Incidence Rates Table
County![]() |
Age-Adjusted Incidence Rate† cases per 100,000 (95% Confidence Interval) ![]() |
CI*Rank⋔ (95% Confidence Interval) ![]() |
Average Annual Count![]() |
Recent Trend |
Recent 5-Year Trend‡ in Incidence Rates (95% Confidence Interval) ![]() |
---|---|---|---|---|---|
Kentucky 7 | 554.3 (550.1, 558.5) | N/A | 14,273 |
falling ![]() |
-0.8 (-0.9, -0.6) |
US (SEER+NPCR) 1 | 480.6 (480.1, 481.1) | N/A | 863,255 |
stable ![]() |
-0.4 (-0.8, 0.0) |
Owsley County 7 | 688.7 (556.7, 845.3) | 1 (1, 110) | 21 |
stable ![]() |
-0.4 (-3.0, 2.3) |
Bath County 7 | 687.2 (603.5, 779.8) | 2 (1, 75) | 52 |
stable ![]() |
0.6 (-0.7, 2.1) |
Breathitt County 7 | 679.2 (595.3, 772.2) | 3 (1, 77) | 53 |
rising ![]() |
1.9 (0.3, 3.6) |
Mercer County 7 | 675.8 (612.6, 744.2) | 4 (1, 50) | 93 |
stable ![]() |
0.1 (-0.8, 1.0) |
Monroe County 7 | 656.8 (568.4, 755.8) | 5 (1, 99) | 44 |
rising ![]() |
1.9 (0.3, 3.8) |
Grant County 7 | 650.5 (586.5, 719.6) | 6 (1, 68) | 84 |
stable ![]() |
0.4 (-0.4, 1.3) |
Marion County 7 | 641.9 (574.4, 715.3) | 7 (1, 80) | 72 |
stable ![]() |
1.0 (-0.3, 2.5) |
Taylor County 7 | 637.9 (580.1, 700.1) | 8 (1, 72) | 96 |
stable ![]() |
-0.1 (-0.8, 0.6) |
Russell County 7 | 632.7 (568.0, 703.4) | 9 (1, 85) | 76 |
stable ![]() |
0.3 (-0.9, 1.6) |
Bracken County 7 | 632.2 (534.5, 743.3) | 10 (1, 113) | 32 |
stable ![]() |
-0.1 (-1.7, 1.7) |
Floyd County 7 | 631.2 (583.0, 682.4) | 11 (1, 66) | 141 |
stable ![]() |
-0.7 (-1.6, 0.3) |
Fleming County 7 | 624.7 (553.3, 703.5) | 12 (1, 98) | 60 |
stable ![]() |
-0.3 (-1.5, 1.0) |
Carter County 7 | 622.1 (568.9, 679.2) | 13 (1, 83) | 108 |
stable ![]() |
0.3 (-0.6, 3.6) |
Henry County 7 | 621.2 (550.7, 698.8) | 14 (1, 105) | 63 |
stable ![]() |
-0.9 (-2.2, 0.4) |
Hart County 7 | 616.0 (548.9, 689.3) | 15 (1, 98) | 68 |
stable ![]() |
0.6 (-0.7, 2.0) |
Fulton County 7 | 614.8 (507.3, 740.1) | 16 (1, 117) | 25 |
stable ![]() |
0.3 (-1.6, 2.2) |
Logan County 7 | 611.2 (558.3, 668.1) | 17 (2, 85) | 105 |
stable ![]() |
-0.3 (-1.5, 1.0) |
Montgomery County 7 | 610.9 (555.6, 670.4) | 18 (2, 89) | 95 |
stable ![]() |
0.1 (-0.8, 1.1) |
Lincoln County 7 | 606.1 (550.8, 665.7) | 19 (2, 91) | 94 |
stable ![]() |
-0.6 (-1.5, 0.4) |
Powell County 7 | 605.8 (523.7, 697.5) | 20 (1, 113) | 43 |
stable ![]() |
-0.4 (-2.2, 1.7) |
Harlan County 7 | 605.7 (551.6, 664.0) | 21 (2, 96) | 101 |
stable ![]() |
0.6 (-0.2, 1.4) |
Barren County 7 | 604.4 (561.2, 650.1) | 22 (4, 84) | 155 |
stable ![]() |
0.1 (-0.8, 1.0) |
