U.S. Cancer Death Rate Falls, But Remains High in Some Regions

Researchers say several factors could influence pockets of high mortality rates

U.S. Cancer Death Rate Falls, But Remains High in Some Regions

There’s some good news in the battle against cancer: The overall rate of death from the disease declined about 20 percent between 1980 and 2014, a new study says.

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Researchers from the University of Washington in Seattle estimated mortality rates by U.S. county from 29 cancers using death records from the National Center for Health Statistics (NCHS) and population counts from the Census Bureau, the NCHS and the Human Mortality Database from 1980 to 2014.

Results were published online Tuesday by the Journal of the American Medical Association (JAMA)

They found that cancer mortality decreased by 20.1 percent between 1980 and 2014, from 240 to 192 deaths per 100,000 population. A total of 19,511,910 cancer deaths were recorded in the United States during this period, including:

A number of factors likely contribute to the decline in deaths from cancer, says oncologist Dale Shepard, MD, PhD. Dr. Shepard did not participate in the study.

“We find cancers earlier, we prevent cancers, and once people have cancer, we have far more effective therapies,” he says. “So I think that would all contribute to a significant improvement in mortality.”

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High cancer mortality rates

At the same time, the researchers found that distinct clusters of counties in the United States have particularly high cancer mortality rate. For many cancers, there were distinct clusters of counties with especially high mortality. The location of these clusters varied by type of cancer and were spread in different regions of the United States.

Clusters of breast cancer, for example, were present in the southern belt and along the Mississippi River, while liver cancer was high along the Texas-Mexico border. Clusters of kidney cancer were observed in North and South Dakota and counties in West Virginia, Ohio, Indiana, Louisiana, Oklahoma, Texas, Alaska, and Illinois.

The researchers say there are several possible explanations for the high rates of cancer mortality in certain counties and regions.

First, cancer incidence could be high due to a combination of risk factor profile and poor prevention and screening programs. Second, cancer detection happens at a late stage because of the interplay of lack of screening, awareness in the population and health care clinicians, and poor access to health care. Third, cancer treatment strategies are poor.

Informing debate

Identification of clusters of high rates of change among U.S. counties is important for providing data to inform the debate on prevention, access to care, and appropriate treatment, the researchers say.

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The data highlights opportunities for improvement at the local level in certain communities, Dr. Shepard says.

“There really are some striking differences,” Dr. Shepard says.

“Environmental factors might be leading to increased cancer, or decreased access to care,” Dr. Shepard says. “Perhaps we’re seeing different therapeutic options in certain areas.”

“I think the big picture is that we truly have a long way to go to not only provide access to care, but quality care to everyone.”

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