COE partnership

seeks to build from existent resources the capacity to address the unmet needs of disadvantaged members in our Colorado communities: “We have a high Hispanic population here, and a lot of them are not insured” (Montezuma County, HSR9). COE has a team of bicultural and bilingual patient navigators to authentically engage Hispanic or Latino/a and other underserved communities in the state.

Photo by Daniel Norris on Unsplash

STEPS

The CU Cancer Center will continue to partner with communities to support existing eﬀorts and to build their capacity to implement programs in cancer prevention, early detection, treatment, and survivorship. We recognize that at this moment, reducing the cancer burden is not a priority across counties in Colorado. Consequently, we need to start by improving awareness, knowledge, and readiness to move into action. COE can assist communities to foster the support of leaders from the public health and healthcare sectors to prioritize cancer as a disease that needs to be included in local Community Health Improvement Plans. Its prioritization will likely be followed by the funding of programs to improve cancer outcomes through state funding allocation such as the State Tobacco Education and Prevention Partnership (STEPP) program.

COE plans to support the STEPP program in the dissemination and implementation of tobacco education and smoking and vaping cessation interventions for disadvantaged populations with higher tobacco rates.

Our next steps include strengthening the CU Cancer Center’s collaboration with the Colorado Cancer Coalition and the Colorado Department of Public Health and Environment in the drafting of the 2026-2030 Colorado Cancer Plan to consider our ﬁndings and prioritize the reduction of the unequal burden of cancer in rural and frontier and disadvantaged communities in cancer disparity counties as part of the state’s plan. We will also partner with the Colorado Cancer Caucus and the American Cancer Society Cancer Action Network to advance legislation that can meaningfully increase guard rails to

Photo by Andrew on Unsplash

sustainably support programs to prevent, detect, and treat cancer early to reduce mortality and improve cancer survivorship in Colorado. Leveraging the CU Cancer Center’s strengths in basic, clinical, and population-health research, we will engage communities in scientific endeavors to investigate drivers of cancer disparities and interventions that are communitydriven and -informed to improve their impact on reducing Colorado’s cancer burden. We plan to rigorously evaluate the effectiveness of our implementation and research programs, gathering data and feedback to refine and enhance our strategies. A collaborative process will ensure that the CU Cancer Center’s efforts are effective, relevant, and responsive to the evolving needs in our catchment area.

Photo by Anna Seeley on Unsplash

Photo by Hailey Haar on Unsplash

ACKNOWLEDGEMENTS

We extend our sincere gratitude to all individuals whose commitment and collaborative spirit have been instrumental in developing this Community Health Needs Assessment report. The success of this initiative underscores the collective eﬀorts of our dedicated collaborators, and we look forward to continuing joint eﬀorts to address cancer disparities and reduce the cancer burden in Colorado.

University of Colorado Cancer Center collaborative teams: Office of Community Outreach & Engagement, Office of Engagement, Access, & Success, and Office of Communications.

REFERENCES

1. United States Census Bureau. 2017-2022 American Community Survey, 2022 ACS 1-year Estimates. Updated October 26, 2023. Accessed January 10, 2024. https://www.census.gov/ programssurveys/acs/technical-documentation/table-and-geography-changes/2022/1-year.html.

2. American Cancer Society. Cancer Facts & Figures 2024. Atlanta: American Cancer Society. Published 2024.

3. Center for Disease Control, National Cancer Institute. State Cancer Proﬁles. Updated January 2024. Accessed January 10, 2024. https://statecancerproﬁles.cancer.gov/index.html.

4. Colorado Central Cancer Registry, 2007-2018. Colorado Department of Public Health and Environment. Published 2019. Accessed January 10, 2024. https://cdphe.colorado.gov/center-for-health-and-environmentaldata/registries-and-vital-statistics/colorado-central-cancer.

5. Colorado Behavioral Risk Factor Surveillance Survey (BRFSS). Colorado Department of Public Health and Environment. Updated 2022. Accessed January 10, 2024. https://cdphe.colorado. gov/center-for-health-and-environmental-data/survey-research/behavioral-risk-factor-surveillance-system.

6. Colorectal cancer: Screening. Published May 18, 2021. Accessed January 10, 2024. U.S. Preventive Services Task Force. https://www.uspreventiveservicestaskforce.org/ uspstf/recommendation/colorectal-cancer-screening

7. Colorado Immunization Information System. Updated 2024. Accessed January 10, 2024. Colorado Department of Public Health and Environment. https://ciis.state.co.us/

8. Plested B, Jumper-Thurman P, Edwards R. Community Readiness Manual. Published 2009. Available at: https://www.myctb.org/wst/iowaspfsig/Shared%20Documents/Assessment/ Assessment%20Deliverables/Community%20Readiness%20Handbook%20-%20Revised%20February%20 2011.pdf

9. Research reported in this publication was supported by Building Rural Cancer Control and Prevention Research Collaborative in Colorado, a supplement to the University of Colorado Cancer Center Support Grant, an NCI-funded program (P30 CA046934).

We invite you to join us in supporting the crucial work of the Office of Community Outreach and Engagement (COE) at the CU Cancer Center. This work is vital in understanding how cancer impacts our communities, especially among those who are most vulnerable. By backing this initiative and the projects described in this report, you contribute to targeted efforts that aim to reduce cancer disparities and improve health outcomes for all Coloradans. Your support will help ensure that every voice is heard and every need is addressed in the fight against cancer.

To learn more, please contact advancement@cuanschutz.edu. To provide philanthropic support to expedite the impact of the Oﬃce of Community Outreach and Engagement, visit https://Giving.cu.edu/CPCF or scan the QR code below.

APPENDIX

Cancer Snapshot

Adams County (Population 520,150)

From 2007-2018 in Adams, 19,938 people were diagnosed with cancer of any type. The four cancers with the highest rates of new cases are shown below.

Age-Adjusted Incidence Rate (per 100,000 persons)

From 2007-2018, 8,982 people in Adams County were diagnosed with screenable cancers (lung and bronchus, breast, prostate, colorectal, cervical). Below are the percentages of these cancers that were diagnosed at late stage. * The above red bars represent Colorado's age-adjusted incidence rates.

Diagnosis at late stage

(Age-adjusted Incidence Rate, per 100,000 persons)

The above red bars represent Colorado's percent of screenable cancers diagnosed at late stage.

County data suppressed

From 2007-2018 in Adams County, 7,155 people died of cancer of any type. The four cancers with the highest rates of death are shown below.

Age-Adjusted Mortality Rate (per 100,000 persons)

Age-Adjusted Incidence Rate (per 100,000 persons)

* The above red bars represent Colorado's age-adjusted mortality rates.

Percentage alive 5 years after diagnosis - Top 6 most common (5-year relative survival)

* The above red bars represent Colorado's 5-year relative survivals. In Colorado, the 6 most common cancers are melanoma of the skin, breast, lung, prostate, colon, and uterine cancers. The percentage of residents in Adams County surviving 5 years after diagnosis for each of the most common cancers are above.

Melanoma of the Skin Female breast Prostate

Corpus and Uterus, NOS

Colon and Rectum

Lung and Bronchus

Adams Rural, high cancer disparity

Cancer Snapshot

Alamosa County (Population 16,460)

From 2007-2018 in Alamosa, 728 people were diagnosed with cancer of any type. The four cancers with the highest rates of new cases are shown below.

Age-Adjusted Incidence Rate (per 100,000 persons)

From 2007-2018, 280 people in Alamosa County were diagnosed with screenable cancers (lung and bronchus, breast, prostate, colorectal, cervical). Below are the percentages of these cancers that were diagnosed at late stage. * The above red bars represent Colorado's age-adjusted incidence rates.

Diagnosis at late stage

* County data suppressed

From 2007-2018 in Alamosa County, 273 people died of cancer of any type. The four cancers with the highest rates of death are shown below.

Age-Adjusted Mortality Rate (per 100,000 persons)

Age-Adjusted Incidence Rate (per 100,000 persons)

Alamosa HSR 8 Rural, high disparity

* The above red bars represent Colorado's age-adjusted mortality rates.