Knox County 7 | 602.4 (552.3, 656.1) | 23 (2, 91) | 111 |
stable ![]() |
-0.2 (-1.4, 1.0) |
Lee County 7 | 600.0 (501.1, 713.8) | 24 (1, 118) | 29 |
stable ![]() |
-0.2 (-2.8, 2.5) |
Nelson County 7 | 598.1 (554.1, 644.7) | 25 (4, 88) | 153 |
stable ![]() |
-0.9 (-2.0, 0.4) |
Butler County 7 | 597.9 (522.4, 681.8) | 26 (1, 110) | 49 |
stable ![]() |
-0.6 (-2.8, 1.6) |
Oldham County 7 | 597.3 (559.9, 636.6) | 27 (6, 78) | 216 |
stable ![]() |
4.0 (-0.4, 7.7) |
Lawrence County 7 | 597.3 (528.4, 673.2) | 28 (1, 110) | 60 |
stable ![]() |
0.2 (-1.3, 1.8) |
Wolfe County 7 | 596.8 (498.0, 711.0) | 29 (1, 119) | 28 |
stable ![]() |
-2.2 (-4.6, 0.3) |
Perry County 7 | 596.6 (543.3, 653.9) | 30 (2, 96) | 98 |
stable ![]() |
-0.9 (-2.0, 0.3) |
Estill County 7 | 595.7 (523.5, 675.8) | 31 (1, 111) | 54 |
stable ![]() |
-0.6 (-2.3, 1.2) |
Boyd County 7 | 595.4 (556.7, 636.2) | 32 (5, 81) | 186 |
stable ![]() |
0.0 (-0.6, 1.7) |
Livingston County 7 | 595.1 (513.1, 688.3) | 33 (1, 114) | 42 |
stable ![]() |
4.2 (-4.0, 15.9) |
Clay County 7 | 594.2 (529.2, 665.0) | 34 (2, 107) | 67 |
stable ![]() |
1.1 (-4.8, 7.6) |
Rockcastle County 7 | 593.2 (527.3, 665.5) | 35 (1, 109) | 64 |
stable ![]() |
-0.5 (-1.6, 0.6) |
Grayson County 7 | 592.0 (538.5, 649.7) | 36 (3, 100) | 98 |
stable ![]() |
-0.4 (-1.4, 0.7) |
Pendleton County 7 | 590.4 (517.5, 671.0) | 37 (1, 113) | 53 |
stable ![]() |
0.0 (-1.3, 1.4) |
Pike County 7 | 588.0 (552.4, 625.4) | 38 (8, 84) | 222 |
stable ![]() |
-0.6 (-1.2, 0.0) |
Metcalfe County 7 | 587.0 (505.1, 679.4) | 39 (1, 116) | 39 |
stable ![]() |
0.0 (-1.4, 1.5) |
Daviess County 7 | 586.7 (558.5, 615.9) | 40 (10, 78) | 343 |
stable ![]() |
-0.5 (-1.1, 0.3) |
Marshall County 7 | 586.4 (540.5, 635.6) | 41 (4, 97) | 131 |
stable ![]() |
-0.2 (-1.0, 0.8) |
McLean County 7 | 586.2 (502.2, 681.5) | 42 (1, 116) | 37 |
stable ![]() |
-0.1 (-1.5, 1.5) |
Johnson County 7 | 583.4 (526.6, 644.9) | 43 (3, 108) | 84 |
stable ![]() |
0.3 (-1.0, 1.7) |
Whitley County 7 | 582.4 (535.0, 633.0) | 44 (6, 100) | 118 |
stable ![]() |
0.2 (-0.7, 1.2) |
Harrison County 7 | 581.4 (519.4, 649.2) | 45 (3, 108) | 70 |
stable ![]() |
-0.7 (-1.9, 0.6) |
Owen County 7 | 579.3 (500.1, 668.5) | 46 (1, 117) | 43 |
stable ![]() |
-0.6 (-2.1, 1.0) |
Crittenden County 7 | 579.1 (495.7, 674.0) | 47 (1, 117) | 37 |
stable ![]() |
0.9 (-1.0, 2.9) |
Adair County 7 | 576.6 (516.7, 642.1) | 48 (3, 113) | 72 |
stable ![]() |
-0.7 (-1.7, 0.2) |
McCracken County 7 | 575.8 (542.8, 610.4) | 49 (13, 91) | 242 |
falling ![]() |
-0.9 (-1.6, -0.1) |
