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Incidence Rates Table

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Incidence Rate Report for Texas by County

Uterus (Corpus & Uterus, NOS) (All Stages^), 2018-2022

All Races (includes Hispanic), Female, All Ages

Sorted by Name

County
 sort alphabetically by name descending
2023 Rural-Urban Continuum Codes Φ
 sort by rural urban descending
Age-Adjusted Incidence Rate
cases per 100,000
(95% Confidence Interval)
 sort by rate descending
CI*Rank
(95% Confidence Interval)
 sort by CI rank descending
Average Annual Count
 sort by count descending
Recent Trend
Recent 5-Year Trend in Incidence Rates
(95% Confidence Interval)
 sort by trend descending
Texas 7 N/A 25.6 (25.3, 26.0) N/A 4,175 rising rising trend 2.3 (2.1, 2.7)
US (SEER+NPCR) 1 N/A 27.9 (27.8, 28.0) N/A 60,686 stable stable trend -0.3 (-0.9, 0.5)
Anderson County 7 Rural 22.8 (15.9, 32.1) 93 (8, 125) 8 rising rising trend 2.9 (0.1, 6.9)
Angelina County 7 Rural 25.5 (19.7, 32.5) 63 (8, 121) 14 stable stable trend 1.8 (-0.6, 4.7)
Aransas County 7 Urban 26.9 (15.8, 43.2) 48 (2, 125) 5 stable stable trend 0.8 (-2.0, 4.1)
Atascosa County 7 Urban 28.6 (20.1, 39.5) 29 (3, 123) 8
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Austin County 7 Urban 17.3 (9.9, 28.5) 124 (13, 125) 4
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Bandera County 7 Urban 20.6 (11.7, 35.4) 110 (5, 125) 4
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Bastrop County 7 Urban 25.5 (19.7, 32.4) 65 (9, 121) 14 stable stable trend -1.2 (-3.8, 2.0)
Bee County 7 Rural 33.9 (21.5, 51.2) 7 (1, 124) 5
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Bell County 7 Urban 23.0 (20.0, 26.2) 89 (37, 115) 44 stable stable trend 1.1 (-0.4, 3.1)
Bexar County 7 Urban 31.6 (30.1, 33.1) 14 (9, 38) 346 rising rising trend 2.4 (1.8, 3.3)
Blanco County 7 Rural 30.1 (16.3, 54.3) 19 (1, 125) 3
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Bosque County 7 Urban 30.4 (17.9, 49.1) 17 (1, 125) 4 stable stable trend 4.0 (-0.3, 10.1)
Bowie County 7 Urban 25.2 (19.8, 31.7) 72 (9, 119) 16 rising rising trend 4.4 (1.8, 8.0)
Brazoria County 7 Urban 24.9 (21.9, 28.2) 76 (24, 104) 52 rising rising trend 2.7 (1.7, 4.2)
Brazos County 7 Urban 20.6 (16.8, 25.1) 109 (38, 124) 21 stable stable trend -0.3 (-2.6, 2.7)
Brown County 7 Rural 19.7 (12.8, 29.3) 117 (13, 125) 6 stable stable trend 1.5 (-1.3, 5.0)
Burleson County 7 Urban 27.0 (15.2, 45.3) 43 (2, 125) 4
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Burnet County 7 Rural 27.1 (20.0, 36.3) 45 (4, 122) 11 stable stable trend 2.5 (-0.3, 6.7)
Caldwell County 7 Urban 25.8 (18.0, 36.0) 59 (4, 125) 8 stable stable trend -0.1 (-3.3, 3.7)
Calhoun County 7 Rural 29.8 (16.4, 49.7) 21 (1, 125) 3
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Cameron County 7 Urban 27.3 (24.3, 30.7) 39 (14, 93) 61 rising rising trend 6.5 (3.2, 13.8)
Cass County 7 Rural 20.1 (12.2, 31.7) 113 (8, 125) 5 stable stable trend 1.2 (-2.8, 6.1)
Chambers County 7 Urban 22.1 (14.4, 32.6) 100 (7, 125) 5 stable stable trend -0.6 (-3.9, 3.6)
Cherokee County 7 Rural 21.9 (14.9, 31.1) 101 (10, 125) 7 stable stable trend 0.7 (-2.4, 4.5)
Collin County 7 Urban 21.5 (19.8, 23.3) 104 (69, 115) 127 rising rising trend 1.2 (0.6, 2.1)
Comal County 7 Urban 27.9 (23.5, 32.8) 34 (9, 104) 32 rising rising trend 1.8 (0.2, 4.3)
Cooke County 7 Rural 15.7 (10.1, 23.8) 125 (42, 125) 5
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Coryell County 7 Urban 25.2 (18.8, 33.1) 71 (7, 124) 11 stable stable trend 1.1 (-2.1, 5.2)
Dallas County 7 Urban 29.3 (28.0, 30.6) 25 (16, 51) 403 rising rising trend 2.0 (1.5, 2.7)
DeWitt County 7 Rural 38.8 (24.2, 59.4) 4 (1, 121) 5
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*
Denton County 7 Urban 21.0 (19.2, 22.9) 107 (68, 118) 104 stable stable trend 0.6 (-0.6, 2.4)
Eastland County 7 Rural 28.2 (16.1, 46.7) 32 (2, 125) 4
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Ector County 7 Urban 33.3 (27.5, 39.9) 10 (3, 79) 24 rising rising trend 12.9 (3.8, 36.2)
El Paso County 7 Urban 25.4 (23.4, 27.6) 67 (30, 92) 119 rising rising trend 2.3 (1.4, 3.3)
Ellis County 7 Urban 26.1 (22.0, 30.8) 54 (12, 110) 30 rising rising trend 1.7 (0.5, 3.4)
Erath County 7 Rural 22.5 (14.1, 34.1) 95 (6, 125) 5 stable stable trend 1.6 (-1.7, 6.1)
Fannin County 7 Rural 26.5 (17.7, 38.4) 51 (4, 125) 6
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Fayette County 7 Rural 24.1 (13.9, 39.3) 81 (3, 125) 4 stable stable trend 0.5 (-2.7, 4.2)
Fort Bend County 7 Urban 22.9 (21.0, 25.0) 90 (50, 110) 109 rising rising trend 1.0 (0.3, 2.1)
Galveston County 7 Urban 20.7 (18.1, 23.7) 108 (61, 121) 47 stable stable trend 0.9 (-0.1, 2.1)
Gillespie County 7 Rural 27.0 (16.3, 42.4) 46 (2, 125) 5 stable stable trend -0.2 (-3.2, 3.3)
Gonzales County 7 Rural 32.5 (19.0, 52.2) 12 (1, 125) 4
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Gray County 7 Rural 34.3 (20.7, 53.8) 6 (1, 124) 4
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Grayson County 7 Urban 19.8 (15.8, 24.6) 115 (41, 125) 19 stable stable trend 0.4 (-2.0, 3.3)
Gregg County 7 Urban 29.1 (23.8, 35.2) 26 (5, 101) 23 rising rising trend 1.7 (0.2, 3.3)
Grimes County 7 Rural 25.4 (16.4, 38.1) 68 (3, 125) 5
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Guadalupe County 7 Urban 26.1 (21.9, 31.0) 55 (12, 109) 28 stable stable trend 1.4 (-0.1, 3.4)
Hardin County 7 Urban 19.2 (12.9, 27.6) 119 (16, 125) 6 rising rising trend 3.2 (0.2, 7.4)
Harris County 7 Urban 25.8 (24.9, 26.7) 60 (38, 77) 640 rising rising trend 2.0 (1.5, 2.6)
Harrison County 7 Urban 19.9 (14.2, 27.1) 114 (20, 125) 9 stable stable trend 1.7 (-0.1, 4.0)
Hays County 7 Urban 29.1 (24.9, 33.8) 27 (7, 92) 36 rising rising trend 2.7 (1.4, 5.0)
Henderson County 7 Rural 25.3 (19.5, 32.4) 70 (8, 122) 15 stable stable trend 1.6 (-0.1, 3.7)
Hidalgo County 7 Urban 30.0 (27.7, 32.5) 20 (10, 56) 124 rising rising trend 8.2 (2.2, 12.8)
