Document Type

Capstone Experience

Graduation Date


Degree Name

Master of Public Health


Health Services Research & Administration

First Committee Member

Hongmei Wang, Ph.D. (Chair)

Second Committee Member

Kendra Ratnapradipa, Ph.D.

Third Committee Member

Ming Qu, Ph.D.


Currently, the studies of cancer burden are focused on the incidence, mortality, and survival of cancer. Due to the early detection and advancement of therapies, more patients can live much longer after a cancer diagnosis. Health care providers and patients want to know more about cancer recurrence, which can significantly impact cancer survivors’ quality of life. At this moment, the cancer recurrence studies are clinically based on specific treatments of particular cancers and are usually limited to small and selected populations. This study utilized the population-based cancer registry data between 1996-2015 to examine the cancer recurrence status in Nebraska. The overall all-cancer recurrence rate is 7.32%, and the age-adjusted incidence rate for cancer recurrence was 38.09 per 100,000. This study focuses on female breast cancer and colorectal cancer, two of the most common cancers in Nebraska. The female breast cancer recurrence rate was 6.64%, and the age-adjusted incidence rate for cancer recurrence was 5.61 per 100,000 population. The colorectal cancer recurrence rate was 7.8%, and the age-adjusted incidence for cancer recurrence was 4.40 per 100,000 population. Logistic regression analysis demonstrated that age at diagnosis, year diagnosed, stage and grade of the initial tumor, and urban/rural status were significantly associated with cancer recurrence for both types of cancer. There was also an association between the type of insurance and cancer recurrence among female breast cancer patients. No significant associations were found between marital status, census tract poverty, and education level with cancer recurrence in both types of cancer.

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