Spencer County 7 | 574.3 (509.6, 645.2) | 50 (3, 112) | 65 |
stable ![]() |
0.2 (-1.2, 1.9) |
Anderson County 7 | 572.1 (511.7, 637.8) | 51 (5, 113) | 72 |
stable ![]() |
-1.1 (-2.5, 0.5) |
Hardin County 7 | 570.7 (542.3, 600.2) | 52 (19, 88) | 322 |
stable ![]() |
-0.8 (-1.6, 0.1) |
Graves County 7 | 570.2 (526.4, 616.8) | 53 (9, 103) | 133 |
stable ![]() |
-0.3 (-1.3, 0.8) |
Carlisle County 7 | 569.2 (453.4, 707.9) | 54 (1, 120) | 18 |
stable ![]() |
-1.1 (-3.7, 1.5) |
Lewis County 7 | 568.6 (497.9, 647.3) | 55 (3, 116) | 51 |
stable ![]() |
0.4 (-0.8, 1.7) |
Clinton County 7 | 567.3 (487.5, 657.6) | 56 (2, 118) | 39 |
stable ![]() |
-0.1 (-2.1, 2.1) |
Pulaski County 7 | 566.3 (533.2, 601.1) | 57 (16, 95) | 236 |
falling ![]() |
-1.0 (-1.6, -0.3) |
Martin County 7 | 564.9 (486.5, 652.9) | 58 (2, 118) | 40 |
stable ![]() |
-0.8 (-2.5, 1.1) |
Bourbon County 7 | 563.2 (505.1, 626.7) | 59 (4, 115) | 73 |
stable ![]() |
-0.1 (-1.5, 1.3) |
Letcher County 7 | 561.8 (506.1, 622.5) | 60 (7, 112) | 83 |
stable ![]() |
-0.7 (-1.7, 0.4) |
Hopkins County 7 | 559.3 (519.7, 601.3) | 61 (14, 106) | 158 |
falling ![]() |
-1.1 (-2.0, -0.3) |
Garrard County 7 | 559.3 (496.4, 628.4) | 62 (4, 116) | 63 |
stable ![]() |
-1.2 (-7.0, 0.1) |
Breckinridge County 7 | 559.1 (502.2, 621.1) | 63 (6, 113) | 78 |
stable ![]() |
-0.1 (-1.4, 1.3) |
Campbell County 7 | 558.9 (529.7, 589.3) | 64 (23, 97) | 298 |
falling ![]() |
-0.9 (-1.5, -0.2) |
Greenup County 7 | 558.3 (515.3, 604.2) | 65 (13, 109) | 133 |
stable ![]() |
-0.7 (-1.4, 0.1) |
Jefferson County 7 | 557.8 (547.4, 568.3) | 66 (44, 79) | 2,362 |
falling ![]() |
-1.1 (-1.4, -0.8) |
Carroll County 7 | 554.3 (473.2, 645.8) | 67 (2, 119) | 35 |
stable ![]() |
-0.5 (-2.4, 1.6) |
Nicholas County 7 | 552.1 (455.6, 664.2) | 68 (1, 120) | 24 |
stable ![]() |
0.3 (-1.4, 2.0) |
Kenton County 7 | 551.6 (529.0, 575.0) | 69 (37, 95) | 488 |
falling ![]() |
-1.1 (-1.8, -0.4) |
Muhlenberg County 7 | 550.1 (504.0, 599.5) | 70 (12, 111) | 111 |
falling ![]() |
-1.0 (-1.9, -0.1) |
Ohio County 7 | 548.4 (495.5, 605.8) | 71 (11, 116) | 83 |
falling ![]() |
-3.7 (-14.1, -0.1) |
Casey County 7 | 547.9 (483.0, 619.6) | 72 (6, 117) | 56 |
stable ![]() |
-0.4 (-2.0, 1.2) |
Hickman County 7 | 544.4 (432.1, 680.8) | 73 (1, 120) | 18 |
stable ![]() |
-0.5 (-3.2, 2.3) |
Woodford County 7 | 542.2 (491.0, 597.5) | 74 (13, 115) | 91 |
stable ![]() |
-1.3 (-2.8, 0.3) |
Madison County 7 | 540.9 (510.2, 573.0) | 75 (31, 107) | 248 |
falling ![]() |
-1.4 (-2.1, -0.7) |
