CDC: Cancer death rate higher in rural America
Cancer death rates appeared higher in rural than urban areas despite lower overall cancer incidence in rural areas, according to data from the CDC published in Morbidity and Mortality Weekly Report.
Although cancer death rates are decreasing nationwide, rural areas demonstrated slower rates of decline, data also showed.
“Although geography alone cannot predict your risk for cancer, it can impact prevention, diagnosis and treatment opportunities — and that’s a significant public health problem in the United States,” Anne Schuchat, MD, CDC acting director, said in a press release. “Many cancer cases and deaths are preventable and with targeted public health efforts and interventions, we can close the growing cancer gap between rural and urban Americans.”
To compare cancer incidence and mortality in rural and urban America, researchers evaluated 2004 to 2013 incidence data from the CDC’s National Program of Cancer Registries and the NCI’s SEER program. They used the CDC’s National Vital Statistics System to evaluate 2006 to 2015 mortality data.
Overall cancer incidence during the most recent 5-year period appeared lower in rural areas — at 442 cases per 100,000 persons compared with 457 cases per 100,000 persons in urban counties with a population greater than 1 million. Age-adjusted incidence rates from 2004 to 2013 decreased 0.8% yearly in rural areas and 1% yearly in urban areas.
However, cancers related to tobacco use and lung cancer, as well as those that can be detected early by cancer screening — such as colorectal and cervical cancers — occurred at a higher incidence in rural areas.
Rural areas had higher death rates than urban areas, at 180 deaths per 100,000 persons compared with 158 deaths per 100,000 persons.
Although death rates decreased in both urban and rural areas, rural areas showed slower rate of decline (–1% vs. –1.6% per year), thus increasing the gap between these two areas over time.
Rural areas experienced higher death rates for cancers of the lung, colon and rectum, prostate, cervix, oral cavity and pharynx, and kidney than all other counties.
The CDC report contained several strategies to address these disparities. These included the promotion of healthy behaviors that reduce cancer risk, such as preventing tobacco initiation, promoting tobacco cessation, eliminating secondhand smoke exposure, limiting UV exposure, and encouraging physical activity and healthy eating.
Researchers also recommend a focus on increasing cancer screenings and vaccinations — such as for HPV and hepatitis B virus — in these areas.
Lastly, rural areas should participate in state-level comprehensive control coalitions, which focus on cancer prevention, education, screening, access to care, support for survivors and pursuit of good health.
“Cancer — its causes, its prevention and its treatment — is complicated,” Lisa C. Richardson, MD, oncologist and director of the CDC’s division of cancer prevention and control, said in the release. “When I treat cancer patients, I don’t do it alone — other health care professionals and family members help the patient during and after treatment. The same is true for community-level preventive interventions. Partnerships are key to reducing cancer incidence and the associated disparities.” – by Alexandra Todak
Disclosure: The researchers report no relevant financial disclosures.