Hill County 7 Rural 28.5 (19.1, 41.2) 30 (2, 124) 7 stable stable trend 5.0 (-0.3, 19.5)
Hockley County 7 Urban 24.8 (14.0, 41.0) 79 (2, 125) 3
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Hood County 7 Rural 27.2 (20.7, 35.4) 40 (4, 121) 14 stable stable trend 0.7 (-2.1, 4.2)
Hopkins County 7 Rural 24.3 (16.0, 35.7) 80 (4, 125) 6
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Houston County 7 Rural 31.8 (19.4, 49.7) 13 (1, 125) 5
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Howard County 7 Rural 23.7 (14.2, 37.1) 85 (4, 125) 4
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Hunt County 7 Urban 22.9 (17.8, 29.2) 91 (14, 124) 14 stable stable trend 1.8 (-0.6, 4.7)
Hutchinson County 7 Rural 28.6 (16.8, 46.1) 28 (2, 125) 4
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Jasper County 7 Rural 26.2 (17.6, 38.1) 56 (4, 125) 6 stable stable trend 2.6 (-0.4, 6.5)
Jefferson County 7 Urban 21.3 (18.0, 25.0) 105 (42, 122) 32 stable stable trend 1.2 (-0.1, 2.6)
Jim Wells County 7 Rural 30.4 (21.0, 42.8) 16 (2, 122) 7 stable stable trend 2.1 (-0.7, 5.6)
Johnson County 7 Urban 18.8 (15.2, 23.0) 121 (57, 125) 20 stable stable trend 0.9 (-0.6, 2.8)
Kaufman County 7 Urban 27.7 (22.7, 33.6) 36 (6, 108) 22 rising rising trend 2.4 (0.7, 5.0)
Kendall County 7 Urban 23.9 (17.0, 33.1) 82 (6, 125) 8
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Kerr County 7 Rural 26.4 (19.2, 35.6) 53 (5, 123) 12 rising rising trend 2.5 (0.1, 5.6)
Kleberg County 7 Rural 38.1 (25.0, 55.7) 5 (1, 119) 6 stable stable trend 2.4 (-0.8, 6.2)
Lamar County 7 Rural 25.5 (18.1, 35.1) 64 (5, 125) 9 stable stable trend 1.0 (-1.8, 4.3)
Lampasas County 7 Urban 22.3 (12.7, 37.1) 98 (4, 125) 4 stable stable trend 1.1 (-2.6, 5.9)
Lavaca County 7 Rural 29.9 (16.9, 48.9) 22 (1, 125) 4
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Lee County 7 Rural 26.7 (14.6, 45.3) 49 (2, 125) 3
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Liberty County 7 Urban 22.5 (16.9, 29.4) 97 (14, 124) 11 rising rising trend 3.4 (1.4, 6.3)
Limestone County 7 Rural 25.4 (15.3, 40.5) 66 (2, 125) 4 rising rising trend 5.3 (1.4, 11.2)
Llano County 7 Rural 17.7 (11.0, 29.9) 123 (18, 125) 5
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Lubbock County 7 Urban 21.8 (18.6, 25.4) 102 (42, 121) 35 stable stable trend 0.5 (-0.8, 2.0)
Matagorda County 7 Rural 23.6 (15.0, 35.4) 87 (5, 125) 5
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Maverick County 7 Urban 39.2 (29.5, 51.0) 3 (1, 85) 11 rising rising trend 4.0 (0.7, 8.9)
McLennan County 7 Urban 24.9 (21.3, 28.9) 75 (20, 111) 37 stable stable trend 1.3 (0.0, 2.8)
Medina County 7 Urban 33.5 (24.6, 44.7) 8 (2, 113) 11 rising rising trend 3.5 (1.2, 6.8)
Midland County 7 Urban 27.5 (22.4, 33.3) 38 (6, 113) 22 rising rising trend 15.9 (0.3, 37.0)
Milam County 7 Rural 24.0 (14.3, 38.3) 83 (3, 125) 4 stable stable trend 1.6 (-2.0, 5.9)
Montague County 7 Rural 25.0 (13.9, 42.0) 74 (2, 125) 3 rising rising trend 4.6 (0.5, 10.4)
Montgomery County 7 Urban 23.1 (20.9, 25.4) 88 (45, 112) 84 rising rising trend 3.1 (1.8, 8.4)
Moore County 7 Rural 33.4 (19.2, 54.1) 9 (1, 125) 3
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Nacogdoches County 7 Rural 20.4 (14.0, 28.7) 111 (13, 125) 7 stable stable trend -0.7 (-3.5, 2.2)
Navarro County 7 Rural 27.1 (19.1, 37.4) 41 (3, 124) 8 stable stable trend 1.8 (-0.9, 4.9)
Nueces County 7 Urban 27.8 (24.5, 31.3) 35 (12, 91) 56 rising rising trend 2.5 (1.0, 4.4)
Orange County 7 Urban 19.1 (14.1, 25.3) 120 (42, 125) 10 rising rising trend 20.8 (3.2, 33.8)
Palo Pinto County 7 Rural 26.5 (16.3, 41.0) 50 (2, 125) 5 stable stable trend 2.9 (-0.7, 7.8)
Panola County 7 Rural 31.5 (20.1, 47.7) 15 (1, 124) 5
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Parker County 7 Urban 21.2 (17.2, 25.9) 106 (35, 123) 21 stable stable trend 0.0 (-1.7, 2.3)
Polk County 7 Rural 29.4 (21.0, 40.3) 23 (3, 122) 10 stable stable trend 1.8 (-1.5, 5.6)
Potter County 7 Urban 25.3 (19.9, 31.7) 69 (9, 122) 16 stable stable trend 0.2 (-1.6, 2.2)
Randall County 7 Urban 22.7 (18.3, 27.9) 94 (24, 122) 20 stable stable trend -1.2 (-6.3, 1.5)
Rockwall County 7 Urban 20.3 (15.5, 26.2) 112 (30, 125) 12 stable stable trend 0.8 (-1.7, 4.5)
Rusk County 7 Urban 29.3 (21.2, 39.7) 24 (3, 122) 9 stable stable trend 2.3 (0.0, 5.0)
San Jacinto County 7 Urban 23.7 (13.7, 38.2) 84 (3, 125) 4
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San Patricio County 7 Urban 27.6 (20.5, 36.4) 37 (4, 120) 11 stable stable trend 0.2 (-2.3, 3.2)
Shelby County 7 Rural 25.6 (15.2, 40.8) 62 (3, 125) 4
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Smith County 7 Urban 24.9 (21.3, 28.9) 77 (19, 111) 37 rising rising trend 1.4 (0.1, 3.1)
Starr County 7 Rural 26.8 (19.4, 36.2) 47 (4, 124) 9 rising rising trend 3.7 (1.1, 7.6)
Tarrant County 7 Urban 25.8 (24.5, 27.2) 58 (35, 82) 300 rising rising trend 2.8 (2.1, 4.7)
Taylor County 7 Urban 26.0 (21.0, 31.8) 57 (10, 116) 20 stable stable trend 1.2 (-1.0, 3.7)
Titus County 7 Rural 19.8 (11.8, 31.3) 116 (7, 125) 4 stable stable trend 2.2 (-2.3, 8.0)
Tom Green County 7 Urban 23.6 (18.7, 29.5) 86 (13, 122) 17 stable stable trend 0.8 (-1.3, 3.2)
Travis County 7 Urban 24.8 (23.1, 26.7) 78 (37, 95) 159 stable stable trend 0.6 (-0.3, 1.7)
Tyler County 7 Rural 18.7 (10.5, 32.7) 122 (9, 125) 3
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Upshur County 7 Urban 22.1 (14.2, 32.8) 99 (6, 125) 6 stable stable trend -0.2 (-3.9, 3.9)
Uvalde County 7 Rural 53.6 (36.7, 75.4) 2 (1, 42) 7
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Val Verde County 7 Rural 28.2 (19.5, 39.4) 33 (3, 124) 7 rising rising trend 2.6 (0.3, 5.5)
Van Zandt County 7 Rural 22.8 (16.3, 31.2) 92 (8, 125) 9 stable stable trend 1.0 (-2.0, 4.3)
Victoria County 7 Urban 27.1 (21.2, 34.2) 44 (6, 118) 15 stable stable trend 1.9 (-0.8, 5.3)
Walker County 7 Rural 30.3 (22.1, 40.5) 18 (3, 120) 10 stable stable trend 5.4 (-12.6, 27.4)