Percentage alive 5 years after diagnosis - Top 6 most common (5-year relative survival)

Alamosa

HSR 8 Rural, high disparity

* The above red bars represent Colorado's 5-year relative survivals. In Colorado, the 6 most common cancers are melanoma of the skin, breast, lung, prostate, colon, uterine cancers. The percentage of residents in Alamosa County surviving 5 years after diagnosis for each of the most common cancers are above.

* County data suppressed

Prostate

Female breast

Melanoma of the Skin

Corpus and Uterus, NOS

Colon and Rectum

Lung and Bronchus

Cancer Snapshot

Arapahoe County (Population 654,450)

From 2007-2018 in Arapahoe, 29,920 people were diagnosed with cancer of any type. The four cancers with the highest rates of new cases are shown below.

Age-Adjusted Incidence Rate (per 100,000 persons)

From 2007-2018, 12,943 people in Arapahoe County were diagnosed with screenable cancers (lung and bronchus, breast, prostate, colorectal, cervical). Below are the percentages of these cancers that were diagnosed at late stage. * The above red bars represent Colorado's age-adjusted incidence rates.

Diagnosis at late stage

(Age-adjusted Incidence Rate, per 100,000 persons)

From 2007-2018 in Arapahoe County, 9,613 people died of cancer of any type. The four cancers with the highest rates of death are shown below.

Age-Adjusted Mortality Rate (per 100,000 persons)

Age-Adjusted Incidence Rate (per 100,000 persons)

Arapahoe Rural, high cancer disparity

* The above red bars represent Colorado's age-adjusted mortality rates.

Percentage alive 5 years after diagnosis - Top 6 most common (5-year relative survival)

Arapahoe Rural, high cancer disparity

* The above red bars represent Colorado's 5-year relative survivals. In Colorado, the 6 most common cancers are melanoma of the skin, breast, lung, prostate, colon, and uterine cancers. The percentage of residents in Arapahoe County surviving 5 years after diagnosis for each of the most common cancers are above.

Melanoma of the Skin Female breast Prostate

Corpus and Uterus, NOS

Colon and Rectum

Lung and Bronchus

Cancer Snapshot

Archuleta County (Population 13,509)

From 2007-2018 in Archuleta, 795 people were diagnosed with cancer of any type. The four cancers with the highest rates of new cases are shown below.

Age-Adjusted Incidence Rate (per 100,000 persons)

The above red bars represent Colorado's age-adjusted incidence rates.

From 2007-2018, 354 people in Archuleta County were diagnosed with screenable cancers (lung and bronchus, breast, prostate, colorectal, cervical). Below are the percentages of these cancers that were diagnosed at late stage.

Diagnosis at late stage

* County data suppressed

From 2007-2018 in Archuleta County, 269 people died of cancer of any type. The four cancers with the highest rates of death are shown below.

Age-Adjusted Mortality Rate (per 100,000 persons)

Age-Adjusted Incidence Rate (per 100,000 persons)

Archuleta HSR 17 Rural, high disparity

* The above red bars represent Colorado's age-adjusted mortality rates.

Percentage alive 5 years after diagnosis - Top 6 most common (5-year relative survival)

Archuleta

HSR 17 Rural, high disparity

* The above red bars represent Colorado's 5-year relative survivals. In Colorado, the 6 most common cancers are melanoma of the skin, breast, lung, prostate, colon, uterine cancers. The percentage of residents in Archuleta County surviving 5 years after diagnosis for each of the most common cancers are above.

* County data suppressed

Melanoma of the Skin

Corpus and Uterus, NOS

Colon and Rectum

Lung and Bronchus

Cancer Snapshot

Boulder County (Population 328,660)

From 2007-2018 in Boulder, 14,921 people were diagnosed with cancer of any type. The four cancers with the highest rates of new cases are shown below.

Age-Adjusted Incidence Rate (per 100,000 persons)

The above red bars represent Colorado's age-adjusted incidence rates.

From 2007-2018, 6,307 people in Boulder County were diagnosed with screenable cancers (lung and bronchus, breast, prostate, colorectal, cervical). Below are the percentages of these cancers that were diagnosed at late stage.

Diagnosis at late stage

* County data suppressed

From 2007-2018 in Boulder County, 4,570 people died of cancer of any type. The four cancers with the highest rates of death are shown below.

Age-Adjusted Mortality Rate (per 100,000 persons)

Age-Adjusted Incidence Rate (per 100,000 persons)

Boulder HSR 16 Rural, high disparity

* The above red bars represent Colorado's age-adjusted mortality rates.

Percentage alive 5 years after diagnosis - Top 6 most common (5-year relative survival)

Boulder

HSR 16 Rural, high disparity

* The above red bars represent Colorado's 5-year relative survivals. In Colorado, the 6 most common cancers are melanoma of the skin, breast, lung, prostate, colon, uterine cancers. The percentage of residents in Boulder County surviving 5 years after diagnosis for each of the most common cancers are above.

* County data suppressed

Melanoma of the Skin

Corpus and Uterus, NOS

Colon and Rectum

Lung and Bronchus

Cancer Snapshot

Broomfield County (Population 73,946)

From 2007-2018 in Broomfield, 2,892 people were diagnosed with cancer of any type. The four cancers with the highest rates of new cases are shown below.

Age-Adjusted Incidence Rate (per 100,000 persons)

The above red bars represent Colorado's age-adjusted incidence rates.

From 2007-2018, 1,270 people in Broomfield County were diagnosed with screenable cancers (lung and bronchus, breast, prostate, colorectal, cervical). Below are the percentages of these cancers that were diagnosed at late stage.

at late stage, screenable

Diagnosis at late stage

* County data suppressed

From 2007-2018 in Broomfield County, 901 people died of cancer of any type. The four cancers with the highest rates of death are shown below.

Age-Adjusted Mortality Rate (per 100,000 persons)

Age-Adjusted Incidence Rate (per 100,000 persons)

Broomfield HSR 16 Rural, high disparity

* The above red bars represent Colorado's age-adjusted mortality rates.

Percentage alive 5 years after diagnosis - Top 6 most common (5-year relative survival)

HSR 16 Rural, high disparity

* The above red bars represent Colorado's 5-year relative survivals. In Colorado, the 6 most common cancers are melanoma of the skin, breast, lung, prostate, colon, uterine cancers. The percentage of residents in Broomfield County surviving 5 years after diagnosis for each of the most common cancers are above.

* County data suppressed

Melanoma of the Skin

Corpus and Uterus, NOS

Colon and Rectum

Lung and Bronchus

Broomfield

Cancer Snapshot

Clear Creek County (Population 9,403)

From 2007-2018 in Clear Creek, 598 people were diagnosed with cancer of any type. The four cancers with the highest rates of new cases are shown below.

Age-Adjusted Incidence Rate (per 100,000 persons)

The above red bars represent Colorado's age-adjusted incidence rates.

From 2007-2018, 220 people in Clear Creek County were diagnosed with screenable cancers (lung and bronchus, breast, prostate, colorectal, cervical). Below are the percentages of these cancers that were diagnosed at late stage.

Diagnosis at late stage

* County data suppressed

From 2007-2018 in Clear Creek County, 177 people died of cancer of any type. The four cancers with the highest rates of death are shown below.

Age-Adjusted Mortality Rate (per 100,000 persons)

Age-Adjusted Incidence Rate (per 100,000 persons)

Clear Creek HSR 17 Rural, high disparity

* The above red bars represent Colorado's age-adjusted mortality rates.

Percentage alive 5 years after diagnosis - Top 6 most common (5-year relative survival)

Clear Creek

HSR 17 Rural, high disparity

* The above red bars represent Colorado's 5-year relative survivals. In Colorado, the 6 most common cancers are melanoma of the skin, breast, lung, prostate, colon, uterine cancers. The percentage of residents in Clear Creek County surviving 5 years after diagnosis for each of the most common cancers are above.

