Catchment Area Profile

The Area We Serve

This profile depicts the unique cancer burden challenges that our 26 counties face. The charge of the Office of Community Outreach and Engagement is to address those challenges by developing creative community‑engaged strategies that serve our population — from prevention to survivorship.

The Office of Community Outreach and Engagement is pleased to present the UF Health Cancer Institute Catchment Area Profile. This summary is designed to explicate our catchment area characteristics, priorities and determinants of cancer incidence, mortality and advanced stage diagnoses to support the UFHCI in reducing the cancer burden across the cancer care continuum. This profile depicts the unique cancer burden challenges that our 26 counties face.

The charge of the Office of Community Outreach and Engagement is to address those challenges by developing creative community‑engaged strategies that serve our population — from prevention to survivorship. We hope this Catchment Area Profile and Cancer InFocus is insightful and exhibits our efforts to assist you in the development or enhancement of your cancer‑related endeavors.

Ramzi Salloum, Ph.D.
Associate Director, Community Outreach and Engagement
UF Health Cancer Institute

Introduction

Profile description

This report describes the catchment area cancer incidence, advanced stage diagnoses and mortality, along with the factors that impact cancer health outcomes — both in terms of burdens or barriers, as well as assets and successes. We highlight data about the catchment area, local expertise that supports cancer control within our 26-county catchment area in North Central Florida, and cancer control research at the UF Health Cancer Institute.

While the UF Health Cancer Institute prioritizes specific cancers — brain, breast, colorectal and lung — this profile includes data on all cancer sites to ensure its utility for a broad range of research interests and needs among our end users.

Intended audience

Our initial audience is the Cancer Institute researchers who do basic, clinical and cancer control and population science research. The aim is to give them access to current data so that they can design studies that are as relevant as possible to our catchment area.

Aims

In this report, we highlight COE’s strategic aims — action areas that guide how we connect UF Health Cancer Institute research with the needs, priorities and strengths of the communities we serve.

1. Defining and monitoring the catchment area’s cancer burden — including disparities in incidence, mortality and risk factors — using clinical data, census tract-level measures and outcomes reported directly by community members.
2. Disseminating and implementing evidence-based interventions to reduce the cancer burden and translate research findings into policy and practice across the cancer continuum in partnership with community stakeholders.
3. Enhancing the impact of UF Health Cancer Institute research by involving the community in setting the research agenda, aligning studies with catchment area needs, linking researchers with community partners, and facilitating improved enrollment of diverse, underrepresented populations in interventional trials.

Community Outreach and Engagement Team

The team is a group of passionate and highly qualified professionals with years of experience in health care disparities, health equity, health system redesign, community-based health education, translational research, program evaluation, biostatistics and geographical information systems. The Community Outreach and Engagement team is also supported by clinical community navigators, community health resource coordinators and community health workers. All work together to connect community members to needed clinical and social services, as well as provide community education and outreach. Community Ccientists, research coordinators and research assistants link investigators and community members and facilitate access to interventional research trials, particularly for communities that are traditionally underrepresented.

Community Advisory Board

The Community Advisory Board (CAB) plays a vital role in collaborating with our leadership team, program directors and cancer center members, meeting quarterly to ensure that our work focuses on cancer‑related issues that are critical to the communities we serve.

The primary activities of the CAB are to:

• Review cancer‑focused catchment area data and make recommendations for research topics of importance to the community;
• Collaborate with researchers and provide recommendations on research design, participant recruitment and retention, interpretation of findings and dissemination of results for UFHCI‑affiliated research projects;
• Serve as a liaison between the local community and UFHCI researchers; and
• Collaborate with and advise the UFHCI Community Outreach and Engagement leadership about programmatic initiatives to reduce cancer risks and burden in the catchment area.

COE guiding principles: Community‑engaged research

Community-engaged research is a framework for research that aims to improve health outcomes by involving the community—however they define themselves (by geography, common interests or other affiliation) (1, 2). The principles ofcommunity-engaged research aim to form equitable partnerships and shared leadership among the community and researchers, with emphasis on transparent bi‑directional communication, mutual benefit, and sustained commitment to change.

Core principles for conducting community-engaged research (adapted from Rhodes et al. 2018 and McCloskey et al. 2011):

• Transparency, honesty, trust
• Shared decision-making
• Mutual co-learning
• Bi-directional communication
• Sustainability
• Equitable compensation

Who participates in community-engaged research?

1. Community members and families
2. Community- and faith-based organizations
3. Researchers
4. Clinicians
5. Educators
6. Health system leaders
7. Business and media
8. Policymakers

The process of community-engaged research

Community‑engaged research can be thought of as a continuum of community involvement, from minimal involvement where the research is largely investigator‑driven, or where there is a one‑way transfer of information or resources, to situations where consulting relationships are in place, culminating in community‑driven research at the other end of the continuum (1).