Waller County 7 Urban 32.7 (23.5, 44.3) 11 (2, 116) 9 rising rising trend 3.5 (0.9, 7.6)
Washington County 7 Rural 22.6 (14.5, 33.8) 96 (7, 125) 6
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Webb County 7 Urban 25.0 (21.3, 29.3) 73 (17, 114) 32 rising rising trend 2.9 (1.2, 5.2)
Wharton County 7 Rural 21.7 (14.1, 32.0) 103 (7, 125) 6 stable stable trend 1.1 (-2.0, 4.8)
Wichita County 7 Urban 25.7 (20.6, 31.8) 61 (9, 118) 19 stable stable trend 2.9 (-4.8, 14.1)
Williamson County 7 Urban 26.3 (24.0, 28.9) 52 (24, 89) 92 rising rising trend 1.5 (0.6, 2.8)
Wilson County 7 Urban 28.4 (20.6, 38.3) 31 (3, 122) 9 stable stable trend 0.1 (-2.1, 3.3)
Wise County 7 Urban 19.4 (13.9, 26.6) 118 (28, 125) 9
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Wood County 7 Rural 27.2 (18.7, 38.3) 42 (3, 124) 9 stable stable trend 1.4 (-1.7, 5.1)
Zavala County 7 Rural 72.1 (43.5, 113.1) 1 (1, 44) 4
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Andrews County 7 Rural
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3 or fewer
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Archer County 7 Urban
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3 or fewer
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Armstrong County 7 Urban
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3 or fewer
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Bailey County 7 Rural
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3 or fewer
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Baylor County 7 Rural
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3 or fewer
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Borden County 7 Rural
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3 or fewer
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Brewster County 7 Rural
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3 or fewer
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Briscoe County 7 Rural
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3 or fewer
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Brooks County 7 Rural
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3 or fewer
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Callahan County 7 Urban
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3 or fewer
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Camp County 7 Rural
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3 or fewer
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Carson County 7 Urban
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3 or fewer
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Castro County 7 Rural
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3 or fewer
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Childress County 7 Rural
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3 or fewer
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Clay County 7 Urban
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3 or fewer
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Cochran County 7 Urban
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3 or fewer
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Coke County 7 Rural
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3 or fewer
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Coleman County 7 Rural
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3 or fewer
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Collingsworth County 7 Rural
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3 or fewer
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Colorado County 7 Rural
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3 or fewer
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Comanche County 7 Rural
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3 or fewer
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Concho County 7 Rural
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3 or fewer
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Cottle County 7 Rural
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3 or fewer
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Crane County 7 Rural
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3 or fewer
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Crockett County 7 Rural
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3 or fewer
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Crosby County 7 Urban
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3 or fewer
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Culberson County 7 Rural
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3 or fewer
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Dallam County 7 Rural
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3 or fewer
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Dawson County 7 Rural
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3 or fewer
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Deaf Smith County 7 Rural
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3 or fewer
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Delta County 7 Rural
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3 or fewer
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Dickens County 7 Rural
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3 or fewer
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Dimmit County 7 Rural
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3 or fewer
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Donley County 7 Rural
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3 or fewer
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Duval County 7 Rural
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3 or fewer
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Edwards County 7 Rural
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3 or fewer
