State Cancer Profiles

Interpretation of Incidence Rates Data

Incidence Rate Report for Pennsylvania by County

Lung & Bronchus (Late Stage^), 2017-2021

All Races (includes Hispanic), Both Sexes, All Ages

Sorted by Name

Explanation of Column Headers

Objective - The objective of *** is from the Healthy People 2020 project done by the Centers for Disease Control and Prevention.

Incidence Rate (95% Confidence Interval) - The incidence rate is based upon 100,000 people and is an annual rate (or average annual rate) based on the time period indicated. Rates are age-adjusted by 5-year age groups to the 2000 U.S. standard million population.

Percent of Cases with Late Stage - This is the number of late stages cases compared to the number of cases for all stages.

Other Notes

• Larger confidence intervals indicate less stability of the data. This is often due to low counts that are not quite low enough to be suppressed.
• Data is currently being suppressed if there are fewer than 16 counts for the time period.

Line by Line Interpretation of the Report

Pennsylvania⁶

• 2023 Rural-Urban Continuum Codes Φ : N/A
• Rate : The incidence rate is 37.5 with a 95% confidence interval from 37.1 to 37.9 and 6,864 average annual cases over 2017-2021.
• CI*Rank ⋔ : N/A
• Percent of Cases with Late Stage : 64.8

US (SEER+NPCR)¹

• 2023 Rural-Urban Continuum Codes Φ : N/A
• Rate : The incidence rate is 34.3 with a 95% confidence interval from 34.2 to 34.4 and 140,561 average annual cases over 2017-2021.
• CI*Rank ⋔ : N/A
• Percent of Cases with Late Stage : 64.9

Adams County⁶

• 2023 Rural-Urban Continuum Codes Φ : Urban
• Rate : The incidence rate is 37.4 with a 95% confidence interval from 33.2 to 42.2 and 60 average annual cases over 2017-2021.
• CI*Rank ⋔ : 45 (14, 62)
• Percent of Cases with Late Stage : 63.2

Allegheny County⁶

• 2023 Rural-Urban Continuum Codes Φ : Urban
• Rate : The incidence rate is 39.7 with a 95% confidence interval from 38.3 to 41.0 and 711 average annual cases over 2017-2021.
• CI*Rank ⋔ : 35 (22, 44)
• Percent of Cases with Late Stage : 65.1

Armstrong County⁶

• 2023 Rural-Urban Continuum Codes Φ : Urban
• Rate : The incidence rate is 43.4 with a 95% confidence interval from 37.9 to 49.6 and 48 average annual cases over 2017-2021.
• CI*Rank ⋔ : 21 (2, 52)
• Percent of Cases with Late Stage : 67.5

Beaver County⁶

• 2023 Rural-Urban Continuum Codes Φ : Urban
• Rate : The incidence rate is 46.1 with a 95% confidence interval from 42.5 to 50.0 and 126 average annual cases over 2017-2021.
• CI*Rank ⋔ : 9 (2, 31)
• Percent of Cases with Late Stage : 69.6

Bedford County⁶

• 2023 Rural-Urban Continuum Codes Φ : Rural
• Rate : The incidence rate is 40.9 with a 95% confidence interval from 34.7 to 48.2 and 33 average annual cases over 2017-2021.
• CI*Rank ⋔ : 28 (2, 60)
• Percent of Cases with Late Stage : 67.6

Berks County⁶

• 2023 Rural-Urban Continuum Codes Φ : Urban
• Rate : The incidence rate is 37.3 with a 95% confidence interval from 35.0 to 39.6 and 212 average annual cases over 2017-2021.
• CI*Rank ⋔ : 46 (26, 55)
• Percent of Cases with Late Stage : 62.5

Blair County⁶

• 2023 Rural-Urban Continuum Codes Φ : Urban
• Rate : The incidence rate is 43.7 with a 95% confidence interval from 39.5 to 48.3 and 82 average annual cases over 2017-2021.
• CI*Rank ⋔ : 19 (3, 45)
• Percent of Cases with Late Stage : 64.7