This continuum provides a range of options for basic, clinical and cancer control and population science research at UFHCI: Researchers can work with community members along any point of this continuum, while still embracing the principles of transparent and open communication when engaging with others.

A stepwise guide to community-engaged research (adapted from Rhodes et al. 2018)

• Network
• Establish partnerships
• Build and maintain trust
• Identify Health priorities
• Conduct background research
• Prioritize
• Build consensus on goals and research questions
• Build a conceptual model
• Design study
• Create analysis and dissemination
• Implementation
• Data collection
• Data analysis
• Co-interpretation of findings
• Dissemination and translation

Integrating COE with clinical research

Tracking the relevance of cancer clinical trials to the catchment area

The UF Health Cancer Institute is uniquely positioned to blend comprehensive patient care and innovative research in a collaborative, multidisciplinary environment. The research at UF aims to address the complex needs of the catchment area to reduce the cancer burden and increase health equity. Therefore, the Office of Community Outreach and Engagement has partnered closely with Disease Site Group (DSG) leadership in the development of the catchment area rubric.

The catchment area rubric was designed to assist DSGs to better articulate how their research relates to the catchment area. This rubric is completed by the COE team for all interventional studies under initial review and is presented at the twice‑monthly Scientific Review and Monitoring Committee (SRMC) meetings. The COE office also
tracks demographic characteristics of all participants on actively enrolling clinical trials and works with investigators to identify strategies to facilitate enrollment and raise awareness within the community about cancer clinical trials opportunities. This work is done in collaboration with other community engagement resources including the Community-Partnered Cancer Disparities Research Consortium (CDRC), UF Clinical and Translational Science Institute (CTSI) and the Florida-California Health Center (CaRE2).

The rubric contains four domains to assess the extent to which the proposed clinical research addresses:

1. A top ten cancer;
2. Top cancer risks (e.g., related to tobacco use);
3. Advanced stage disease and/or;
4. Disparities based on rural residence, race, ethnicity and/or sex.

Facilitating cancer clinical trials enrollment

In addition to reviewing all interventional cancer clinical trials using the catchment area rubric, the UFHCI and COE office, in collaboration with the Cancer Informatics Shared Resource (CI SR), has developed a Trial Performance Dashboard to (1) assess cancer trial feasibility with a focus on identifying potential participants based on trial inclusion and exclusion criteria, and (2) examine recruitment and enrollment progress relative to those potentially eligible for the trials, with a particular focus on enrollment of individuals who are traditionally underrepresented in cancer clinical trials.

The dashboard leverages a diverse set of patient data sources (Figure 5) including trial data from the UF Clinical Trials Management System OnCore®, patient data from the UF Health system (i.e., UF Integrated Data Repository linked with UF Tumor Registry), in addition to patient data from the Florida Cancer Data System (FCDS) and the OneFlorida Clinical Research Consortium (i.e., a unique data resource covering ~15 million, > 60% Floridians), that covers the broader Florida regions in our catchment area.

The COE office uses this information to meet with investigators to discuss opportunities to enhance their ability to enroll individuals who are potentially eligible from diverse backgrounds by (1) identifying opportunities to create patient registries, (2) partnering with HealthStreet to reach out to community members and screen them for trial eligibility, (3) partnering with County Extension and other initiatives and community groups to provide education about the particular cancers addressed through the trials to raise awareness, among other strategies.

Collaborative partnership profiles

The Office of Community Outreach and Engagement is using community‑engaged research principles that include forming equitable partnerships to build trust and collaborate with community members, organizations, clinicians, families, health‑system leaders and policy makers in planning and decision‑making about catchment area cancer‑related needs and outreach (4).

These key programs for the COE office were selected based on their roles in building trust with communities, particularly in rural areas (UF/IFAS County Extension, HealthStreet), facilitating research that addresses catchment area burden and enrollment of underrepresented groups in cancer clinical trials (HealthStreet, OneFlorida+, CaRE2 Health Center), and engaging communities through education and outreach (UF/IFAS County Extension, HealthStreet, OneFlorida, CaRE2 Health Center). At the UFHCI, leadership, researchers, scientific teams and staff have a long‑term commitment to strengthening these essential partnerships, as well as forging new bonds with additional organizations.