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Falls County 7 Urban
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3 or fewer
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Fisher County 7 Rural
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3 or fewer
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Floyd County 7 Rural
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3 or fewer
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Foard County 7 Rural
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3 or fewer
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Franklin County 7 Rural
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3 or fewer
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Freestone County 7 Rural
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3 or fewer
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Frio County 7 Rural
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3 or fewer
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Gaines County 7 Rural
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3 or fewer
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Garza County 7 Urban
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3 or fewer
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Glasscock County 7 Rural
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3 or fewer
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Goliad County 7 Urban
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3 or fewer
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Hale County 7 Rural
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3 or fewer
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Hall County 7 Rural
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3 or fewer
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Hamilton County 7 Rural
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3 or fewer
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Hansford County 7 Rural
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3 or fewer
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Hardeman County 7 Rural
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3 or fewer
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Hartley County 7 Rural
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3 or fewer
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Haskell County 7 Rural
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3 or fewer
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Hemphill County 7 Rural
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3 or fewer
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Hudspeth County 7 Urban
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3 or fewer
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Irion County 7 Urban
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3 or fewer
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Jack County 7 Rural
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3 or fewer
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Jackson County 7 Rural
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Jeff Davis County 7 Rural
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Jim Hogg County 7 Rural
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3 or fewer
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Jones County 7 Urban
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Karnes County 7 Rural
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Kenedy County 7 Rural
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Kent County 7 Rural
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Kimble County 7 Rural
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3 or fewer
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King County 7 Rural
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Kinney County 7 Rural
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3 or fewer
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Knox County 7 Rural
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3 or fewer
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La Salle County 7 Rural
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3 or fewer
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Lamb County 7 Rural
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3 or fewer
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Leon County 7 Rural
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3 or fewer
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Lipscomb County 7 Rural
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3 or fewer
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Live Oak County 7 Rural
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3 or fewer
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Loving County 7 Rural
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3 or fewer
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Lynn County 7 Urban
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3 or fewer
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Madison County 7 Rural
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3 or fewer
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Marion County 7 Rural
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Martin County 7 Urban
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3 or fewer
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Mason County 7 Rural
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3 or fewer
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McCulloch County 7 Rural
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3 or fewer
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McMullen County 7 Rural
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Menard County 7 Rural