* County data suppressed

Melanoma of the Skin

Corpus and Uterus, NOS

Colon and Rectum

Lung and Bronchus

Cancer Snapshot

Crowley County (Population 5,782)

From 2007-2018 in Crowley, 245 people were diagnosed with cancer of any type. The four cancers with the highest rates of new cases are shown below.

Age-Adjusted Incidence Rate (per 100,000 persons)

The above red bars represent Colorado's age-adjusted incidence rates.

From 2007-2018, 104 people in Crowley County were diagnosed with screenable cancers (lung and bronchus, breast, prostate, colorectal, cervical). Below are the percentages of these cancers that were diagnosed at late stage.

Diagnosis at late stage

* County data suppressed

From 2007-2018 in Crowley County, 98 people died of cancer of any type. The four cancers with the highest rates of death are shown below.

Age-Adjusted Mortality Rate (per 100,000 persons)

Age-Adjusted Incidence Rate (per 100,000 persons)

* The above red bars represent Colorado's age-adjusted mortality rates.

Percentage alive 5 years after diagnosis - Top 6 most common (5-year relative survival)

Crowley HSR 6 Rural, high disparity Crowley

HSR 6 Rural, high disparity

* The above red bars represent Colorado's 5-year relative survivals. In Colorado, the 6 most common cancers are melanoma of the skin, breast, lung, prostate, colon, uterine cancers. The percentage of residents in Crowley County surviving 5 years after diagnosis for each of the most common cancers are above.

* County data suppressed

Melanoma of the Skin

Corpus and Uterus, NOS

Colon and Rectum

Lung and Bronchus

Cancer Snapshot

Denver County (Population 710,800)

From 2007-2018 in Denver, 31,090 people were diagnosed with cancer of any type. The four cancers with the highest rates of new cases are shown below.

Age-Adjusted Incidence Rate (per 100,000 persons)

From 2007-2018, 14,073 people in Denver County were diagnosed with screenable cancers (lung and bronchus, breast, prostate, colorectal, cervical). Below are the percentages of these cancers that were diagnosed at late stage. * The above red bars represent Colorado's age-adjusted incidence rates.

Diagnosis at

late stage (Age-adjusted Incidence Rate, per 100,000 persons)

The above red bars represent Colorado's percent of screenable cancers diagnosed at late stage. * County data suppressed

From 2007-2018 in Denver County, 11,094 people died of cancer of any type. The four cancers with the highest rates of death are shown below.

Age-Adjusted Mortality Rate (per 100,000 persons)

Age-Adjusted Incidence Rate (per 100,000 persons)

Denver Rural, high cancer disparity

* The above red bars represent Colorado's age-adjusted mortality rates.

Percentage alive 5 years after diagnosis - Top 6 most common (5-year relative survival)

Denver Rural, high cancer disparity

* The above red bars represent Colorado's 5-year relative survivals. In Colorado, the 6 most common cancers are melanoma of the skin, breast, lung, prostate, colon, and uterine cancers. The percentage of residents in Denver County surviving 5 years after diagnosis for each of the most common cancers are above.

Melanoma of the Skin

Female breast

Prostate

Corpus and Uterus, NOS

Colon and Rectum

Lung and Bronchus

Cancer Snapshot

Dolores County (Population 2,329)

From 2007-2018 in Dolores, 102 people were diagnosed with cancer of any type. The four cancers with the highest rates of new cases are shown below.

Age-Adjusted Incidence Rate (per 100,000 persons)

The above red bars represent Colorado's age-adjusted incidence rates.

From 2007-2018, 43 people in Dolores County were diagnosed with screenable cancers (lung and bronchus, breast, prostate, colorectal, cervical). Below are the percentages of these cancers that were diagnosed at late stage.

Diagnosis at late stage

* County data suppressed

From 2007-2018 in Dolores County, 42 people died of cancer of any type. The four cancers with the highest rates of death are shown below.

Mortality

Age-Adjusted Incidence Rate (per 100,000 persons)

Dolores HSR 9 Rural, high disparity

* The above red bars represent Colorado's age-adjusted mortality rates.

Percentage alive 5 years after diagnosis - Top 6 most common (5-year relative survival)

HSR 9 Rural, high disparity

* The above red bars represent Colorado's 5-year relative survivals. In Colorado, the 6 most common cancers are melanoma of the skin, breast, lung, prostate, colon, uterine cancers. The percentage of residents in Dolores County surviving 5 years after diagnosis for each of the most common cancers are above.

* County data suppressed

Prostate

Female breast

Melanoma of the Skin

Corpus and Uterus, NOS

Colon and Rectum

Lung and Bronchus

Dolores

Cancer Snapshot

Douglas County (Population 360,210)

From 2007-2018 in Douglas, 13,419 people were diagnosed with cancer of any type. The four cancers with the highest rates of new cases are shown below.

Age-Adjusted Incidence Rate (per 100,000 persons)

From 2007-2018, 5,367 people in Douglas County were diagnosed with screenable cancers (lung and bronchus, breast, prostate, colorectal, cervical). Below are the percentages of these cancers that were diagnosed at late stage. * The above red bars represent Colorado's age-adjusted incidence rates.

Diagnosis at late stage (Age-adjusted Incidence Rate, per 100,000 persons)

The above red bars represent Colorado's percent of screenable cancers diagnosed at late stage.

County data suppressed

From 2007-2018 in Douglas County, 3,309 people died of cancer of any type. The four cancers with the highest rates of death are shown below.

Age-Adjusted Mortality Rate (per 100,000 persons)

Age-Adjusted Incidence Rate (per 100,000 persons)

* The above red bars represent Colorado's age-adjusted mortality rates.

Percentage alive 5 years after diagnosis - Top 6 most common (5-year relative survival)

Douglas Rural, high cancer disparity

* The above red bars represent Colorado's 5-year relative survivals. In Colorado, the 6 most common cancers are melanoma of the skin, breast, lung, prostate, colon, and uterine cancers. The percentage of residents in Douglas County surviving 5 years after diagnosis for each of the most common cancers are above.

Melanoma of the Skin

Female breast

Prostate

Corpus and Uterus, NOS

Colon and Rectum

Lung and Bronchus

Douglas Rural, high cancer disparity

Cancer Snapshot

Eagle County (Population 55,650)

From 2007-2018 in Eagle, 1,891 people were diagnosed with cancer of any type. The four cancers with the highest rates of new cases are shown below.

Age-Adjusted Incidence Rate (per 100,000 persons)

The above red bars represent Colorado's age-adjusted incidence rates.

From 2007-2018, 760 people in Eagle County were diagnosed with screenable cancers (lung and bronchus, breast, prostate, colorectal, cervical). Below are the percentages of these cancers that were diagnosed at late stage.

Diagnosis at late stage

* County data suppressed

From 2007-2018 in Eagle County, 407 people died of cancer of any type. The four cancers with the highest rates of death are shown below.

Age-Adjusted Mortality Rate (per 100,000 persons)

Age-Adjusted Incidence Rate (per 100,000 persons)

HSR 12 Rural, high disparity

* The above red bars represent Colorado's age-adjusted mortality rates.

Percentage alive 5 years after diagnosis - Top 6 most common (5-year relative survival)

* The above red bars represent Colorado's 5-year relative survivals. In Colorado, the 6 most common cancers are melanoma of the skin, breast, lung, prostate, colon, uterine cancers. The percentage of residents in Eagle County surviving 5 years after diagnosis for each of the most common cancers are above.

* County data suppressed HSR 12 Rural, high disparity

Melanoma of the Skin

Corpus and Uterus, NOS

Colon and Rectum

Lung and Bronchus

Cancer Snapshot

Elbert County (Population 26,457)

From 2007-2018 in Elbert, 1,322 people were diagnosed with cancer of any type. The four cancers with the highest rates of new cases are shown below.

Age-Adjusted Incidence Rate (per 100,000 persons)

The above red bars represent Colorado's age-adjusted incidence rates.

From 2007-2018, 581 people in Elbert County were diagnosed with screenable cancers (lung and bronchus, breast, prostate, colorectal, cervical). Below are the percentages of these cancers that were diagnosed at late stage.