UF/IFAS & County Extension Offices

Learn about UF/IFAS Extension

UF HealthStreet

Learn about HealthStreet

OneFlorida+

Learn about OneFlorida+

CaRE2 Health Center

Learn about CaRE2

Acknowledgements

Our work is fostered through several well-established initiatives, including HealthStreet (a UF Clinical and Translational Science Institute (CTSI) and UFHCI‑supported community health engagement resource), the UF/IFAS County Extension Program, OneFlorida+, the U54 CA233444‑funded CaRE2 Health Center and the UFHCI Cancer Informatics Shared Resource.

The COE office also has long‑standing collaborations with local and state partners, including the Florida Department of Health, the WellFlorida Council, Inc., the North Central Florida Cancer Control Collaborative, the Rural Women’s Health Project, Agency for Health Care Administration, the Florida Medicaid Program, CommunityHealth IT, the Area Health Education Centers, and Sisters Alive, a local support group for Black women.

We specifically wish to thank the following people for their dedication and work:

• UFHCI Leadership and Program Leaders
• UFHCI Community Advisory Board
• Community Scientists Kristie Hill and E. Stanley Richardson
• UFHCI Bioinformatics and Computational Biology
• UFHCI Cancer Informatics Shared Resource
• The Rural Women’s Health Project—special thanks to Kaeli Flannery and Robin Lewy
• UF Faculty: Betsy Shenkman, Ph.D., Ramzi Salloum, Ph.D., Easton Wollney, Ph.D., Kathryn Pluta, Ph.D., Jaclyn Hall, Ph.D., Yi Guo, Ph.D., Rahma Mkuu, Ph.D.

Catchment area and population

Catchment area

The UF Health Cancer Institute serves more than 3.4 million residents across 26 counties of North, Central and East Florida, spanning the size of Southern New England. Residents from the catchment area account for 77.1% of the patients seen at UF Health.

Most of the counties (17) are rural and all are classified as medically underserved or as having medically underserved areas. The population has the highest fraction (24%) of residents age 65 and older in Florida.

Catchment area population in perspective

Below are some of the defining characteristics of our catchment area population. Note that health inequities may be magnified when considering intersections among population characteristics. Unique aspects of the UFHCI catchment area population compared to Florida and the United States include:

Key definitions

Rurality and small metro

The UF Health Cancer Institute uses Rural Urban Continuum Codes (RUCC) codes 4-9 to define our rural population and evaluate gaps in community resources and health services. RUCC “distinguishes U.S. metropolitan (metro) counties by the population size of their metro area, and nonmetropolitan (non-metro) counties by their degree of urbanization and adjacency to a metro area.” (6)

RUCC 4-9 categorizes non-metro, or rural counties, by those that have a population of fewer than 250,000 and:

• An urban population of 20,000 or more, (adjacent or nonadjacent to a metro area)
• An urban population of 5,000 to 20,000 (adjacent or nonadjacent to a metro area), or
• An urban population of fewer than 5,000 (adjacent or nonadjacent to a metro area).

The UFHCI Catchment Area has 10 counties considered rural using RUCC codes 4-9. The remaining counties are considered non-rural. All rural counties in the catchment area have a population of less than 75,000 based on the 2020 census. Five of those rural counties (Dixie, Hamilton, Lafayette, Madison, Union) are assigned RUCC codes 8 or 9, indicating high rurality.

Rural counties:

• Bradford County
• Columbia County
• Dixie County
• Hamilton County
• Lafayette County
• Madison County
• Putnam County
• Suwannee County
• Taylor County
• Union County

Non-rural counties:

• Alachua County
• Baker County
• Citrus County
• Clay County
• Flagler County
• Gadsden County
• Gilchrist County
• Jefferson County
• Lake County
• Leon County
• Levy County
• Marion County
• St. Johns County
• Sumter County
• Volusia County
• Wakulla County

Socioeconomic vulnerability (SEV) in the catchment area

Race

Race and gender

Addressing racial inequity through local community action

UF Health Cancer Institute’s Community-Partnered Cancer Disparities Research Collaborative (CDRC), directed by Dr. Carolyn M. Tucker, is a model of how racial inequities in cancer can be addressed through sustained local action and trust-based partnership. Built on the principles of community-engaged research, the CDRC brings together faculty researchers, Black church pastors, cancer survivors, undergraduate interns, and community leaders to co-define problems and co-create solutions that advance prevention, treatment, and survivorship among underserved populations.

The collaborative operates on the understanding that racial inequities in cancer are not simply clinical gaps but are rooted in broader structural and cultural barriers to access, trust, and representation. To address this, the CDRC conducts research that is informed at every stage by community voices. Community partners serve as co-researchers, shaping study design, guiding outreach, and ensuring interventions are culturally relevant.

This shared leadership structure deepens trust and ensures that findings can be translated into practices and policies that truly resonate within the communities most affected by inequity.