Green County 7 | 540.4 (466.2, 624.2) | 76 (5, 119) | 41 |
falling ![]() |
-3.9 (-12.1, -0.5) |
Leslie County 7 | 538.3 (458.4, 629.0) | 77 (3, 119) | 35 |
stable ![]() |
-1.1 (-3.3, 1.2) |
Washington County 7 | 538.2 (464.5, 621.0) | 78 (5, 119) | 41 |
stable ![]() |
1.0 (-0.7, 3.0) |
Franklin County 7 | 536.0 (498.4, 575.9) | 79 (27, 113) | 160 |
falling ![]() |
-1.2 (-2.0, -0.3) |
Calloway County 7 | 534.9 (491.9, 580.8) | 80 (27, 114) | 120 |
stable ![]() |
-0.8 (-1.9, 0.4) |
Henderson County 7 | 532.9 (493.9, 574.3) | 81 (30, 113) | 148 |
falling ![]() |
-0.9 (-1.6, -0.2) |
Larue County 7 | 530.8 (462.4, 607.0) | 82 (9, 119) | 47 |
falling ![]() |
-3.2 (-15.4, -0.4) |
Simpson County 7 | 530.7 (469.1, 598.6) | 83 (12, 119) | 58 |
stable ![]() |
-0.7 (-1.6, 0.3) |
Mason County 7 | 530.4 (467.8, 599.5) | 84 (11, 119) | 56 |
rising ![]() |
5.8 (0.5, 10.9) |
Christian County 7 | 528.7 (491.7, 567.7) | 85 (33, 114) | 158 |
falling ![]() |
-1.1 (-2.0, -0.2) |
Clark County 7 | 527.6 (484.3, 573.9) | 86 (27, 116) | 117 |
stable ![]() |
-1.0 (-2.3, 0.3) |
Webster County 7 | 527.3 (457.2, 605.7) | 87 (10, 119) | 43 |
stable ![]() |
-0.9 (-2.2, 0.5) |
Laurel County 7 | 526.4 (492.3, 562.4) | 88 (41, 113) | 189 |
falling ![]() |
-5.4 (-11.2, -1.5) |
Cumberland County 7 | 524.7 (435.6, 629.2) | 89 (3, 120) | 27 |
stable ![]() |
-0.6 (-2.9, 1.8) |
Meade County 7 | 522.2 (472.1, 576.3) | 90 (22, 118) | 87 |
falling ![]() |
-1.1 (-2.0, -0.2) |
Boone County 7 | 521.7 (496.6, 547.8) | 91 (57, 111) | 353 |
falling ![]() |
-1.0 (-1.7, -0.2) |
Bullitt County 7 | 521.3 (491.7, 552.2) | 92 (50, 113) | 251 |
falling ![]() |
-1.1 (-1.9, -0.2) |
Lyon County 7 | 520.9 (442.5, 611.6) | 93 (7, 120) | 35 |
stable ![]() |
-0.2 (-2.3, 2.1) |
Jackson County 7 | 514.7 (446.3, 591.2) | 94 (12, 120) | 45 |
stable ![]() |
-0.5 (-2.8, 2.0) |
Union County 7 | 513.4 (442.8, 592.3) | 95 (10, 120) | 43 |
stable ![]() |
-0.6 (-2.2, 1.1) |
McCreary County 7 | 512.2 (450.2, 580.5) | 96 (18, 119) | 53 |
stable ![]() |
-1.2 (-2.4, 0.0) |
Fayette County 7 | 511.7 (495.3, 528.4) | 97 (72, 111) | 790 |
falling ![]() |
-1.5 (-1.9, -1.1) |
Warren County 7 | 510.0 (484.3, 536.7) | 98 (62, 114) | 313 |
falling ![]() |
-1.0 (-1.8, -0.2) |
Shelby County 7 | 509.3 (471.0, 550.1) | 99 (47, 118) | 141 |
stable ![]() |
-0.9 (-1.9, 0.3) |
Wayne County 7 | 508.2 (456.0, 565.4) | 100 (29, 119) | 75 |
stable ![]() |
0.0 (-1.6, 1.6) |
Menifee County 7 | 507.9 (415.8, 616.7) | 101 (3, 120) | 24 |
stable ![]() |
-1.5 (-3.6, 0.7) |
Ballard County 7 | 504.4 (422.1, 599.8) | 102 (5, 120) | 28 |
