Introduction Lung cancer is the most common cause of cancer-related death in the United States (US). Tobacco smoking is a well-recognized cause of lung cancer. About 2% of the United States (US) population lives in Tennessee (TN). Nearly 21 % of TN adults are current smokers as per 2019 data, compared to 14% across the US. The percentage of smokers has historically been high in TN and its surroundings. This can be attributed to the area's socio-economic and cultural characteristics, along with large areas of tobacco farming in the region. This increases the risk of lung cancer in the TN population. Surveillance Epidemiology and End Results Program (SEER) is a collection of cancer registries across the US, covering about 35% of the US population (TN cancer registry is not a part of SEER). Our study compares lung cancer incidence and characteristics in the TN cancer registry with the SEER 18 registry. Materials and Methods Data were collected from the TN cancer registry and SEER separately for lung and bronchial cancer. Data was analyzed for different histological subtypes, age groups, gender, stage at diagnosis, and rural/urban residence. Stata and Microsoft Excel were used in data analysis. A Chi-square test was used to calculate the statistical significance. Results From 2008 to 2017, 58644 cases of lung cancer were reported in the Tennessee cancer registry. During the same period, 519112 cases were reported in the SEER registry. The most frequent histological subtype of lung cancer in TN and SEER was adenocarcinoma (frequency of 17,503 Vs. 182346), followed by squamous cell carcinoma and small cell carcinoma. Most cancers in TN and SEER were diagnosed at stage of distant metastasis (46% vs. 52% ), followed by regional metastasis, localized, and in situ (Image1). The frequency of lung cancer diagnosis was high among those older than 65 in TN and SEER (64% vs. 69%). Males had a higher incidence of lung cancer in both registries. Most lung cancers were reported in the urban area in both registries. Chronic obstructive pulmonary disease was the most commonly reported secondary diagnosis (3,099), followed by pleural effusion in the TN database; the comparable data were not available in SEER. Relative survival at 12 months and five years for lung cancer in TN were 46.6 % and 19.5 % (Vs. 46.4% and 19.9% in SEER) Discussion and Conclusion If both registries were perfect, then lung and bronchial cancer incidence will be 9241 and 6048 per million in ten years in TN and SEER, respectively. But after careful analysis, we conclude that such analysis will be erroneous. The proportion of different histological types, stage at diagnosis, age groups, and gender were in the same order in both groups. Although chi-square test values are significant for all the variables, we infer no conclusion considering the data's inherent bias. Further in-depth analysis of the data is required.

This study couples biological data with aspects of material culture and mortuary ritual for several sites within the proposed Coosa chiefdom described by sixteenth-century Spanish accounts to explore how cultural identities were actively constructed and maintained within the region. The primary goal is to examine regional interactions between these communities and their constructions of social identity and sociopolitical dynamics vis à vis their biological affinities. Questions regarding regional interactions between these groups have been a stimulus for archaeological debate. These interactions may have played a crucial role in the construction of separate cultural identities. What is not clear is to what extent differences in cultural identity reflect or are related to differences in biological relationships. The skeletal samples used in this study represent six Late Mississippian archaeological sites assigned to three archaeological phases: the Dallas Phase, Fains Island (40JE1), Cox (40AN19), and David Davis (40HA301) sites; the Mouse Creek Phase, Ledford Island (40BY13) site; and the Barnett Phase, King (9FL5) and Little Egypt (9MU102) sites. Twenty-seven dental and 22 cranial nonmetric traits were recorded for 923 individuals. Biological affinities were calculated using the Mahalanobis D2 statistic for the cranial and dental non-metric traits. Biological Distance measures were compared to a geographic matrix to examine isolation by distance between the sites. Further analysis was conducted by constructing an R matrix to examine levels of heterogeneity. Comparisons between biological distance and geographical distances suggest that the samples used in this analysis do not conform to the expected isolation-by-distance model. Furthermore, East Tennessee groups appear distinct from their North Georgia neighbors suggesting little biological interaction between these groups. The results of the biological distance analysis conforms to differences in material culture and mortuary ritual between these groups. The results suggests that if there was a political alliance within the region for this period it is not associated with biological relatedness nor did it act as a unifying force for individual communities’ cultural identity.