Bradford County⁶

• 2023 Rural-Urban Continuum Codes Φ : Rural
• Rate : The incidence rate is 39.5 with a 95% confidence interval from 34.0 to 45.8 and 39 average annual cases over 2017-2021.
• CI*Rank ⋔ : 36 (5, 61)
• Percent of Cases with Late Stage : 66.1

Bucks County⁶

• 2023 Rural-Urban Continuum Codes Φ : Urban
• Rate : The incidence rate is 33.8 with a 95% confidence interval from 32.1 to 35.5 and 322 average annual cases over 2017-2021.
• CI*Rank ⋔ : 57 (44, 61)
• Percent of Cases with Late Stage : 64.4

Butler County⁶

• 2023 Rural-Urban Continuum Codes Φ : Urban
• Rate : The incidence rate is 30.3 with a 95% confidence interval from 27.4 to 33.3 and 88 average annual cases over 2017-2021.
• CI*Rank ⋔ : 64 (49, 67)
• Percent of Cases with Late Stage : 61.5

Cambria County⁶

• 2023 Rural-Urban Continuum Codes Φ : Urban
• Rate : The incidence rate is 37.8 with a 95% confidence interval from 34.2 to 41.8 and 84 average annual cases over 2017-2021.
• CI*Rank ⋔ : 44 (17, 58)
• Percent of Cases with Late Stage : 69.5

Cameron County⁶

• 2023 Rural-Urban Continuum Codes Φ : Rural
• Rate : The incidence rate is 35.8 with a 95% confidence interval from 20.4 to 63.5 and 3 average annual cases over 2017-2021.
• CI*Rank ⋔ : 51 (1, 67)
• Percent of Cases with Late Stage : 68.0

Carbon County⁶

• 2023 Rural-Urban Continuum Codes Φ : Urban
• Rate : The incidence rate is 39.0 with a 95% confidence interval from 33.8 to 45.0 and 42 average annual cases over 2017-2021.
• CI*Rank ⋔ : 37 (8, 61)
• Percent of Cases with Late Stage : 63.9

Centre County⁶

• 2023 Rural-Urban Continuum Codes Φ : Urban
• Rate : The incidence rate is 24.4 with a 95% confidence interval from 21.2 to 28.0 and 43 average annual cases over 2017-2021.
• CI*Rank ⋔ : 67 (62, 67)
• Percent of Cases with Late Stage : 61.3

Chester County⁶

• 2023 Rural-Urban Continuum Codes Φ : Urban
• Rate : The incidence rate is 27.3 with a 95% confidence interval from 25.6 to 29.2 and 188 average annual cases over 2017-2021.
• CI*Rank ⋔ : 66 (61, 67)
• Percent of Cases with Late Stage : 60.5

Clarion County⁶

• 2023 Rural-Urban Continuum Codes Φ : Rural
• Rate : The incidence rate is 40.6 with a 95% confidence interval from 33.3 to 49.2 and 23 average annual cases over 2017-2021.
• CI*Rank ⋔ : 29 (2, 64)
• Percent of Cases with Late Stage : 67.5

Clearfield County⁶

• 2023 Rural-Urban Continuum Codes Φ : Rural
• Rate : The incidence rate is 38.0 with a 95% confidence interval from 33.2 to 43.4 and 47 average annual cases over 2017-2021.
• CI*Rank ⋔ : 43 (12, 62)
• Percent of Cases with Late Stage : 62.9

Clinton County⁶

• 2023 Rural-Urban Continuum Codes Φ : Rural
• Rate : The incidence rate is 38.1 with a 95% confidence interval from 31.0 to 46.6 and 21 average annual cases over 2017-2021.
• CI*Rank ⋔ : 42 (3, 66)
• Percent of Cases with Late Stage : 67.7

Columbia County⁶

• 2023 Rural-Urban Continuum Codes Φ : Rural
• Rate : The incidence rate is 41.2 with a 95% confidence interval from 35.5 to 47.7 and 39 average annual cases over 2017-2021.
• CI*Rank ⋔ : 26 (3, 58)
• Percent of Cases with Late Stage : 68.2

Crawford County⁶

• 2023 Rural-Urban Continuum Codes Φ : Rural
• Rate : The incidence rate is 38.4 with a 95% confidence interval from 33.8 to 43.7 and 52 average annual cases over 2017-2021.
• CI*Rank ⋔ : 40 (10, 61)
• Percent of Cases with Late Stage : 59.9