Diagnosis

at late stage

* County data suppressed

From 2007-2018 in Elbert County, 433 people died of cancer of any type. The four cancers with the highest rates of death are shown below.

Age-Adjusted Mortality Rate (per 100,000 persons)

Age-Adjusted Incidence Rate (per 100,000 persons)

Elbert HSR 5 Rural, high disparity

* The above red bars represent Colorado's age-adjusted mortality rates.

Percentage alive 5 years after diagnosis - Top 6 most common (5-year relative survival)

Elbert

HSR 5 Rural, high disparity

* The above red bars represent Colorado's 5-year relative survivals. In Colorado, the 6 most common cancers are melanoma of the skin, breast, lung, prostate, colon, uterine cancers. The percentage of residents in Elbert County surviving 5 years after diagnosis for each of the most common cancers are above.

* County data suppressed

Melanoma of the Skin

Corpus and Uterus, NOS

Colon and Rectum

Lung and Bronchus

Cancer Snapshot

El Paso County (Population 730,320)

From 2007-2018 in El Paso, 32,930 people were diagnosed with cancer of any type. The four cancers with the highest rates of new cases are shown below.

Age-Adjusted Incidence Rate (per 100,000 persons)

From 2007-2018, 14,086 people in El Paso County were diagnosed with screenable cancers (lung and bronchus, breast, prostate, colorectal, cervical). Below are the percentages of these cancers that were diagnosed at late stage.

Diagnosis at late stage

(Age-adjusted Incidence Rate, per 100,000 persons)

County data suppressed

From 2007-2018 in El Paso County, 10,720 people died of cancer of any type. The four cancers with the highest rates of death are shown below.

Age-Adjusted Mortality Rate (per 100,000 persons)

Age-Adjusted Incidence Rate (per 100,000 persons)

El Paso Rural, high cancer disparity

* The above red bars represent Colorado's age-adjusted mortality rates.

Percentage alive 5 years after diagnosis - Top 6 most common (5-year relative survival)

El Paso Rural, high cancer disparity

* The above red bars represent Colorado's 5-year relative survivals. In Colorado, the 6 most common cancers are melanoma of the skin, breast, lung, prostate, colon, and uterine cancers. The percentage of residents in El Paso County surviving 5 years after diagnosis for each of the most common cancers are above.

Melanoma of the Skin

Corpus and Uterus, NOS

Colon and Rectum

Lung and Bronchus

Cancer Snapshot

Garfield County (Population 61,683)

From 2007-2018 in Garfield, 2,640 people were diagnosed with cancer of any type. The four cancers with the highest rates of new cases are shown below.

Age-Adjusted Incidence Rate (per 100,000 persons)

From 2007-2018, 1,152 people in Garfield County were diagnosed with screenable cancers (lung and bronchus, breast, prostate, colorectal, cervical). Below are the percentages of these cancers that were diagnosed at late stage. * The above red bars represent Colorado's age-adjusted incidence rates.

Diagnosis at late stage

* County data suppressed

From 2007-2018 in Garfield County, 827 people died of cancer of any type. The four cancers with the highest rates of death are shown below.

Age-Adjusted Mortality Rate (per 100,000 persons)

Age-Adjusted Incidence Rate (per 100,000 persons)

Garfield HSR 12 Rural, high disparity

* The above red bars represent Colorado's age-adjusted mortality rates.

Percentage alive 5 years after diagnosis - Top 6 most common (5-year relative survival)

Garfield

HSR 12 Rural, high disparity

* The above red bars represent Colorado's 5-year relative survivals. In Colorado, the 6 most common cancers are melanoma of the skin, breast, lung, prostate, colon, uterine cancers. The percentage of residents in Garfield County surviving 5 years after diagnosis for each of the most common cancers are above.

* County data suppressed

Melanoma of the Skin

Corpus and Uterus, NOS

Colon and Rectum

Lung and Bronchus

Cancer Snapshot

Gilpin County (Population 5,856)

From 2007-2018 in Gilpin, 285 people were diagnosed with cancer of any type. The four cancers with the highest rates of new cases are shown below.

Age-Adjusted Incidence Rate (per 100,000 persons)

The above red bars represent Colorado's age-adjusted incidence rates.

From 2007-2018, 127 people in Gilpin County were diagnosed with screenable cancers (lung and bronchus, breast, prostate, colorectal, cervical). Below are the percentages of these cancers that were diagnosed at late stage.

Diagnosis

at late stage

* County data suppressed

From 2007-2018 in Gilpin County, 91 people died of cancer of any type. The four cancers with the highest rates of death are shown below.

Age-Adjusted Mortality Rate (per 100,000 persons)

Age-Adjusted Incidence Rate (per 100,000 persons)

Gilpin HSR 17 Rural, high disparity

* The above red bars represent Colorado's age-adjusted mortality rates.

Percentage alive 5 years after diagnosis - Top 6 most common (5-year relative survival)

HSR 17 Rural, high disparity

* The above red bars represent Colorado's 5-year relative survivals. In Colorado, the 6 most common cancers are melanoma of the skin, breast, lung, prostate, colon, uterine cancers. The percentage of residents in Gilpin County surviving 5 years after diagnosis for each of the most common cancers are above.

* County data suppressed

Melanoma of the Skin

Corpus and Uterus, NOS

Colon and Rectum

Lung and Bronchus

Gilpin

Cancer Snapshot

Grand County (Population 15,724)

From 2007-2018 in Grand, 648 people were diagnosed with cancer of any type. The four cancers with the highest rates of new cases are shown below.

Age-Adjusted Incidence Rate (per 100,000 persons)

The above red bars represent Colorado's age-adjusted incidence rates.

From 2007-2018, 306 people in Grand County were diagnosed with screenable cancers (lung and bronchus, breast, prostate, colorectal, cervical). Below are the percentages of these cancers that were diagnosed at late stage.

Diagnosis at late stage

* County data suppressed

From 2007-2018 in Grand County, 216 people died of cancer of any type. The four cancers with the highest rates of death are shown below.

Age-Adjusted Mortality Rate (per 100,000 persons)

Age-Adjusted Incidence Rate (per 100,000 persons)

* The above red bars represent Colorado's age-adjusted mortality rates.

Percentage alive 5 years after diagnosis - Top 6 most common (5-year relative survival)

Grand HSR 12 Rural, high disparity Grand

HSR 12 Rural, high disparity

* The above red bars represent Colorado's 5-year relative survivals. In Colorado, the 6 most common cancers are melanoma of the skin, breast, lung, prostate, colon, uterine cancers. The percentage of residents in Grand County surviving 5 years after diagnosis for each of the most common cancers are above.

* County data suppressed

Melanoma of the Skin

Corpus and Uterus, NOS

Colon and Rectum

Lung and Bronchus

Cancer Snapshot

Gunnison County (Population 17,018)

From 2007-2018 in Gunnison, 626 people were diagnosed with cancer of any type. The four cancers with the highest rates of new cases are shown below.

Age-Adjusted Incidence Rate (per 100,000 persons)

The above red bars represent Colorado's age-adjusted incidence rates.

From 2007-2018, 241 people in Gunnison County were diagnosed with screenable cancers (lung and bronchus, breast, prostate, colorectal, cervical). Below are the percentages of these cancers that were diagnosed at late stage.

Diagnosis at late stage

* County data suppressed

From 2007-2018 in Gunnison County, 163 people died of cancer of any type. The four cancers with the highest rates of death are shown below.

Age-Adjusted Mortality Rate (per 100,000 persons)

Age-Adjusted Incidence Rate (per 100,000 persons)

Gunnison HSR 10 Rural, high disparity

* The above red bars represent Colorado's age-adjusted mortality rates.

Percentage alive 5 years after diagnosis - Top 6 most common (5-year relative survival)

Gunnison

HSR 10 Rural, high disparity

* The above red bars represent Colorado's 5-year relative survivals. In Colorado, the 6 most common cancers are melanoma of the skin, breast, lung, prostate, colon, uterine cancers. The percentage of residents in Gunnison County surviving 5 years after diagnosis for each of the most common cancers are above.