A hallmark of this approach is the Power Over Cancer series — community gatherings held in churches and neighborhood venues that create spaces for dialogue about cancer prevention, early detection, and survivorship. Rather than functioning as clinical service events, these gatherings focus on education, resource navigation, and open conversation, connecting residents with both the scientific expertise of UF researchers and the lived wisdom of local survivors. In this way, they serve as bridges between institutional knowledge and community experience.

Through these sustained efforts, the CDRC has created a framework for addressing racial inequity that is grounded in respect, reciprocity, and shared purpose. By integrating academic rigor with community partnership, the Collaborative strengthens the capacity of both researchers and local leaders to take informed, collective action against cancer disparities in North Central Florida.

An integrative and intersectional framework

Throughout this report, we encourage the use of a multifaceted framework of intersectionality to understand the unique, overlapping burdens of our population. This integrative and intersectional framework is especially important when examining advanced stage diagnoses and mortality, which is a particularly high burden in our catchment area, compared to the state of Florida.

Intersectional framework: An intersectional framework encourages researchers to examine health inequities as overlapping systems of hardship that are placed upon an individual, recognizing that multiple characteristics (such as age, gender, race, ethnicity, rurality, and socio‑economic status) may place individuals and populations at increased risk for being marginalized in society (10, 11). Intersectionality encourages an understanding that social categories (e.g., race, socioeconomic status, gender, sexual orientation) are not independent and unidimensional but rather multiple, interdependent and mutually constitutive.

Social determinants of health: “Social determinants of health are conditions in the environments in which people are born, live, learn, work, play, worship, and age that affect a wide range of health, functioning, and quality‑of‑life outcomes and risks” (12).

Rural and small metro: “10 of our 26 counties, or about 9% of UFHCI’s county-level catchment area population, are considered rural based on RUCC 4-9. The remaining counties are classified as metropolitan.”

Socioeconomic vulnerability: “Socioeconomic Vulnerability is a census tract‑based measure that uses poverty, unemployment, income, and education levels to designate areas of potential negative effects on communities caused by…stresses on human health” (8) The UFHCI catchment area has many areas of high SEV.

Important Note on small numbers: There is an unequal distribution of the racial and ethnic groups of the catchment area population in rural/non‑rural and high/low SEV areas. Tables may create cells with low raw counts as we investigate the intersections of multiple, overlapping categories. Small numbers can lead to unstable (very high or low) rates. For example, due to the greater poverty (high SEV) in rural areas, there are relatively few low‑SEV communities in rural areas, and we see especially low numbers for Black or Hispanic residents within low‑SEV rural areas. UFHCI researchers are encouraged to pay attention to groups that are underserved and/or traditionally underrepresented in research, however, small numbers must be interpreted with a degree of caution. In addition, given that the Hispanic/Latino population in the catchment area is relatively small compared to the state, caution is urged in interpreting data specific to this group. Throughout this report, we will note where small numbers exist to aid readers in the interpretation of the data. Blank cells indicate a rate was not calculated due to an n<16, and italics indicate a raw count <30.

Rurality: Individuals who reside in rural counties in the Catchment Area have a higher rate of advanced stage cancer incidence than individuals who reside in nonrural counties in the Catchment Area.

SEV: In UFHCI’s Catchment Area, socioeconomic vulnerability does not seem to have as great an impact upon advanced stage incidence compared to rurality, although individuals who live in high SEV areas still have greater advanced stage cancer incidence than Florida overall and compared to those in low SEV areas.

Race and rurality: Advanced stage cancer incidence rate for white individuals in rural areas in our CA is higher than for those in non-rural areas and higher than for individuals from all races who are living in rural areas. For Black residents in our CA, incidence rates in rural and non-rural areas are similar to individuals from all races who live in rural areas, which is still higher compared to non-rural areas.

Race and SEV: All race and ethnicity groups have higher rates of advanced stage incidence in high SEV areas vs. low SEV areas.

Race and Rurality and SEV: Overall, the catchment area sees higher rates of advanced stage diagnosis among communities designated as high SEV within non-rural counties than those residing in other CA communities.

DATA SOURCES: U.S. Census Bureau, 2024, Population Estimation: Age and Sex, ACS 5-Year Estimates; U.S. Census Bureau, 2024, Population Estimation: Race and Ethnicity, ACS 5-Year Estimates.

• A greater percentage of people in the UFHCI catchment area identified as non‑Hispanic white (NHW) compared to Florida and the U.S.
• A similar percentage of catchment area residents identified as non‑Hispanic Black (NHB) compared to the state of Florida. Within the catchment area counties, more Black individuals live in rural areas compared to non‑rural areas.
• A smaller percentage of individuals who are Hispanic compared to Florida and the U.S.
• Our catchment area has a greater number of individuals aged 65 or older, compared to the state of Florida and the U.S.
• Poverty rates in the catchment area are about 15% of residents, higher than those in the state and U.S.

