Date repository last updated: June 10, 2023

• Alaina H. Shreves^1,2 - ORCID
• Ian D. Buller^3,4 - ORCID
• Elizabeth Chase^5,6 - ORCID
• Hannah Creutzfeldt^3,7 - ORCID
• Jared A. Fisher³ - ORCID
• Barry I. Graubard⁶ - ORCID
• Robert N. Hoover⁸ - ORCID
• Debra T. Silverman³ - ORCID
• Susan S. Devesa⁵ - Co-Senior Author - ORCID
• Rena R. Jones³ - Co-Senior Author & Corresponding Author - ORCID

1. Department of Epidemiology, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, 02115, USA
2. Trans-Divisional Research Program, Division of Cancer Epidemiology and Genetics (DCEG), National Cancer Institute (NCI), National Institutes of Health (NIH), Rockville, MD, 20850, USA
3. Occupational and Environmental Epidemiology Branch, DCEG, NCI, Rockville, MD, 20850, USA
4. Cancer Prevention Fellowship Program, Division of Cancer Prevention, NCI, Rockville, MD, 20850, USA
5. Infections and Immunology Branch, DCEG, NCI, NIH, Rockville, MD, 20850, USA
6. Department of Biostatistics, University of Michigan School of Public Health, University of Michigan, Rockville, MD, 20850, USA
7. Fielding School of Public Health, University of California Los Angeles, Los Angeles, CA, 90095, USA
8. Office of the Director, DCEG, NCI, NIH, Rockville, MD, 20850, USA

Lung cancer is the leading cause of cancer death in the United States (US) and variations in lung cancer mortality and smoking behavior are evident by sex and region. We apply geospatial statistical methods to describe patterns in lung cancer mortality rates (2005-2018) in relation to patterns in cigarette smoking prevalences (1997-2003) by sex at the US county level. Our findings identify counties where lung carcinogens other than smoking may be driving lung cancer mortality and where further study is needed.

This repository includes R scripts used to calculate the Lee's L statistic and render the geographic visualizations found in the following peer-reviewed manuscript:

Shreves AH, Buller ID, Chase E, Creutzfeld H, Fisher JA, Graubard BI, Hoover RN, Silverman DT, Devesa SS, Jones RR. (2023) Geographic Patterns in U.S. Lung Cancer Mortality and Cigarette Smoking. Cancer Epidemiology, Biomarkers & Prevention, 32(2):193-201. DOI:10.1158/1055-9965.EPI-22-0253 PMID:36413442.

The repository also includes the code to create the project hexagon sticker.

• Step 1: You must download the data (see Data Availability section)
• Step 2: Save the data set to the data directory in this repository. Currently specified as a CSV file, but modify the path on Line 58 of the preparation.R file based on data location and file name
• Step 3: Run R scripts for figures. The preparation.R file will source the functions.R file.

County-level U.S. lung cancer mortality rates and smoking prevalences are downloadable from Model-based Small Area Estimates of Cancer-Related Measures from the Surveillance Research Program within the Division of Cancer Control and Population Sciences of the National Cancer Institute and the National Vital Statistics System from the National Center for Health Statistics of the Centers for Disease Control and Prevention.

For questions about the manuscript please e-mail the corresponding author Dr. Rena R. Jones.