* County data suppressed

Melanoma of the Skin

Corpus and Uterus, NOS

Colon and Rectum

Lung and Bronchus

Cancer Snapshot

Hinsdale County (Population 911)

From 2007-2018 in Hinsdale, 58 people were diagnosed with cancer of any type. The four cancers with the highest rates of new cases are shown below.

Age-Adjusted Incidence Rate (per 100,000 persons)

The above red bars represent Colorado's age-adjusted incidence rates.

From 2007-2018, 26 people in Hinsdale County were diagnosed with screenable cancers (lung and bronchus, breast, prostate, colorectal, cervical). Below are the percentages of these cancers that were diagnosed at late stage.

Diagnosis at late stage

* County data suppressed

From 2007-2018 in Hinsdale County, 20 people died of cancer of any type. The four cancers with the highest rates of death are shown below.

Age-Adjusted Incidence Rate (per 100,000 persons)

Hinsdale HSR 10 Rural, high disparity

* The above red bars represent Colorado's age-adjusted mortality rates.

Percentage alive 5 years after diagnosis - Top 6 most common (5-year relative survival)

Hinsdale

HSR 10 Rural, high disparity

* The above red bars represent Colorado's 5-year relative survivals. In Colorado, the 6 most common cancers are melanoma of the skin, breast, lung, prostate, colon, uterine cancers. The percentage of residents in Hinsdale County surviving 5 years after diagnosis for each of the most common cancers are above.

* County data suppressed

Melanoma of the Skin

Corpus and Uterus, NOS Colon and Rectum Lung and Bronchus

Cancer Snapshot

Jefferson County (Population 580,520)

From 2007-2018 in Jefferson, 32,944 people were diagnosed with cancer of any type. The four cancers with the highest rates of new cases are shown below.

Age-Adjusted Incidence Rate (per 100,000 persons)

From 2007-2018, 13,796 people in Jefferson County were diagnosed with screenable cancers (lung and bronchus, breast, prostate, colorectal, cervical). Below are the percentages of these cancers that were diagnosed at late stage. * The above red bars represent Colorado's age-adjusted incidence rates.

Diagnosis at late stage (Age-adjusted Incidence Rate, per 100,000 persons)

The above red bars represent Colorado's percent of screenable cancers diagnosed at late stage. * County data suppressed

From 2007-2018 in Jefferson County, 10,807 people died of cancer of any type. The four cancers with the highest rates of death are shown below.

Age-Adjusted Mortality Rate (per 100,000 persons)

Age-Adjusted Incidence Rate (per 100,000 persons)

Jefferson Rural, high cancer disparity

* The above red bars represent Colorado's age-adjusted mortality rates.

Percentage alive 5 years after diagnosis - Top 6 most common (5-year relative survival)

Jefferson Rural, high cancer disparity

* The above red bars represent Colorado's 5-year relative survivals. In Colorado, the 6 most common cancers are melanoma of the skin, breast, lung, prostate, colon, and uterine cancers. The percentage of residents in Jefferson County surviving 5 years after diagnosis for each of the most common cancers are above.

Melanoma of the Skin

Female breast

Prostate

Corpus and Uterus, NOS

Colon and Rectum

Lung and Bronchus

Cancer Snapshot

Kit Carson County (Population 7,039)

From 2007-2018 in Kit Carson, 456 people were diagnosed with cancer of any type. The four cancers with the highest rates of new cases are shown below.

Age-Adjusted Incidence Rate (per 100,000 persons)

From 2007-2018, 213 people in Kit Carson County were diagnosed with screenable cancers (lung and bronchus, breast, prostate, colorectal, cervical). Below are the percentages of these cancers that were diagnosed at late stage. * The above red bars represent Colorado's age-adjusted incidence rates.

Diagnosis

at late stage

* County data suppressed

From 2007-2018 in Kit Carson County, 209 people died of cancer of any type. The four cancers with the highest rates of death are shown below.

Age-Adjusted Mortality Rate (per 100,000 persons)

Age-Adjusted Incidence Rate (per 100,000 persons)

Kit Carson HSR 5 Rural, high disparity

* The above red bars represent Colorado's age-adjusted mortality rates.

Percentage alive 5 years after diagnosis - Top 6 most common (5-year relative survival)

Kit Carson

HSR 5 Rural, high disparity

* The above red bars represent Colorado's 5-year relative survivals. In Colorado, the 6 most common cancers are melanoma of the skin, breast, lung, prostate, colon, uterine cancers. The percentage of residents in Kit Carson County surviving 5 years after diagnosis for each of the most common cancers are above.

* County data suppressed

Prostate

Female breast

Melanoma of the Skin

Corpus and Uterus, NOS

Colon and Rectum

Lung and Bronchus

Cancer Snapshot

Lake County (Population 7,403)

From 2007-2018 in Lake, 287 people were diagnosed with cancer of any type. The four cancers with the highest rates of new cases are shown below.

Age-Adjusted Incidence Rate (per 100,000 persons)

The above red bars represent Colorado's age-adjusted incidence rates.

From 2007-2018, 150 people in Lake County were diagnosed with screenable cancers (lung and bronchus, breast, prostate, colorectal, cervical). Below are the percentages of these cancers that were diagnosed at late stage.

Diagnosis at late stage

* County data suppressed

From 2007-2018 in Lake County, 104 people died of cancer of any type. The four cancers with the highest rates of death are shown below.

Age-Adjusted Mortality Rate (per 100,000 persons)

Age-Adjusted Incidence Rate (per 100,000 persons)

* The above red bars represent Colorado's age-adjusted mortality rates.

Percentage alive 5 years after diagnosis - Top 6 most common (5-year relative survival)

HSR 13 Rural, high disparity Lake HSR 13 Rural, high disparity Lake

* The above red bars represent Colorado's 5-year relative survivals. In Colorado, the 6 most common cancers are melanoma of the skin, breast, lung, prostate, colon, uterine cancers. The percentage of residents in Lake County surviving 5 years after diagnosis for each of the most common cancers are above.

* County data suppressed

Melanoma of the Skin

Corpus and Uterus, NOS

Colon and Rectum

Lung and Bronchus

Cancer Snapshot

La Plata County (Population 55,983)

From 2007-2018 in La Plata, 2,816 people were diagnosed with cancer of any type. The four cancers with the highest rates of new cases are shown below.

Age-Adjusted Incidence Rate (per 100,000 persons)

The above red bars represent Colorado's

From 2007-2018, 1,191 people in La Plata County were diagnosed with screenable cancers (lung and bronchus, breast, prostate, colorectal, cervical). Below are the percentages of these cancers that were diagnosed at late stage.

Diagnosis at late stage

From 2007-2018 in La Plata County, 896 people died of cancer of any type. The four cancers with the highest rates of death are shown below.

Age-Adjusted Mortality Rate (per 100,000 persons)

Age-Adjusted Incidence Rate (per 100,000 persons)

La Plata HSR 9 Rural, high disparity

* The above red bars represent Colorado's age-adjusted mortality rates.

Percentage alive 5 years after diagnosis - Top 6 most common (5-year relative survival)

La Plata

HSR 9 Rural, high disparity

* The above red bars represent Colorado's 5-year relative survivals. In Colorado, the 6 most common cancers are melanoma of the skin, breast, lung, prostate, colon, uterine cancers. The percentage of residents in La Plata County surviving 5 years after diagnosis for each of the most common cancers are above.

* County data suppressed

Melanoma of the Skin

Corpus and Uterus, NOS

Colon and Rectum

Lung and Bronchus

Cancer Snapshot

Larimer County (Population 359,360)

From 2007-2018 in Larimer, 16,798 people were diagnosed with cancer of any type. The four cancers with the highest rates of new cases are shown below.

Age-Adjusted Incidence Rate (per 100,000 persons)

From 2007-2018, 7,309 people in Larimer County were diagnosed with screenable cancers (lung and bronchus, breast, prostate, colorectal, cervical). Below are the percentages of these cancers that were diagnosed at late stage. * The above red bars represent Colorado's age-adjusted incidence rates.