Cancer in the catchment area

Cancer incidence, advanced stage cancer incidence and mortality rates

Overall, the UF Health Cancer Institute has higher age-adjusted cancer incidence than the state of Florida and the U.S. The catchment area also has higher age-adjusted advanced cancer incidence compared to Florida and higher mortality rates compared to both the state and national rates (Note: Advanced stage diagnosis incidence data for all sites is not available for the U.S.).

5-year average annual age-adjusted incidence & advanced stage incidence rates per 100,000 population, FCDS 2016-2020; 5-year average annual age-adjusted mortality rate per 100,000 population, FDOH 2017-2021 | DATA SOURCES: For Florida (FL) and Catchment Area (CArea) Incidence: FCDS, 2016-2020, and Mortality: FDOH Bureau of Vital Statistics, 2017-2021 (data received 2022). *For U.S. Incidence & Mortality: NCI/CDC State Cancer Profiles, 2017-2021 (Incidence) and 2018-2022 (Mortality) | NOTE: NCI/CDC State Cancer Profiles does not provide Advanced Stage Incidence data for all cancer sites.

*For U.S. Incidence & Mortality: CDC, 2013-2017, United States Cancer Statistics
** For FL and catchment area Incidence: FCDS, 2013-2017 and Mortality: FDOH, 2014-2018, FLHealthCharts – Death Count Query System
Average Annual Age-Adjusted Cancer Incidence and Mortality per 100,000 Population; CDC does not provide advanced stage cancer incidence data

Rates by county

Eleven counties in the catchment area have higher cancer incidence than overall state rates.

• Fourteen counties in the catchment area have higher advanced stage incidence than the state incidence rates.
• Of those 14 counties with high advanced stage diagnosis rates, 9 counties are designated as rural counties.
• Advanced stage incidence rates in the catchment area point to a need for translational research that can lead to impactful interventions.
• Rural counties to the north and west of the UFHCI showed the highest mortality from cancer.

Cancer incidence rates by sex

5-year average annual age-adjusted incidence rate per 100,000 population, FCDS 2016-2020 | DATA SOURCE: Florida (FL) and Catchment Area (CArea) Incidence: FCDS, 2016-2020 (data received 2022) | NOTE: County rurality classified based on RUCC 4-9.

Advanced stage cancer incidence rates by sex

Cancer mortality rates by race, ethnicity and gender

5-year average annual age-adjusted mortality rate per 100,000 population, FDOH 2017-2021 | DATA SOURCES: For Florida (FL) and Catchment Area (CArea) Mortality: FDOH Vital Statistics, 2017-2021 (data received 2022); *For U.S. Mortality: NCI/CDC State Cancer Profiles, 2018-2022. | NOTE: County rurality classified based on RUCC 4-9 as rural.

Top cancers in the catchment area

Considering all cancer sites, the UFHCI catchment area has higher rates of incidence, advanced stage incidence and mortality compared to state and national rates. It is also possible to see patterns among the top cancers within the catchment area compared to state and national rates.

• Among top cancers, lung, colorectal, melanoma, oropharyngeal, kidney, pancreas, ovary, uterine, and cervical cancers showed higher age‑adjusted incidence and/or advanced stage incidence in the catchment area relative to FL and U.S.
• The catchment area has higher advanced stage cancers than Florida for most top cancers, except breast, blood** and prostate, where there are lower rates in the catchment area than the state.
• Mortality for lung, blood, colorectal, bladder and esophageal cancers are higher in the 26 counties that the UFHCI serves than for Florida and the U.S.
• Only lung, breast, colorectal and cervical cancers have evidence‑based screening recommendations backed by the National Cancer Institute (NCI) and the U.S. Preventive Services Task Force (USPSTF). As these cancers are among the top advanced stage diagnoses in the catchment area, research and interventions that support screening are a priority for the UFHCI.

Top 10 cancer incidence, advanced stage incidence and mortality in the catchment area: Age-adjusted rates per 100K population, all cancer sites or types

DATA SOURCES: For Florida (FL) and Catchment Area (CArea) Mortality: FDOH Vital Statistics, 2017-2021 (data received 2022); *For U.S. Incidence & Mortality: NCI/CDC State Cancer Profiles, 2018-2022. | NOTES: NCI/CDC State Cancer Profiles U.S. rates for Skin Cancer only include Melanomas of the Skin; and U.S. rates for Head & Neck Cancers only include cancers of the Oral Cavity & Pharynx, based on available SEER/NPCR data.