Cumberland County⁶

• 2023 Rural-Urban Continuum Codes Φ : Urban
• Rate : The incidence rate is 30.5 with a 95% confidence interval from 28.0 to 33.2 and 110 average annual cases over 2017-2021.
• CI*Rank ⋔ : 62 (50, 67)
• Percent of Cases with Late Stage : 62.1

Dauphin County⁶

• 2023 Rural-Urban Continuum Codes Φ : Urban
• Rate : The incidence rate is 33.8 with a 95% confidence interval from 31.2 to 36.7 and 128 average annual cases over 2017-2021.
• CI*Rank ⋔ : 56 (37, 63)
• Percent of Cases with Late Stage : 63.8

Delaware County⁶

• 2023 Rural-Urban Continuum Codes Φ : Urban
• Rate : The incidence rate is 34.9 with a 95% confidence interval from 33.0 to 36.9 and 260 average annual cases over 2017-2021.
• CI*Rank ⋔ : 53 (38, 60)
• Percent of Cases with Late Stage : 62.8

Elk County⁶

• 2023 Rural-Urban Continuum Codes Φ : Rural
• Rate : The incidence rate is 33.0 with a 95% confidence interval from 26.3 to 41.3 and 17 average annual cases over 2017-2021.
• CI*Rank ⋔ : 58 (12, 67)
• Percent of Cases with Late Stage : 64.9

Erie County⁶

• 2023 Rural-Urban Continuum Codes Φ : Urban
• Rate : The incidence rate is 46.6 with a 95% confidence interval from 43.6 to 49.9 and 179 average annual cases over 2017-2021.
• CI*Rank ⋔ : 5 (2, 26)
• Percent of Cases with Late Stage : 72.6

Fayette County⁶

• 2023 Rural-Urban Continuum Codes Φ : Urban
• Rate : The incidence rate is 46.0 with a 95% confidence interval from 41.8 to 50.5 and 95 average annual cases over 2017-2021.
• CI*Rank ⋔ : 11 (2, 36)
• Percent of Cases with Late Stage : 66.8

Forest County⁶

• 2023 Rural-Urban Continuum Codes Φ : Rural
• Rate : The incidence rate is 43.4 with a 95% confidence interval from 28.0 to 85.5 and 5 average annual cases over 2017-2021.
• CI*Rank ⋔ : 20 (1, 67)
• Percent of Cases with Late Stage : 76.5

Franklin County⁶

• 2023 Rural-Urban Continuum Codes Φ : Urban
• Rate : The incidence rate is 32.4 with a 95% confidence interval from 29.1 to 35.9 and 74 average annual cases over 2017-2021.
• CI*Rank ⋔ : 59 (38, 66)
• Percent of Cases with Late Stage : 65.3

Fulton County⁶

• 2023 Rural-Urban Continuum Codes Φ : Rural
• Rate : The incidence rate is 39.9 with a 95% confidence interval from 28.8 to 54.5 and 9 average annual cases over 2017-2021.
• CI*Rank ⋔ : 34 (1, 67)
• Percent of Cases with Late Stage : 56.8

Greene County⁶

• 2023 Rural-Urban Continuum Codes Φ : Rural
• Rate : The incidence rate is 53.9 with a 95% confidence interval from 45.2 to 63.9 and 29 average annual cases over 2017-2021.
• CI*Rank ⋔ : 1 (1, 32)
• Percent of Cases with Late Stage : 71.1

Huntingdon County⁶

• 2023 Rural-Urban Continuum Codes Φ : Rural
• Rate : The incidence rate is 34.4 with a 95% confidence interval from 28.4 to 41.5 and 24 average annual cases over 2017-2021.
• CI*Rank ⋔ : 55 (13, 67)
• Percent of Cases with Late Stage : 62.7

Indiana County⁶

• 2023 Rural-Urban Continuum Codes Φ : Rural
• Rate : The incidence rate is 30.6 with a 95% confidence interval from 26.2 to 35.5 and 37 average annual cases over 2017-2021.
• CI*Rank ⋔ : 61 (39, 67)
• Percent of Cases with Late Stage : 68.8