Diagnosis at late stage

(Age-adjusted Incidence Rate, per 100,000 persons)

The above red bars represent Colorado's percent of screenable cancers diagnosed at late stage. * County data suppressed

From 2007-2018 in Larimer County, 5,384 people died of cancer of any type. The four cancers with the highest rates of death are shown below.

Age-Adjusted Mortality Rate (per 100,000 persons)

Age-Adjusted Incidence Rate (per 100,000 persons)

Larimer Rural, high cancer disparity

* The above red bars represent Colorado's age-adjusted mortality rates.

Percentage alive 5 years after diagnosis - Top 6 most common (5-year relative survival)

Larimer Rural, high cancer disparity

* The above red bars represent Colorado's 5-year relative survivals. In Colorado, the 6 most common cancers are melanoma of the skin, breast, lung, prostate, colon, and uterine cancers. The percentage of residents in Larimer County surviving 5 years after diagnosis for each of the most common cancers are above.

Melanoma of the Skin Prostate

Female breast

Colon and Rectum

Corpus and Uterus, NOS

Lung and Bronchus

Cancer Snapshot

Moffat County (Population 13,232)

From 2007-2018 in Moffat, 690 people were diagnosed with cancer of any type. The four cancers with the highest rates of new cases are shown below.

Age-Adjusted Incidence Rate (per 100,000 persons)

The above red bars represent Colorado's age-adjusted incidence rates.

From 2007-2018, 324 people in Moffat County were diagnosed with screenable cancers (lung and bronchus, breast, prostate, colorectal, cervical). Below are the percentages of these cancers that were diagnosed at late stage.

Diagnosis at late stage

* County data suppressed

From 2007-2018 in Moffat County, 285 people died of cancer of any type. The four cancers with the highest rates of death are shown below.

Age-Adjusted Mortality Rate (per 100,000 persons)

Age-Adjusted Incidence Rate (per 100,000 persons)

Moffat HSR 11 Rural, high disparity

* The above red bars represent Colorado's age-adjusted mortality rates.

Percentage alive 5 years after diagnosis - Top 6 most common (5-year relative survival)

HSR 11 Rural, high disparity

* The above red bars represent Colorado's 5-year relative survivals. In Colorado, the 6 most common cancers are melanoma of the skin, breast, lung, prostate, colon, uterine cancers. The percentage of residents in Moffat County surviving 5 years after diagnosis for each of the most common cancers are above.

* County data suppressed

Prostate Female breast

Melanoma of the Skin

Corpus and Uterus, NOS

Colon and Rectum

Lung and Bronchus

Moffat

Cancer Snapshot

Morgan County (Population 29,045)

From 2007-2018 in Morgan, 1,518 people were diagnosed with cancer of any type. The four cancers with the highest rates of new cases are shown below.

Age-Adjusted Incidence Rate (per 100,000 persons)

The above red bars represent Colorado's age-adjusted incidence rates.

From 2007-2018, 703 people in Morgan County were diagnosed with screenable cancers (lung and bronchus, breast, prostate, colorectal, cervical). Below are the percentages of these cancers that were diagnosed at late stage.

Diagnosis at late stage

* County data suppressed

From 2007-2018 in Morgan County, 635 people died of cancer of any type. The four cancers with the highest rates of death are shown below.

Mortality

Age-Adjusted Incidence Rate (per 100,000 persons)

* The above red bars represent Colorado's age-adjusted mortality rates.

Percentage alive 5 years after diagnosis - Top 6 most common (5-year relative survival)

Morgan HSR 1 Rural, high disparity Morgan

HSR 1 Rural, high disparity

* The above red bars represent Colorado's 5-year relative survivals. In Colorado, the 6 most common cancers are melanoma of the skin, breast, lung, prostate, colon, uterine cancers. The percentage of residents in Morgan County surviving 5 years after diagnosis for each of the most common cancers are above.

* County data suppressed

Corpus and Uterus, NOS

Colon and Rectum

Lung and Bronchus

Cancer Snapshot

Ouray County (Population 4,936)

From 2007-2018 in Ouray, 309 people were diagnosed with cancer of any type. The four cancers with the highest rates of new cases are shown below.

Age-Adjusted Incidence Rate (per 100,000 persons)

The above red bars represent Colorado's age-adjusted incidence rates.

From 2007-2018, 134 people in Ouray County were diagnosed with screenable cancers (lung and bronchus, breast, prostate, colorectal, cervical). Below are the percentages of these cancers that were diagnosed at late stage.

Diagnosis at late stage

* County data suppressed

From 2007-2018 in Ouray County, 98 people died of cancer of any type. The four cancers with the highest rates of death are shown below.

Mortality

Age-Adjusted Incidence Rate (per 100,000 persons)

Ouray HSR 10 Rural, high disparity

* The above red bars represent Colorado's age-adjusted mortality rates.

Percentage alive 5 years after diagnosis - Top 6 most common (5-year relative survival)

Ouray

HSR 10 Rural, high disparity

* The above red bars represent Colorado's 5-year relative survivals. In Colorado, the 6 most common cancers are melanoma of the skin, breast, lung, prostate, colon, uterine cancers. The percentage of residents in Ouray County surviving 5 years after diagnosis for each of the most common cancers are above.

* County data suppressed

Melanoma of the Skin

Corpus and Uterus, NOS

Colon and Rectum

Lung and Bronchus

Cancer Snapshot

Park County (Population 17,597)

From 2007-2018 in Park, 932 people were diagnosed with cancer of any type. The four cancers with the highest rates of new cases are shown below.

Age-Adjusted Incidence Rate (per 100,000 persons)

The above red bars represent Colorado's age-adjusted incidence rates.

From 2007-2018, 401 people in Park County were diagnosed with screenable cancers (lung and bronchus, breast, prostate, colorectal, cervical). Below are the percentages of these cancers that were diagnosed at late stage.

Diagnosis at late stage

* County data suppressed

From 2007-2018 in Park County, 290 people died of cancer of any type. The four cancers with the highest rates of death are shown below.

Age-Adjusted Mortality Rate (per 100,000 persons)

Age-Adjusted Incidence Rate (per 100,000 persons)

Park HSR 17 Rural, high disparity

* The above red bars represent Colorado's age-adjusted mortality rates.

Percentage alive 5 years after diagnosis - Top 6 most common (5-year relative survival)

Park

HSR 17 Rural, high disparity

* The above red bars represent Colorado's 5-year relative survivals. In Colorado, the 6 most common cancers are melanoma of the skin, breast, lung, prostate, colon, uterine cancers. The percentage of residents in Park County surviving 5 years after diagnosis for each of the most common cancers are above.

* County data suppressed

Melanoma of the Skin

Corpus and Uterus, NOS

Colon and Rectum

Lung and Bronchus

Cancer Snapshot

Pitkin County (Population 17,325)

From 2007-2018 in Pitkin, 904 people were diagnosed with cancer of any type. The four cancers with the highest rates of new cases are shown below.

Age-Adjusted Incidence Rate (per 100,000 persons)

The above red bars represent Colorado's age-adjusted incidence rates.

From 2007-2018, 358 people in Pitkin County were diagnosed with screenable cancers (lung and bronchus, breast, prostate, colorectal, cervical). Below are the percentages of these cancers that were diagnosed at late stage.

Diagnosis

at late stage

* County data suppressed

From 2007-2018 in Pitkin County, 223 people died of cancer of any type. The four cancers with the highest rates of death are shown below.

Mortality

Age-Adjusted Incidence Rate (per 100,000 persons)

Pitkin HSR 12 Rural, high disparity

* The above red bars represent Colorado's age-adjusted mortality rates.

Percentage alive 5 years after diagnosis - Top 6 most common (5-year relative survival)

Pitkin

HSR 12 Rural, high disparity

* The above red bars represent Colorado's 5-year relative survivals. In Colorado, the 6 most common cancers are melanoma of the skin, breast, lung, prostate, colon, uterine cancers. The percentage of residents in Pitkin County surviving 5 years after diagnosis for each of the most common cancers are above.

