Overview of Karmanos Cancer Institute Catchment Area (KCI-CA)

Karmanos Cancer Institute (KCI) has a long and distinguished history as a comprehensive cancer center serving southeast Michigan. In 2014, KCI affiliated with McLaren Health Care and there are now 16 sites serving a catchment area covering 46 of Michigan’s 83 counties. The catchment area is now defined as the 46-county area that is home to 95% of our patients; KCI sees one-third of all new cancer patients in the catchment area (Figure 1).

The KCI catchment area (KCI-CA) is home to 6.7 million residents who are diverse across a range of characteristics. To better describe and address this diversity, the KCI-CA has four regions, consistent with Community Health Assessment Regions as defined by the Michigan Department of Health and Human Services (MDHHS) (Figure 2).

The Southeast region includes the metropolitan Detroit area, defined as a tri-county area (Wayne, Oakland, Macomb) and home to over 3.86 million residents. According to the U.S. Census 2021 population estimates, the city of Detroit is the largest city in the state (639,000+ residents). Detroit is a resource-challenged area, with a median household income of $30,894 and 35% of residents living below poverty level, compared to 12.6% in the state of Michigan. The majority of census tracts in the city of Detroit are medically underserved areas based on HRSA definitions. About 78.3% of Detroit residents identify as Black or African American, a group that disproportionately carries the KCI catchment area’s cancer burden.

Another population with a strong presence in metropolitan Detroit are Arab Americans, who are not officially recognized by the U.S. government as a distinct minority group. Therefore, there is no nationally coordinated cancer-related surveillance of this group. Recent reports estimate 277,534 Arab Americans in Michigan, with 50% living in Wayne County. In fact, the proportion of Arab Americans in the city of Dearborn (directly adjacent to Detroit) is larger than that of any other U.S. city (Figure 3).

Beyond the metro Detroit area, the KCI catchment area is also characterized by a high proportion of rural (i.e., non-metropolitan) residents. About 45% of the population in the Central region live in a rural area while about 70% of the population in the North region are rural dwelling (Figure 4).

Across all of the groups, sexual and gender minorities (SGMs) are represented. According to a 2020 report from the UCLA School of Law Williams Institute, SGMs comprise 4% of the state’s population, similar to the representation nationwide, with about 311,000 adults. However, data suggest that, in MI, this group is more likely to be unemployed and food-insecure and less likely to receive routine healthcare compared to non-SGMs in the state.

Cancer incidence and mortality

Figure 5 shows overall cancer incidence rates in the KCI-CA.

Figure 6 shows incidence rates for leading cancers in the KCI catchment area.

Figure 7 presents a closer look at cancer incidence trends.

Figure 8 shows overall mortality rates in the KCI-CA.

Figure 9 shows mortality rates for leading cancers in the KCI catchment area.

Figure 10 presents a closer look at cancer mortality trends.

Cancer disparities

A striking area of disparity is related to African American racial group membership. Figure 11 shows differences in cancer incidence between African Americans in Detroit, those in the KCI catchment area, those across the U.S., and whites in the catchment area.

Figure 12 shows differences in cancer mortality between African Americans in Detroit, those in the KCI catchment area, those across the U.S., and whites in the catchment area.

Figure 13 shows racial differences in cancer incidence and mortality across leading cancers: prostate, breast, lung, colon/rectum, uterus, pancreas, cervix, and multiple myeloma.

Rural cancer disparities also exist, as shown in Figure 14.

Figure 15 shows rural lung cancer disparities.

Cancer risk factors

Several risk factors, including those typically included in the social determinants of health, are relevant to the cancer burden observed in the KCI catchment area.

Figures 16-18 presents 2018-2020 MI-BRFSS data based on KCI catchment area sub-regions for which data are available: Detroit (Southeast), Genesee County (East, including Flint), Central Michigan (including five counties in the Central region), and Northwest (including four counties in the North region).

Human papillomavirus (HPV) Vaccination Rate in Michigan

Raising Human Papillomavirus (HPV) vaccination rates is a high priority both for Karmanos Cancer Institute Catchment Area and in the state of Michigan. According to the Centers for Disease Control and Prevention (CDC), 79 million Americans are currently infected, and 14 million Americans become newly infected every year. The graphs above show vaccination rate coverage as of June 2022 for females and males 13 through 17 years old, respectively. Below are some trends that demonstrate the importance in immunizing patients.

Michigan ranks 21st in the country in the percentage of adolescents ages 13-17 who received all recommended doses of the human papillomavirus (HPV) vaccine
In the state of Michigan, only 43.1% of males and 45.1% of females have completed the 3 dose HPV vaccination series.
KCI’s entire catchment area currently falls below the target annual vaccination goal rate of 80%

Community engagement

The Research and Advocacy Consortium (RAC) is a growing network of faith-based, social service, and public health organizations throughout KCI’s 46 county catchment area as formal members and partners (Figure 19). These organizations, which together serve millions of Michigan residents, have committed to supporting evidence-based interventions to improve cancer outcomes; aid in the dissemination of and implementation of research discoveries and innovations; and support the implementation of cancer-relevant health policy recommendations. RAC members meet several times a year as an entire consortium.

Michigan Cancer HealthLink is a community-academic partnership to increase research capacity in local communities. The HealthLink model is informed by a participatory research approach in which researchers and community members collaborate on an ongoing basis in an iterative process of problem definition, problem solving, building research and programmatic skills, and broadening and deepening relationships. Michigan Cancer HealthLink is represented by a network of Cancer Action Councils (CACs), groups of cancer survivors, caregivers, and advocates who use knowledge of their respective communities to inform local cancer-related research (Figure 20).

Review CAC research priorities and questions.

Last updated: 9/25/22