Jefferson County⁶

• 2023 Rural-Urban Continuum Codes Φ : Rural
• Rate : The incidence rate is 34.5 with a 95% confidence interval from 28.4 to 41.7 and 24 average annual cases over 2017-2021.
• CI*Rank ⋔ : 54 (13, 67)
• Percent of Cases with Late Stage : 60.8

Juniata County⁶

• 2023 Rural-Urban Continuum Codes Φ : Rural
• Rate : The incidence rate is 39.9 with a 95% confidence interval from 31.1 to 50.9 and 14 average annual cases over 2017-2021.
• CI*Rank ⋔ : 33 (1, 66)
• Percent of Cases with Late Stage : 66.1

Lackawanna County⁶

• 2023 Rural-Urban Continuum Codes Φ : Urban
• Rate : The incidence rate is 45.2 with a 95% confidence interval from 41.9 to 48.7 and 146 average annual cases over 2017-2021.
• CI*Rank ⋔ : 12 (3, 32)
• Percent of Cases with Late Stage : 67.7

Lancaster County⁶

• 2023 Rural-Urban Continuum Codes Φ : Urban
• Rate : The incidence rate is 30.4 with a 95% confidence interval from 28.6 to 32.3 and 229 average annual cases over 2017-2021.
• CI*Rank ⋔ : 63 (55, 66)
• Percent of Cases with Late Stage : 63.8

Lawrence County⁶

• 2023 Rural-Urban Continuum Codes Φ : Urban
• Rate : The incidence rate is 44.1 with a 95% confidence interval from 39.2 to 49.6 and 62 average annual cases over 2017-2021.
• CI*Rank ⋔ : 17 (2, 47)
• Percent of Cases with Late Stage : 67.5

Lebanon County⁶

• 2023 Rural-Urban Continuum Codes Φ : Urban
• Rate : The incidence rate is 31.8 with a 95% confidence interval from 28.4 to 35.5 and 67 average annual cases over 2017-2021.
• CI*Rank ⋔ : 60 (41, 66)
• Percent of Cases with Late Stage : 61.5

Lehigh County⁶

• 2023 Rural-Urban Continuum Codes Φ : Urban
• Rate : The incidence rate is 39.0 with a 95% confidence interval from 36.5 to 41.6 and 188 average annual cases over 2017-2021.
• CI*Rank ⋔ : 38 (19, 52)
• Percent of Cases with Late Stage : 64.8

Luzerne County⁶

• 2023 Rural-Urban Continuum Codes Φ : Urban
• Rate : The incidence rate is 44.1 with a 95% confidence interval from 41.5 to 46.9 and 214 average annual cases over 2017-2021.
• CI*Rank ⋔ : 18 (5, 33)
• Percent of Cases with Late Stage : 67.0

Lycoming County⁶

• 2023 Rural-Urban Continuum Codes Φ : Urban
• Rate : The incidence rate is 45.1 with a 95% confidence interval from 40.6 to 50.1 and 76 average annual cases over 2017-2021.
• CI*Rank ⋔ : 13 (2, 40)
• Percent of Cases with Late Stage : 69.5

McKean County⁶

• 2023 Rural-Urban Continuum Codes Φ : Rural
• Rate : The incidence rate is 44.6 with a 95% confidence interval from 37.2 to 53.2 and 27 average annual cases over 2017-2021.
• CI*Rank ⋔ : 15 (1, 57)
• Percent of Cases with Late Stage : 69.5

Mercer County⁶

• 2023 Rural-Urban Continuum Codes Φ : Rural
• Rate : The incidence rate is 41.1 with a 95% confidence interval from 36.9 to 45.7 and 74 average annual cases over 2017-2021.
• CI*Rank ⋔ : 27 (5, 53)
• Percent of Cases with Late Stage : 67.5

Mifflin County⁶

• 2023 Rural-Urban Continuum Codes Φ : Rural
• Rate : The incidence rate is 41.6 with a 95% confidence interval from 35.2 to 49.1 and 31 average annual cases over 2017-2021.
• CI*Rank ⋔ : 25 (2, 59)
• Percent of Cases with Late Stage : 70.1