Effective Screening Recommendations

NCI and the U.S. Preventive Services Task Force (USPSTF) have outlined evidence‑based recommendations for cancers with effective screening tests. NCI defines tests as effective if they “find cancer early, reduce the chance that someone who is screened regularly will die from the cancer, and have more potential benefits than harms,” including iatrogenic side effects or disease, false positive and negative results, and overdiagnosis (15, 16).

All four of these recommended tests—for lung, breast, colorectal, and cervical cancers—address cancers in the UFHCI top ten for incidence, advanced incidence and/or mortality.

• Lung
  • Effective screening test: Low Dose Computed Tomography
  • NCI/USPSTF Screening Guidelines (16): Adults aged 55 to 80 with a 30 pack-year smoking history and currently smoke or have quit within the past 15 years. Screening should be discontinued once a person has not smoked for 15 years or develops a health problem that substantially limits life expectancy or the ability or willingness to have curative lung surgery.
  • USPSTF Grade: B
• Breast
  • Effective screening test: Mammogram
  • NCI/USPSTF Screening Guidelines (16): Biennial screening mammography for women aged 50 to 74. Women at higher risk for breast cancer may benefit more than average-risk women from beginning screening in their 40s.
  • USPSTF Grade: B (C)
• Colorectal
  • Effective screening test: Colonoscopy, sigmoidoscopy and stool tests
  • NCI/USPSTF Screening Guidelines (16): Screening for colorectal cancer starting at age 50 and continuing until age 75.
  • USPSTF Grade: A
• Cervical
  • Effective screening test: Pap test/smear, HPV test
  • NCI/USPSTF Screening Guidelines (16): Women aged 21 to 29, screening every 3 years with cervical cytology alone. Women aged 30 to 65: Every 3 years with cervical cytology alone OR Every 5 years with high-risk human papillomavirus (hrHPV) testing alone OR Every 5 years with hrHPV testing in combination with cytology (cotesting). Does not recommend screening for under 21 or older than 65, women who had a hysterectomy with no history of precancerous lesions or cervical cancer.
  • USPSTF Grade: A

Other screening tests may be indicated for individuals who are at an increased risk of cancer, but these tests do not meet NCI’s definition of effective. These tests are listed below.

• Breast: Breast MRI for women with BRCA1/BRCA2; clinical breast exams and regular breast self-exams.
• Colorectal: Virtual colonoscopy
• Prostate: PSA test
• Ovarian: CA-125 test
• Ovarian/endometrial: Transvaginal ultrasound
• Liver: Alpha-fetoprotein blood test
• Melanoma: Skin exams

Site-specific analysis of cancer incidence

Comparisons by gender, race and ethnicity

• Women in the catchment area have higher incidence rates for lung, colorectal, melanoma, kidney, ovarian and pancreatic cancers, compared to the state incidence rates.
• Men in the catchment area have incidence rates higher than state levels for lung, melanoma, head and neck, pancreatic and liver cancers.
• The cancer incidence rates for lung, melanoma, kidney, and oropharyngeal cancers are higher compared to the state and national rates.
• Incidence in the catchment area’s Black population is marked by rates higher than state and national rates for pancreatic and oropharyngeal cancers.
• The Hispanic population in the catchment area is small compared to the state and to the U.S., but it is growing. Incidence rates for this group are characterized by higher rates of ovarian cancer compared to state and national rates.

Top 10 cancer incidence by gender: Age-adjusted incidence rates per 100K population, all cancer sites or types, 2016-2020

5-year average annual age-adjusted incidence rate per 100,000 population, FCDS 2016-2020 | DATA SOURCES: For Florida (FL) and Catchment Area (CArea) Incidence: FCDS, 2016-2020 (data received 2022); *For U.S. Incidence: NCI/CDC State Cancer Profiles, 2017-2021. | NOTES: NCI/CDC State Cancer Profiles U.S. rates for Skin Cancer only include Melanomas of the Skin; and U.S. rates for Head & Neck Cancers only include cancers of the Oral Cavity & Pharynx, based on available SEER/NPCR data.

Top 10 cancer incidence by race and ethnicity: Age-adjusted incidence rates per 100K population, 2016-2020

5-year average annual age-adjusted incidence rate per 100,000 population, FCDS 2016-2020 | DATA SOURCES: For Florida (FL) and Catchment Area (CArea) Incidence: FCDS, 2016-2020 (data received 2022); *For U.S. Incidence: NCI/CDC State Cancer Profiles, 2017-2021. | NOTES: NCI/CDC State Cancer Profiles U.S. rates for Skin Cancer only include Melanomas of the Skin; and U.S. rates for Head & Neck Cancers only include cancers of the Oral Cavity & Pharynx, based on vailable SEER/NPCR data.