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3 or fewer
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Mills County 7 Rural
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Mitchell County 7 Rural
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Morris County 7 Rural
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3 or fewer
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Motley County 7 Rural
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3 or fewer
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Newton County 7 Rural
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3 or fewer
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Nolan County 7 Rural
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3 or fewer
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Ochiltree County 7 Rural
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3 or fewer
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Oldham County 7 Urban
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3 or fewer
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Parmer County 7 Rural
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3 or fewer
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Pecos County 7 Rural
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3 or fewer
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Presidio County 7 Rural
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3 or fewer
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Rains County 7 Rural
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3 or fewer
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Reagan County 7 Rural
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3 or fewer
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Real County 7 Rural
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3 or fewer
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Red River County 7 Rural
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3 or fewer
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Reeves County 7 Rural
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3 or fewer
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Refugio County 7 Rural
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3 or fewer
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Roberts County 7 Rural
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3 or fewer
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Robertson County 7 Urban
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3 or fewer
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Runnels County 7 Rural
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3 or fewer
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Sabine County 7 Rural
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3 or fewer
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San Augustine County 7 Rural
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3 or fewer
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San Saba County 7 Rural
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3 or fewer
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Schleicher County 7 Rural
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3 or fewer
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Scurry County 7 Rural
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3 or fewer
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Shackelford County 7 Rural
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3 or fewer
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Sherman County 7 Rural
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3 or fewer
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Somervell County 7 Rural
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3 or fewer
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Stephens County 7 Rural
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3 or fewer
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Sterling County 7 Rural
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3 or fewer
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Stonewall County 7 Rural
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3 or fewer
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Sutton County 7 Rural
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3 or fewer
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Swisher County 7 Rural
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3 or fewer
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Terrell County 7 Rural
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3 or fewer
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Terry County 7 Rural
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3 or fewer
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Throckmorton County 7 Rural
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3 or fewer
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Trinity County 7 Rural
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3 or fewer
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Upton County 7 Rural
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3 or fewer
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Ward County 7 Rural
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3 or fewer
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Wheeler County 7 Rural
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3 or fewer
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Wilbarger County 7 Rural
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3 or fewer
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Willacy County 7 Rural
*
*
3 or fewer
*
*
Winkler County 7 Rural
*
*
3 or fewer
*
*
Yoakum County 7 Rural
*
*
3 or fewer
*
*
Young County 7 Rural
*
*
3 or fewer
*
*
Zapata County 7 Rural
*
*
3 or fewer
*
*