* County data suppressed

Melanoma of the Skin

Corpus and Uterus, NOS

Colon and Rectum

Lung and Bronchus

Cancer Snapshot

Rio Blanco County (Population 6,511)

From 2007-2018 in Rio Blanco, 347 people were diagnosed with cancer of any type. The four cancers with the highest rates of new cases are shown below.

Age-Adjusted Incidence Rate (per 100,000 persons)

The above red bars represent Colorado's age-adjusted incidence rates.

From 2007-2018, 157 people in Rio Blanco County were diagnosed with screenable cancers (lung and bronchus, breast, prostate, colorectal, cervical). Below are the percentages of these cancers that were diagnosed at late stage.

Diagnosis at late stage

* County data suppressed

From 2007-2018 in Rio Blanco County, 136 people died of cancer of any type. The four cancers with the highest rates of death are shown below.

Age-Adjusted Mortality Rate (per 100,000 persons)

Age-Adjusted Incidence Rate (per 100,000 persons)

Rio Blanco HSR 11 Rural, high disparity

* The above red bars represent Colorado's age-adjusted mortality rates.

Percentage alive 5 years after diagnosis - Top 6 most common (5-year relative survival)

Rio Blanco

HSR 11 Rural, high disparity

* The above red bars represent Colorado's 5-year relative survivals. In Colorado, the 6 most common cancers are melanoma of the skin, breast, lung, prostate, colon, uterine cancers. The percentage of residents in Rio Blanco County surviving 5 years after diagnosis for each of the most common cancers are above.

* County data suppressed

Melanoma of the Skin

Corpus and Uterus, NOS

Colon and Rectum

Lung and Bronchus

Cancer Snapshot

Rio Grande County (Population 11,442)

From 2007-2018 in Rio Grande, 679 people were diagnosed with cancer of any type. The four cancers with the highest rates of new cases are shown below.

Age-Adjusted Incidence Rate (per 100,000 persons)

The above red bars represent Colorado's age-adjusted incidence rates.

From 2007-2018, 278 people in Rio Grande County were diagnosed with screenable cancers (lung and bronchus, breast, prostate, colorectal, cervical). Below are the percentages of these cancers that were diagnosed at late stage.

Diagnosis at late stage

* County data suppressed

From 2007-2018 in Rio Grande County, 258 people died of cancer of any type. The four cancers with the highest rates of death are shown below.

Age-Adjusted Mortality Rate (per 100,000 persons)

Age-Adjusted Incidence Rate (per 100,000 persons)

Rio Grande HSR 8 Rural, high disparity

* The above red bars represent Colorado's age-adjusted mortality rates.

Percentage alive 5 years after diagnosis - Top 6 most common (5-year relative survival)

Rio Grande

HSR 8 Rural, high disparity

* The above red bars represent Colorado's 5-year relative survivals. In Colorado, the 6 most common cancers are melanoma of the skin, breast, lung, prostate, colon, uterine cancers. The percentage of residents in Rio Grande County surviving 5 years after diagnosis for each of the most common cancers are above.

* County data suppressed

Melanoma of the Skin

Corpus and Uterus, NOS

Colon and Rectum

Lung and Bronchus

Cancer Snapshot

Routt County (Population 24,944)

From 2007-2018 in Routt, 1,094 people were diagnosed with cancer of any type. The four cancers with the highest rates of new cases are shown below.

Age-Adjusted Incidence Rate (per 100,000 persons)

The above red bars represent Colorado's age-adjusted incidence rates.

From 2007-2018, 437 people in Routt County were diagnosed with screenable cancers (lung and bronchus, breast, prostate, colorectal, cervical). Below are the percentages of these cancers that were diagnosed at late stage.

Diagnosis at late stage

* County data suppressed

From 2007-2018 in Routt County, 300 people died of cancer of any type. The four cancers with the highest rates of death are shown below.

Mortality

Age-Adjusted Incidence Rate (per 100,000 persons)

Routt HSR 11 Rural, high disparity

* The above red bars represent Colorado's age-adjusted mortality rates.

Percentage alive 5 years after diagnosis - Top 6 most common (5-year relative survival)

HSR 11 Rural, high disparity

* The above red bars represent Colorado's 5-year relative survivals. In Colorado, the 6 most common cancers are melanoma of the skin, breast, lung, prostate, colon, uterine cancers. The percentage of residents in Routt County surviving 5 years after diagnosis for each of the most common cancers are above.

* County data suppressed

Melanoma of the Skin

Corpus and Uterus, NOS

Colon and Rectum

Lung and Bronchus

Routt

Cancer Snapshot

San Juan County (Population 690)

From 2007-2018 in San Juan, 34 people were diagnosed with cancer of any type. The four cancers with the highest rates of new cases are shown below.

Age-Adjusted Incidence Rate (per 100,000 persons)

The above red bars represent Colorado's age-adjusted incidence rates.

From 2007-2018, 18 people in San Juan County were diagnosed with screenable cancers (lung and bronchus, breast, prostate, colorectal, cervical). Below are the percentages of these cancers that were diagnosed at late stage.

Diagnosis at late stage

* County data suppressed

From 2007-2018 in San Juan County, 11 people died of cancer of any type. The four cancers with the highest rates of death are shown below.

Age-Adjusted Mortality Rate (per 100,000 persons)

Age-Adjusted Incidence Rate (per 100,000 persons)

San Juan HSR 9 Rural, high disparity

* The above red bars represent Colorado's age-adjusted mortality rates.

Percentage alive 5 years after diagnosis - Top 6 most common (5-year relative survival)

HSR 9 Rural, high disparity

Lung and Bronchus

* The above red bars represent Colorado's 5-year relative survivals. In Colorado, the 6 most common cancers are melanoma of the skin, breast, lung, prostate, colon, uterine cancers. The percentage of residents in San Juan County surviving 5 years after diagnosis for each of the most common cancers are above.

* County data suppressed

San Juan

Cancer Snapshot

San Miguel County (Population 8,082)

From 2007-2018 in San Miguel, 304 people were diagnosed with cancer of any type. The four cancers with the highest rates of new cases are shown below.

Age-Adjusted Incidence Rate (per 100,000 persons)

The above red bars represent Colorado's age-adjusted incidence rates.

From 2007-2018, 119 people in San Miguel County were diagnosed with screenable cancers (lung and bronchus, breast, prostate, colorectal, cervical). Below are the percentages of these cancers that were diagnosed at late stage.

Diagnosis

at late stage

* County data suppressed

From 2007-2018 in San Miguel County, 72 people died of cancer of any type. The four cancers with the highest rates of death are shown below.

Age-Adjusted Mortality Rate (per 100,000 persons)

Age-Adjusted Incidence Rate (per 100,000 persons)

San Miguel HSR 10 Rural, high disparity

* The above red bars represent Colorado's age-adjusted mortality rates.

Percentage alive 5 years after diagnosis - Top 6 most common (5-year relative survival)

San Miguel

HSR 10 Rural, high disparity

* The above red bars represent Colorado's 5-year relative survivals. In Colorado, the 6 most common cancers are melanoma of the skin, breast, lung, prostate, colon, uterine cancers. The percentage of residents in San Miguel County surviving 5 years after diagnosis for each of the most common cancers are above.

* County data suppressed

Melanoma of the Skin

Corpus and Uterus, NOS

Colon and Rectum

Lung and Bronchus

Cancer Snapshot

Summit County (Population 30,955)

From 2007-2018 in Summit, 885 people were diagnosed with cancer of any type. The four cancers with the highest rates of new cases are shown below.

Age-Adjusted Incidence Rate (per 100,000 persons)

The above red bars represent Colorado's age-adjusted incidence rates.

From 2007-2018, 374 people in Summit County were diagnosed with screenable cancers (lung and bronchus, breast, prostate, colorectal, cervical). Below are the percentages of these cancers that were diagnosed at late stage.

Diagnosis at late stage

* County data suppressed

From 2007-2018 in Summit County, 211 people died of cancer of any type. The four cancers with the highest rates of death are shown below.