stable ![]() |
-1.4 (-3.0, 0.3) |
Todd County 7 | 501.2 (429.7, 581.8) | 103 (13, 120) | 37 |
stable ![]() |
-0.9 (-2.6, 1.0) |
Jessamine County 7 | 499.4 (463.4, 537.5) | 104 (59, 118) | 149 |
falling ![]() |
-2.1 (-5.8, -1.0) |
Caldwell County 7 | 499.3 (433.7, 572.9) | 105 (24, 120) | 44 |
stable ![]() |
-1.4 (-2.8, 0.0) |
Scott County 7 | 497.6 (458.3, 539.2) | 106 (53, 119) | 132 |
falling ![]() |
-2.8 (-9.0, -1.0) |
Trigg County 7 | 496.2 (435.8, 563.5) | 107 (28, 120) | 56 |
stable ![]() |
-1.1 (-2.4, 0.3) |
Boyle County 7 | 495.6 (450.4, 544.3) | 108 (49, 119) | 92 |
stable ![]() |
-1.0 (-2.3, 0.3) |
Edmonson County 7 | 491.6 (425.8, 565.8) | 109 (23, 120) | 44 |
stable ![]() |
-0.8 (-1.6, 0.0) |
Rowan County 7 | 491.4 (435.1, 553.1) | 110 (35, 120) | 58 |
falling ![]() |
-4.9 (-9.2, -2.8) |
Gallatin County 7 | 489.6 (400.7, 593.1) | 111 (7, 120) | 25 |
stable ![]() |
0.0 (-2.5, 3.0) |
Allen County 7 | 487.8 (434.5, 546.2) | 112 (41, 120) | 65 |
stable ![]() |
-0.6 (-2.2, 1.2) |
Knott County 7 | 483.5 (419.5, 555.0) | 113 (32, 120) | 46 |
stable ![]() |
-1.0 (-2.9, 1.1) |
Hancock County 7 | 483.1 (403.4, 574.9) | 114 (16, 120) | 28 |
stable ![]() |
1.3 (-0.8, 3.8) |
Morgan County 7 | 475.4 (410.3, 548.4) | 115 (36, 120) | 41 |
stable ![]() |
-0.7 (-3.0, 0.6) |
Magoffin County 7 | 475.3 (407.9, 551.4) | 116 (31, 120) | 38 |
falling ![]() |
-10.6 (-21.2, -3.6) |
Robertson County 7 | 469.5 (326.3, 662.7) | 117 (1, 120) | 8 |
stable ![]() |
0.3 (-4.7, 6.2) |
Trimble County 7 | 468.7 (391.1, 558.5) | 118 (25, 120) | 28 |
stable ![]() |
-0.1 (-2.6, 2.6) |
Bell County 7 | 459.8 (413.3, 510.3) | 119 (73, 120) | 77 |
stable ![]() |
-1.2 (-2.9, 0.4) |
Elliott County 7 | 381.2 (309.8, 465.7) | 120 (91, 120) | 21 |
stable ![]() |
-1.9 (-4.0, 0.5) |
Notes:
Created by statecancerprofiles.cancer.gov on 10/04/2023 6:18 am.
State Cancer Registries may provide more current or more local data.
⋔ Results presented with the CI*Rank statistics help show the usefulness of ranks. For example, ranks for relatively rare diseases or less populated areas may be essentially meaningless because of their large variability, but ranks for more common diseases in densely populated regions can be very useful. More information about methodology can be found on the CI*Rank website.
† Incidence rates (cases per 100,000 population per year) are age-adjusted to the 2000 US standard population (19 age groups: <1, 1-4, 5-9, ... , 80-84, 85+). 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.