Monroe County⁶

• 2023 Rural-Urban Continuum Codes Φ : Rural
• Rate : The incidence rate is 37.1 with a 95% confidence interval from 33.6 to 40.9 and 89 average annual cases over 2017-2021.
• CI*Rank ⋔ : 49 (20, 60)
• Percent of Cases with Late Stage : 59.0

Montgomery County⁶

• 2023 Rural-Urban Continuum Codes Φ : Urban
• Rate : The incidence rate is 29.8 with a 95% confidence interval from 28.4 to 31.3 and 353 average annual cases over 2017-2021.
• CI*Rank ⋔ : 65 (56, 66)
• Percent of Cases with Late Stage : 63.1

Montour County⁶

• 2023 Rural-Urban Continuum Codes Φ : Rural
• Rate : The incidence rate is 46.1 with a 95% confidence interval from 34.9 to 60.1 and 12 average annual cases over 2017-2021.
• CI*Rank ⋔ : 10 (1, 65)
• Percent of Cases with Late Stage : 69.7

Northampton County⁶

• 2023 Rural-Urban Continuum Codes Φ : Urban
• Rate : The incidence rate is 35.3 with a 95% confidence interval from 32.8 to 37.9 and 159 average annual cases over 2017-2021.
• CI*Rank ⋔ : 52 (33, 60)
• Percent of Cases with Late Stage : 59.9

Northumberland County⁶

• 2023 Rural-Urban Continuum Codes Φ : Rural
• Rate : The incidence rate is 46.4 with a 95% confidence interval from 41.5 to 51.8 and 68 average annual cases over 2017-2021.
• CI*Rank ⋔ : 6 (1, 39)
• Percent of Cases with Late Stage : 69.0

Perry County⁶

• 2023 Rural-Urban Continuum Codes Φ : Urban
• Rate : The incidence rate is 42.9 with a 95% confidence interval from 36.0 to 50.8 and 30 average annual cases over 2017-2021.
• CI*Rank ⋔ : 22 (1, 59)
• Percent of Cases with Late Stage : 65.5

Philadelphia County⁶

• 2023 Rural-Urban Continuum Codes Φ : Urban
• Rate : The incidence rate is 40.2 with a 95% confidence interval from 38.9 to 41.6 and 709 average annual cases over 2017-2021.
• CI*Rank ⋔ : 30 (20, 42)
• Percent of Cases with Late Stage : 62.7

Pike County⁶

• 2023 Rural-Urban Continuum Codes Φ : Rural
• Rate : The incidence rate is 40.0 with a 95% confidence interval from 34.5 to 46.3 and 41 average annual cases over 2017-2021.
• CI*Rank ⋔ : 32 (4, 60)
• Percent of Cases with Late Stage : 64.2

Potter County⁶

• 2023 Rural-Urban Continuum Codes Φ : Rural
• Rate : The incidence rate is 47.9 with a 95% confidence interval from 36.3 to 62.6 and 13 average annual cases over 2017-2021.
• CI*Rank ⋔ : 4 (1, 63)
• Percent of Cases with Late Stage : 74.7

Schuylkill County⁶

• 2023 Rural-Urban Continuum Codes Φ : Rural
• Rate : The incidence rate is 51.2 with a 95% confidence interval from 46.9 to 55.7 and 112 average annual cases over 2017-2021.
• CI*Rank ⋔ : 2 (1, 17)
• Percent of Cases with Late Stage : 64.6

Snyder County⁶

• 2023 Rural-Urban Continuum Codes Φ : Rural
• Rate : The incidence rate is 42.0 with a 95% confidence interval from 34.6 to 50.7 and 24 average annual cases over 2017-2021.
• CI*Rank ⋔ : 23 (1, 63)
• Percent of Cases with Late Stage : 70.2

Somerset County⁶

• 2023 Rural-Urban Continuum Codes Φ : Rural
• Rate : The incidence rate is 38.9 with a 95% confidence interval from 33.9 to 44.6 and 47 average annual cases over 2017-2021.
• CI*Rank ⋔ : 39 (6, 61)
• Percent of Cases with Late Stage : 72.4