Notes:
Created by statecancerprofiles.cancer.gov on 03/18/2026 1:19 am.

State Cancer Registries may provide more current or more local data.

† Incidence rates (cases per 100,000 population per year) are age-adjusted to the 2000 US standard population (SEER areas use 20 age groups and NPCR areas use 19 age groups). Rates are for invasive cancer only (except for bladder cancer which is invasive and in situ) or unless otherwise specified. Rates calculated using SEER*Stat. Population counts for denominators are based on Census populations as modified by NCI. The US Population Data File is used for SEER and NPCR incidence rates.

Rates and trends are computed using different standards for malignancy. For more information see malignant.html.

^ All Stages refers to any stage. Due to changes in stage coding, Combined Summary Stage with Expanded Regional Codes (2004+) is used for data from Surveillance, Epidemiology, and End Results (SEER) databases and Merged Summary Stage is used for data from National Program of Cancer Registries databases. Due to the increased complexity with staging, other staging variables maybe used if necessary.

Φ Rural–urban county classifications are based on the 2023 USDA Rural–Urban Continuum Codes (except for Connecticut Counties which use 2013 codes). State-level cancer rates for rural areas are calculated using cancer cases registered exclusively in rural counties, while state-level cancer rates for urban areas are calculated using cases registered exclusively in urban counties.

Source: SEER and NPCR data. For more specific information please see the table.

* Data has been suppressed to ensure confidentiality and stability of rate estimates. Counts are suppressed if fewer than 16 records were reported in a specific area-sex-race category.

Data for United States does not include Puerto Rico.

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