Table 1.

Association between position in a time zonea and age-adjusted county-level cancer incidence in 11 states within the continental United States, SEER program 2000–2012b

MaleFemale
CancercCasesRR (95% CI)fPCasesRR (95% CI)fP
All cancers2,095,3941.029 (1.017–1.041)2.7 × 10−61,972,5141.039 (1.027–1.051)3.8 × 10−10
Oral cavity and pharynxd54,8891.037 (0.997–1.078)0.0723,1991.086 (1.029–1.145)2.6 × 10−3
Esophagus30,9561.003 (0.960–1.049)0.898,7511.163 (1.075–1.258)1.8 × 10−4
 Adenocarcinoma21,3551.000 (0.947–1.056)13,4481.054 (0.946–1.175)0.34
 Squamous cell6,5701.024 (0.942–1.114)0.574,1501.071 (0.956–1.201)0.24
Stomach35,9901.087 (1.035–1.142)9.6 × 10−421,9241.039 (0.974–1.107)0.24
Colon and rectum205,0561.023 (1.002–1.044)0.03193,3491.045 (1.024–1.066)1.8 × 10−5
Liver and intrahepatic bile duct39,2761.110 (1.046–1.177)6.0 × 10−415,7961.099 (1.028–1.175)6.0 × 10−3
Gallbladder2,8340.875 (0.763–1.003)0.066,6831.030 (0.943–1.124)0.51
Pancreas51,1501.041 (1.008–1.075)0.01550,5531.047 (1.013–1.083)0.01
Larynx24,5780.997 (0.951–1.045)0.96,1581.077 (0.996–1.165)0.07
Lung and bronchus288,4521.002 (0.977–1.028)0.87256,6181.046 (1.017–1.076)1.6 × 10−3
 Adenocarcinoma89,1661.006 (0.967–1.047)0.7594,7711.058 (1.019–1.100)3.8 × 10−3
 Squamous cell65,6651.003 (0.965–1.043)0.8738,3241.029 (0.974–1.087)0.31
 Small cell35,8520.985 (0.941–1.031)0.5135,8341.037 (0.986–1.090)0.16
Melanoma of the skin119,3041.050 (0.998–1.103)0.0685,9341.023 (0.967–1.083)0.43
Breast4,4631.074 (0.972–1.187)0.16593,7531.037 (1.019–1.055)6.5 × 10−5
 HR positive3,7131.038 (0.932–1.156)0.49435,6491.055 (1.026–1.084)1.8 × 10−4
 HR negative1410.450 (0.134–1.514)0.292,2251.025 (0.995–1.056)0.1
Cervix uteri034,2831.031 (0.985–1.080)0.19
Corpus and uterus NOSe0113,3441.100 (1.067–1.135)2.4 × 10−9
Ovary062,9581.011 (0.977–1.045)0.54
Prostate578,1191.042 (1.018–1.066)4.8 × 10−40
Urinary bladder147,2661.012 (0.986–1.038)0.3947,0731.025 (0.983–1.070)0.24
Kidney and renal pelvis80,4531.020 (0.989–1.052)0.247,9641.009 (0.972–1.047)0.64
Brain32,0431.019 (0.978–1.061)0.3724,8080.995 (0.949–1.042)0.82
Thyroid24,2741.042 (0.976–1.112)0.2273,3821.063 (1.008–1.121)0.02
Non-Hodgkin lymphoma95,1431.059 (1.028–1.091)1.6 × 10−480,8611.039 (1.010–1.070)0.01
Myeloma26,9590.980 (0.935–1.027)0.3920,8391.064 (1.013–1.118)0.01
Chronic lymphocytic leukemia25,2511.134 (1.076–1.196)3.1 × 10−617,0721.118 (1.052–1.189)3.7 × 10−4
Acute myeloid leukemia17,9901.030 (0.975–1.089)0.2814,8151.045 (0.987–1.106)0.13
  • NOTE: P values less than 1.8 × 10−3 (0.05/28) for men and less than 1.7 × 10−3 (0.05/30) for women are in bold and indicate statistical significance using Bonferroni correction.

  • aThe position in the time zone (PTZ) is calculated as the distance (in degrees longitude) between the population centroid of each county and the middle meridian of the located time zone (EST:75, CST:90, MST:105, and WST:120).

  • bA weighted (by population size) logarithmic linear regression was used between PTZ and age-adjusted (2000 U.S. standard population) county-level cancer incidence rate. Model adjusted for latitude, poverty percentage, smoking and state.

  • cOrdered by organ systems, based on SEER Statistics Review 1975 to 2013.

  • dExcluding lip and salivary glands.

  • eNot otherwise specified.

  • fRRs are per five degrees of longitude difference, equivalent to 20 minutes.