Sullivan County⁶

• 2023 Rural-Urban Continuum Codes Φ : Rural
• Rate : The incidence rate is 44.2 with a 95% confidence interval from 27.8 to 71.5 and 5 average annual cases over 2017-2021.
• CI*Rank ⋔ : 16 (1, 67)
• Percent of Cases with Late Stage : 72.2

Susquehanna County⁶

• 2023 Rural-Urban Continuum Codes Φ : Rural
• Rate : The incidence rate is 40.2 with a 95% confidence interval from 33.4 to 48.3 and 27 average annual cases over 2017-2021.
• CI*Rank ⋔ : 31 (2, 64)
• Percent of Cases with Late Stage : 65.6

Tioga County⁶

• 2023 Rural-Urban Continuum Codes Φ : Rural
• Rate : The incidence rate is 37.1 with a 95% confidence interval from 30.7 to 44.8 and 25 average annual cases over 2017-2021.
• CI*Rank ⋔ : 48 (5, 66)
• Percent of Cases with Late Stage : 68.1

Union County⁶

• 2023 Rural-Urban Continuum Codes Φ : Rural
• Rate : The incidence rate is 37.2 with a 95% confidence interval from 30.4 to 45.4 and 21 average annual cases over 2017-2021.
• CI*Rank ⋔ : 47 (5, 66)
• Percent of Cases with Late Stage : 70.7

Venango County⁶

• 2023 Rural-Urban Continuum Codes Φ : Rural
• Rate : The incidence rate is 48.4 with a 95% confidence interval from 41.9 to 55.8 and 43 average annual cases over 2017-2021.
• CI*Rank ⋔ : 3 (1, 42)
• Percent of Cases with Late Stage : 70.7

Warren County⁶

• 2023 Rural-Urban Continuum Codes Φ : Rural
• Rate : The incidence rate is 45.0 with a 95% confidence interval from 37.9 to 53.3 and 30 average annual cases over 2017-2021.
• CI*Rank ⋔ : 14 (1, 54)
• Percent of Cases with Late Stage : 74.9

Washington County⁶

• 2023 Rural-Urban Continuum Codes Φ : Urban
• Rate : The incidence rate is 46.2 with a 95% confidence interval from 42.8 to 49.7 and 151 average annual cases over 2017-2021.
• CI*Rank ⋔ : 8 (2, 29)
• Percent of Cases with Late Stage : 67.0

Wayne County⁶

• 2023 Rural-Urban Continuum Codes Φ : Rural
• Rate : The incidence rate is 41.6 with a 95% confidence interval from 35.7 to 48.5 and 38 average annual cases over 2017-2021.
• CI*Rank ⋔ : 24 (2, 58)
• Percent of Cases with Late Stage : 65.9

Westmoreland County⁶

• 2023 Rural-Urban Continuum Codes Φ : Urban
• Rate : The incidence rate is 36.0 with a 95% confidence interval from 33.8 to 38.3 and 217 average annual cases over 2017-2021.
• CI*Rank ⋔ : 50 (32, 58)
• Percent of Cases with Late Stage : 66.4

Wyoming County⁶

• 2023 Rural-Urban Continuum Codes Φ : Urban
• Rate : The incidence rate is 46.3 with a 95% confidence interval from 37.3 to 57.2 and 20 average annual cases over 2017-2021.
• CI*Rank ⋔ : 7 (1, 58)
• Percent of Cases with Late Stage : 67.1

York County⁶

• 2023 Rural-Urban Continuum Codes Φ : Urban
• Rate : The incidence rate is 38.4 with a 95% confidence interval from 36.3 to 40.7 and 246 average annual cases over 2017-2021.
• CI*Rank ⋔ : 41 (23, 52)
• Percent of Cases with Late Stage : 64.0

Notes:
Created by statecancerprofiles.cancer.gov on 10/13/2024 3:52 pm.

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 (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.

Rates are computed using cancers classified as malignant based on ICD-O-3. For more information see malignant.html.

^ Late Stage is defined as cases determined to be regional or distant. Due to changes in stage coding, Combined Summary Stage (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 Continuum Codes provided by the USDA.
Source: SEER and NPCR data. For more specific information please see the table.

Data for the United States does not include data from Indiana.
Data for the United States does not include Puerto Rico.