Age-Adjusted Mortality Rate (per 100,000 persons)

Age-Adjusted Incidence Rate (per 100,000 persons)

Summit HSR 12 Rural, high disparity

* The above red bars represent Colorado's age-adjusted mortality rates.

Percentage alive 5 years after diagnosis - Top 6 most common (5-year relative survival)

HSR 12 Rural, high disparity

* The above red bars represent Colorado's 5-year relative survivals. In Colorado, the 6 most common cancers are melanoma of the skin, breast, lung, prostate, colon, uterine cancers. The percentage of residents in Summit County surviving 5 years after diagnosis for each of the most common cancers are above.

* County data suppressed

Melanoma of the Skin

Corpus and Uterus, NOS

Colon and Rectum

Lung and Bronchus

Summit

Cancer Snapshot

Teller County (Population 2,475)

From 2007-2018 in Teller, 1,611 people were diagnosed with cancer of any type. The four cancers with the highest rates of new cases are shown below.

Age-Adjusted Incidence Rate (per 100,000 persons)

The above red bars represent Colorado's age-adjusted incidence rates.

From 2007-2018, 691 people in Teller County were diagnosed with screenable cancers (lung and bronchus, breast, prostate, colorectal, cervical). Below are the percentages of these cancers that were diagnosed at late stage.

Diagnosis at late stage

* County data suppressed

From 2007-2018 in Teller County, 494 people died of cancer of any type. The four cancers with the highest rates of death are shown below.

Age-Adjusted Mortality Rate (per 100,000 persons)

Age-Adjusted Incidence Rate (per 100,000 persons)

Teller HSR 17 Rural, high disparity

* The above red bars represent Colorado's age-adjusted mortality rates.

Percentage alive 5 years after diagnosis - Top 6 most common (5-year relative survival)

Teller

HSR 17 Rural, high disparity

* The above red bars represent Colorado's 5-year relative survivals. In Colorado, the 6 most common cancers are melanoma of the skin, breast, lung, prostate, colon, uterine cancers. The percentage of residents in Teller County surviving 5 years after diagnosis for each of the most common cancers are above.

* County data suppressed

Melanoma of the Skin

Corpus and Uterus, NOS

Colon and Rectum

Lung and Bronchus

Cancer Snapshot

Weld County (Population 331,470)

From 2007-2018 in Weld, 12,272 people were diagnosed with cancer of any type. The four cancers with the highest rates of new cases are shown below.

Age-Adjusted Incidence Rate (per 100,000 persons)

From 2007-2018, 5,519 people in Weld County were diagnosed with screenable cancers (lung and bronchus, breast, prostate, colorectal, cervical). Below are the percentages of these cancers that were diagnosed at late stage. * The above red bars represent Colorado's age-adjusted incidence rates.

Diagnosis at late stage (Age-adjusted Incidence Rate, per 100,000 persons)

County data suppressed

From 2007-2018 in Weld County, 4,163 people died of cancer of any type. The four cancers with the highest rates of death are shown below.

Age-Adjusted Mortality Rate (per 100,000 persons)

Age-Adjusted Incidence Rate (per 100,000 persons)

Weld Rural, high cancer disparity

* The above red bars represent Colorado's age-adjusted mortality rates.

Percentage alive 5 years after diagnosis - Top 6 most common (5-year relative survival)

Weld Rural, high cancer disparity

* The above red bars represent Colorado's 5-year relative survivals. In Colorado, the 6 most common cancers are melanoma of the skin, breast, lung, prostate, colon, and uterine cancers. The percentage of residents in Weld County surviving 5 years after diagnosis for each of the most common cancers are above.

Melanoma of the Skin

Female breast

Prostate

Corpus and Uterus, NOS

Colon and Rectum

Lung and Bronchus

Cancer Snapshot

Yuma County (Population 9,938)

From 2007-2018 in Yuma, 627 people were diagnosed with cancer of any type. The four cancers with the highest rates of new cases are shown below.

Age-Adjusted Incidence Rate (per 100,000 persons)

The above red bars represent Colorado's age-adjusted incidence rates.

From 2007-2018, 256 people in Yuma County were diagnosed with screenable cancers (lung and bronchus, breast, prostate, colorectal, cervical). Below are the percentages of these cancers that were diagnosed at late stage.

Diagnosis

at late stage

* County data suppressed

From 2007-2018 in Yuma County, 260 people died of cancer of any type. The four cancers with the highest rates of death are shown below.

Age-Adjusted Mortality Rate (per 100,000 persons)

Age-Adjusted Incidence Rate (per 100,000 persons)

Yuma HSR 1 Rural, high disparity

* The above red bars represent Colorado's age-adjusted mortality rates.

Percentage alive 5 years after diagnosis - Top 6 most common (5-year relative survival)

HSR 1 Rural, high disparity

* The above red bars represent Colorado's 5-year relative survivals. In Colorado, the 6 most common cancers are melanoma of the skin, breast, lung, prostate, colon, uterine cancers. The percentage of residents in Yuma County surviving 5 years after diagnosis for each of the most common cancers are above.

* County data suppressed

Melanoma of the Skin

Corpus and Uterus, NOS

Colon and Rectum

Lung and Bronchus

Yuma

2025 Community Health Needs Assessment

COMMUNITY HEALTH NEEDS ASSESSMENT

2025

TABLE OF CONTENTS

UNIVERSITY OF COLORADO CANCER CENTER

LETTER FROM THE DIRECTOR

MESSAGE FROM THE OFFICE OF

COMMUNITY OUTREACH & ENGAGEMENT

MESSAGE FROM THE OFFICE OF

ENGAGEMENT, ACCESS, & SUCCESS

COMMUNITY OUTREACH & ENGAGEMENT

Mission Statement

Scope

EXECUTIVE SUMMARY

AT A GLANCE COLORADO

COLORAD O’S UNIQUE GEOGRAPHY

Altitude

Utraviolet Radiation (UV)

DEMOGRAPHICS

CANCER BURDEN IN COLORADO

CANCER INCIDENCE

CANCER MORTALITY

CANCER DISPARITIES

CANCER DISPARITIES BY RURAL AND URBAN STATUS

CANCER RISK FACTORS

Figure 8: Prevalence of Common Risk Factors for Cancer, Stratiﬁed by

Race and Ethnicity (2022)a

CANCER SCREENING

COLORADO’S COMMUNITY HEALTH NEEDS ASSESSMENT

STATE AND COUNTY CANCER DISPARITIES METHODS

COMMUNITY READINESS & CAPACITY METHODS

KEY FINDINGS

STATE AND COUNTY CANCER DISPARITIES FINDINGS

Rural and Urban Disparity Counties (24 of 64 Counties)

A. HEALTH STATISTIC REGION 1

Cancer Snapshot

Logan County (Population 21,302)

Diagnosis at late stage

Cancer Snapshot

Phillips County (Population 4,493)

Diagnosis at late stage

Cancer Snapshot

Sedgwick County (Population 2,391)

Diagnosis at late

Cancer Snapshot

Washington County (Population 4,817)

Diagnosis at late stage

B. HEALTH STATISTIC REGION 5

Cancer Snapshot

Cheyenne County (Population 1,726)

Diagnosis at late stage

Cancer Snapshot

Lincoln County (Population 5,583)

Diagnosis at late stage

C. HEALTH STATISTIC REGION 6

Cancer Snapshot

Baca County (Population 3,496)

Diagnosis at late stage

Cancer Snapshot

Bent County (Population 5,561)

Diagnosis at late stage

Cancer Snapshot

Huerfano County (Population 6,896)

Diagnosis at late stage

Cancer Snapshot

Kiowa County (Population 1,347)

Diagnosis at late stage

Cancer Snapshot

Las Animas County (Population 14,422)

Diagnosis at late stage

Cancer Snapshot

Otero County (Population 18,580)

Diagnosis at late stage

Cancer Snapshot

Prowers County (Population 11,968)

Diagnosis at late stage

D. HEALTH STATISTIC REGION 7

Cancer Snapshot

Pueblo County (Population 168,135)

E. HEALTH STATISTIC REGION 8