Comparisons by geographic designations: Rural/non-rural and low/high SEV

Among top cancers, breast, melanoma, and bladder cancers showed higher incidence in non‑rural and low vulnerable areas compared to other areas in the catchment area.

Top 10 cancer incidence by UFHCI catchment area geographic designations

DATA SOURCE: Average Annual Age-Adjusted Advanced Stage Cancer Incidence per 100,000 Population, FCDS, 2016-2020. NOTE: Blood cancers are comprised from Leukemia, Hodgkin’s Lymphoma, Non-Hodgkins’s Lymphoma, and Myeloma based on CDC SEER ICD-0-3 Cancer Classification Codes. These Data are not available at the national level.

5-year average annual age-adjusted incidence rate per 100,000 population, FCDS 2016-2020. | DATA SOURCE: Catchment Area (CArea) Incidence: FCDS, 2016-2020 (data received 2022). | NOTE: County rurality classified based on RUCC 4-9 as rural.

Site-specific analysis of advanced stage incidence

Comparisons by gender, race and ethnicity

Top 10 advanced stage cancer incidence by gender: Age-adjusted incidence rates (regional and distant stages) per 100K population, 2016-2020

5-year average annual age-adjusted advanced stage incidence (late stage diagnosis) rate per 100,000 population, FCDS 2016-2020 | DATA SOURCES: Florida (FL) and Catchment Area (CA) Incidence: FCDS, 2016-2020 (data received 2022). U.S. Incidence: NCI/CDC State Cancer Profiles, 2017-2021. | NOTE: Data not available at the U.S. level for advanced staged incidence of all sites and for blood/hemetologic cancers overall; U.S. rates for Skin Cancer only include Melanomas of the Skin; and U.S. rates for Head & Neck Cancers only include cancers of the Oral Cavity & Pharynx, based on SEER/NPCR data.

• Women in the catchment area have higher advanced stage incidence rates for lung, colorectal, pancreatic, ovarian, uterine, and cervical cancers, compared to the state advanced stage incidence rates.
• Men in the catchment area have advanced stage incidence rates higher than state levels for all cancers except blood and prostate cancers.

Top 10 advanced stage cancer incidence by race and ethnicity: Age-adjusted incidence rates (regional & distant stages) per 100K population, 2016-2020

5-year average annual age-adjusted advanced stage incidence (late stage diagnosis) rate per 100,000 population, FCDS 2016-2020 | DATA SOURCES: Florida (FL) and Catchment Area (CArea) Incidence: FCDS, 2016-2020 (data received 2022); U.S. Incidence: NCI/CDC State Cancer Profiles, 2017-2021. | NOTES: Data not available at the U.S. level for advanced staged incidence of All Sites and for Blood/Hemetologic cancers overall; U.S. rates for Skin Cancer only include Melanomas of the Skin; and U.S. rates for Head & Neck Cancers only include cancers of the Oral Cavity & Pharynx, based on available SEER/NPCR data.

• Advanced incidence in the catchment area’s white population is marked by rates higher than state rates for lung, colorectal, oropharyngeal, pancreatic, ovarian, uterine, and cervical cancers.
• Advanced incidence in the catchment area’s Black population is marked by rates higher than state rates for lung, pancreatic, and oropharyngeal cancers.
• The Hispanic population in the catchment area is small compared to the state and to the U.S., but it is growing. Advanced incidence rates for this group are characterized by higher rates of ovarian, uterine, oropharyngeal, and cervical cancer compared to state rates.

Comparisons by geographic designations: rural/non-rural and low/high SEV

Top 10 advanced stage cancer incidence by UFHCI catchment area geographic designations

Data Source: Average Annual Age‑Adjusted Cancer Incidence per 100,000 Population, FCDS, 2013‑2017. Note: 1) Blood cancers are comprised from Leukemia, Hodgkin’s Lymphoma, Non‑Hodgkin’s Lymphoma, and Myeloma based on CDC SEER. ICD‑O‑3 Cancer Classification Codes. These data are not available at the national level.

• Breast, pancreatic, and uterine cancers have higher advanced stage incidence rates in non‑rural and high SEV areas compared to other areas of the catchment.
• Among the top cancers, lung, colorectal, oropharyngeal and kidney cancers showed high advanced incidence in rural and high SEV areas.