‡ Incidence data come from different sources. Due to different years of data availability, most of the trends are AAPCs based on APCs but some are APCs calculated in SEER*Stat. Please refer to the source for each area for additional information.
Rates and trends are computed using different standards for malignancy. For more information see malignant.html.
^ All Stages refers to any stage in the Surveillance, Epidemiology, and End Results (SEER) summary stage.
1 Source: National Program of Cancer Registries and Surveillance, Epidemiology, and End Results SEER*Stat Database - United States Department of Health and Human Services, Centers for Disease Control and Prevention and National Cancer Institute. Based on the 2022 submission.
7 Source: SEER November 2022 submission.
8 Source: Incidence data provided by the SEER Program. AAPCs are calculated by the Joinpoint Regression Program and are based on APCs. Data are age-adjusted to the 2000 US standard population (19 age groups: <1, 1-4, 5-9, ... , 80-84,85+). Rates are for invasive cancer only (except for bladder cancer which is invasive and in situ) or unless otherwise specified. Population counts for denominators are based on Census populations as modifed by NCI. The US Population Data File is used with SEER November 2022 data.
Interpret Rankings provides insight into interpreting cancer incidence statistics. When the population size for a denominator is small, the rates may be unstable. A rate is unstable when a small change in the numerator (e.g., only one or two additional cases) has a dramatic effect on the calculated rate.
Data for the United States does not include data from Nevada.
Data for the United States does not include Puerto Rico.
When displaying county information, the CI*Rank for the state is not shown because it's not comparable. To see the state CI*Rank please view the statistics at the US By State level.
Created by statecancerprofiles.cancer.gov on 10/04/2023 6:18 am.
State Cancer Registries may provide more current or more local data.
Trend
Rising when 95% confidence interval of average annual percent change is above 0.
Stable when 95% confidence interval of average annual percent change includes 0.
Falling when 95% confidence interval of average annual percent change is below 0.
Rising when 95% confidence interval of average annual percent change is above 0.
Stable when 95% confidence interval of average annual percent change includes 0.
Falling when 95% confidence interval of average annual percent change is below 0.
⋔ Results presented with the CI*Rank statistics help show the usefulness of ranks. For example, ranks for relatively rare diseases or less populated areas may be essentially meaningless because of their large variability, but ranks for more common diseases in densely populated regions can be very useful. More information about methodology can be found on the CI*Rank website.
† Incidence rates (cases per 100,000 population per year) are age-adjusted to the 2000 US standard population (19 age groups: <1, 1-4, 5-9, ... , 80-84, 85+). 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.
‡ Incidence data come from different sources. Due to different years of data availability, most of the trends are AAPCs based on APCs but some are APCs calculated in SEER*Stat. Please refer to the source for each area for additional information.
Rates and trends are computed using different standards for malignancy. For more information see malignant.html.
^ All Stages refers to any stage in the Surveillance, Epidemiology, and End Results (SEER) summary stage.
1 Source: National Program of Cancer Registries and Surveillance, Epidemiology, and End Results SEER*Stat Database - United States Department of Health and Human Services, Centers for Disease Control and Prevention and National Cancer Institute. Based on the 2022 submission.
7 Source: SEER November 2022 submission.
8 Source: Incidence data provided by the SEER Program. AAPCs are calculated by the Joinpoint Regression Program and are based on APCs. Data are age-adjusted to the 2000 US standard population (19 age groups: <1, 1-4, 5-9, ... , 80-84,85+). Rates are for invasive cancer only (except for bladder cancer which is invasive and in situ) or unless otherwise specified. Population counts for denominators are based on Census populations as modifed by NCI. The US Population Data File is used with SEER November 2022 data.
Interpret Rankings provides insight into interpreting cancer incidence statistics. When the population size for a denominator is small, the rates may be unstable. A rate is unstable when a small change in the numerator (e.g., only one or two additional cases) has a dramatic effect on the calculated rate.
Data for the United States does not include data from Nevada.
Data for the United States does not include Puerto Rico.
When displaying county information, the CI*Rank for the state is not shown because it's not comparable. To see the state CI*Rank please view the statistics at the US By State level.