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Early detection is the primary way to control breast cancer, and mammography screening can reduce breast cancer mortality 30 to 40 percent among women aged 50 years and older. Geographic areas with a high proportion of cases with late-stage diagnoses may reflect gaps in screening efforts. We used a spatial scan statistic, adjusting for the multitude of possible region locations and sizes, to test whether any particular region of Massachusetts had statistically significant excesses of late-stage diagnoses during the period 1982 to 1986. The novel geographic analysis technique utilized here can also be used in the control of other types of cancer.

OBJECTIVE: To examine the rate of weight gain over time among Americans by age, gender, and race. PARTICIPANTS: Scientific sample of 5117 Americans, ages 25–74?y in 1971 followed for 20?y. RESULTS: Rates of weight gain estimated by mixed effects models are highest among young adults and rates of weight loss are greatest among older adults. The overall shape of the growth curves are similar for men and women, black and white, in terms of both weight gain and weight loss. Rates are also affected by baseline body mass index (BMI=wt in kg/height in m2). CONCLUSIONS: Americans gain weight until middle age, stabilize, and begin to lose weight near age 60. Weight loss during old age is especially evident for obese Americans. The ability to accurately identify groups with increased risk and target them for obesity prevention will help combat the steady rise of overweight and obesity in America.