Site-specific analysis of mortality

Top 10 cancer mortality by gender: Age-adjusted mortality rate per 100K population, 2017-2021

5-year average annual age-adjusted mortality rate per 100,000 population, FDOH 2017-2021 | DATA SOURCE: Florida (FL) and Catchment Area (CArea) Mortality: FDOH Bureau of Vital Statistics, 2017-2021 (data received 2022); U.S. Mortality: NCI/CDC State Cancer Profiles, 2018-2022. | NOTE: U.S. rates for Skin Cancer only include Melanomas of the Skin; and U.S. rates for Head & Neck Cancers only include cancers of the Oral Cavity & Pharynx, based on available SEER/NPCR data.

• Women in the UFHCI catchment area have higher mortality rates for almost all disease sites compared to the state and national mortality rates.
• Men in the catchment area have mortality rates higher than state and national levels for all cancers.

Top 10 cancer mortality by race and ethnicity: Age-adjusted mortality rates per 100K population, 2017-2021

• Mortality in the catchment area’s white population is marked by rates higher than state and national rates for all top 10 disease sites in the catchment area.
• Mortality in the catchment area’s Black population is marked by rates higher than state rates for all top 10 disease sites in the catchment area.
• The Hispanic population in the catchment area is small compared to the state and to the U.S. but it is growing. Mortality rates for this group are characterized by higher rates of ovarian and liver cancers compared to state and national rates.
• Note that comparisons across race demonstrate higher rates of mortality within the Black population for prostate, breast, colorectal, blood, pancreatic, uterine, liver, and cervical cancers compared to the white population.

Comparisons by geographic designations: Rural/non-rural

There are no cancers that have higher mortality rates in non‑rural areas compared to rural areas. Rural mortality rates exceed those of non‑rural areas of the catchment for all cancers shown below.

5-year average annual age-adjusted mortality rate per 100,000 population, FDOH 2017-2021 | DATA SOURCE: Florida (FL) and Catchment Area (CArea) Mortality: FDOH Bureau of Vital Statistics, 2017-2021 (data received 2022); U.S. Mortality: NCI/CDC State Cancer Profiles, 2018-2022. | NOTE: U.S. rates for Skin Cancer only include Melanomas of the Skin; and U.S. rates for Head & Neck Cancers only include cancers of the Oral Cavity & Pharynx, based on available SEER/NPCR data.

Top 10 cancer mortality by catchment area geographic designations

DATA SOURCE: Average Annual Age-Adjusted Cancer Mortality per 100,000 Population, FDOH Vital Statistics, 2017-2021

Risk factors in the catchment area: Tobacco and cancer screening rates

Tobacco products include cigarette, cigars or smokeless tobacco, as well as e‑cigarettes and vaping products. While cigarette smoking continues to decline in Florida, rates in the catchment area remain some of the highest in the state.

Adult smoking rates in the UFHCI catchment area

DATA SOURCE: Current Smoking Prevalence, NCI/CDC State Cancer Profiles, 2023

Lung cancer risk factors and community-based programs

Several community efforts from our growing network of partners are also addressing tobacco burden and aiming to increase cancer screening rates in our catchment area and beyond. Our partners doing tobacco cessation treatment services and leading recent policy change are assets to the UFHCI and the communities it aims to serve.

Tobacco Free Alachua: Tobacco 21: Tobacco Free Alachua is a community‑based partnership tasked with developing and promoting policies and programs that reduce the use and effects of tobacco in Alachua County. (20) “Tobacco 21,” a county‑wide policy that raises the age of tobacco sales from 18 to 21 and creates a 1,000‑foot buffer for sales around schools, was passed by the Alachua County Board of County Commissioners in January 2019. Local policy change was enacted in Alachua County with direct support from the COE office. Alachua was the first Florida county to implement Tobacco 21 and COE is sharing information with Volusia, Sarasota and Hillsborough counties outside of its catchment area, to assist them in enacting policy change. COE leadership, and UF faculty and staff went on record to present UFHCI’s data on the catchment area’s tobacco use and lung cancer burden in support of Tobacco Free Alachua, a community partner.

Area Health Education Centers (AHEC) Program: The Area Health Education Centers (AHEC) Program offices and centers work extensively with health care systems to integrate strategies that ensure tobacco use is assessed and treated at every encounter. They educate and prepare current and future health care professionals to address tobacco use with patients using evidence‑based methods and provide free intensive tobacco treatment services for Florida residents by offering group tobacco cessation classes and nicotine replacement products, such as patches, lozenges and gum. Gulfcoast North AHEC, Central Florida AHEC and the UF AHEC Program along with three of its affiliated nonprofit centers – Big Bend AHEC in Tallahassee, Northeast Florida AHEC in Jacksonville, and Suwannee River AHEC in Alachua – provide tobacco training, cessation and systems change activities throughout the UF Health Cancer Institute’s 26‑county catchment area. Over 1,700 participants in the UFHCI catchment area attended an AHEC group session in 2018.

References and data sources