SEATTLE - The rate at which Americans die from cancers varies dramatically by where they live, according to a new scientific analysis.
Lung cancer kills more people in the United States than any other cancer, but death rates are more than 20 times higher in some parts of the country than others. The nation's highest death rate from lung cancer in 2014 - the latest year included in the study - was in Union County, Florida, at 231 deaths per 100,000 residents. The lowest death rate from lung cancer was in Summit County, Colorado, with only 11 deaths per 100,000 people.
Similar differences were seen across cancers among more than 3,000 counties and cities in the US.
"Such significant disparities among US counties is unacceptable," said Dr. Ali Mokdad, lead author on the study and Professor of Global Health at the Institute for Health Metrics and Evaluation (IHME) at the University of Washington in Seattle. "Every person should have access to early screenings for cancer, as well as adequate treatment."
The study, "Trends and patterns of disparities in cancer mortality among US counties, 1980-2014," examines 29 types of cancer, analyzing mortality rates and how they have changed. It was published in the January 24 issue of JAMA .
In the 35 years examined, more than 19.5 million Americans died of cancer. The national mortality rate from all cancers combined fell by 20%. Despite this trend, 160 counties showed increases in all-cancer death rates over the same period, raising questions about access to care, prevention efforts, treatment, and other issues.
"As the US enters a new debate about access to health care, these findings on the wide differences in cancer mortality should inform the discussion," explained researcher Laura Dwyer-Lindgren, a co-author of the study. "What's causing cancer to be so much more fatal in one part of the country than in other parts demands further investigation."
Other county-level trends in the study include:
"It is essential that state and local health officials, as well as other health policy decision-makers and cancer care advocates, take note of and act on this important evidence to save more lives in their communities," said Dr. Christopher Murray, Director of IHME.
Dr. Murray and the other authors suggest several potential explanations for high rates of cancer mortality in particular areas. Known cancer risk factors -- smoking, diet, and obesity, among others -- combined with poor prevention programs may increase cancer cases. Additionally, lack of early detection for some cancers and lack of specialized treatment can be deadly.
"For cancers with high survival rates, such as testicular cancer and Hodgkin lymphoma, wide differences in mortality rates in the US should raise a red flag," explains Dr. Christina Fitzmaurice, Assistant Professor at IHME and the Division of Hematology at the University of Washington. "Clusters of counties with increasing death rates from these cancers need to be examined and questions raised regarding access to primary care for early detection and specialized cancer treatment services."
Below are the five counties with the highest mortality rates from lung cancer in 2014:
Below are the five counties with the lowest mortality rates from lung cancer in 2014:
Below are the five counties with the highest mortality rates from breast cancer (females only) in 2014:
Below are the five counties with the lowest mortality rates from breast cancer (females only) in 2014:
Below are the five counties with the highest mortality rates from prostate cancer in 2014:
Below are the five counties with the lowest mortality rates from prostate cancer in 2014:
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To allow the public access to these findings, IHME has updated its US Health Map data visualization tool and county profiles, and new downloadable spreadsheets have been added to the Global Health Data Exchange (GHDx).
Link to the study in JAMA : http://jamanetwork.com/journals/jama/fullarticle/10.1001/jama.2016.20324
US Health Map data visualization tool: http://vizhub.healthdata.org/us-health-map/
County profiles: http://www.healthdata.org/us-county-profiles
GHDx US data for download: http://ghdx.healthdata.org/us-data
Media contacts:
Kayla Albrecht
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+1-206-897-3792 (office); +1-206-335-2669 (cell)
albrek7@uw.edu
Dean R. Owen
+1 -206-897-2858 (office); +1-206-434-5630 (cell)
dean1227@uw.edu
Established in 2007, the Institute for Health Metrics and Evaluation (IHME) is an independent global health research center at the University of Washington in Seattle that provides rigorous and comparable measurement of the world's most important health problems and evaluates strategies to address them. IHME makes this information available so that policymakers, donors, practitioners, researchers, and local and global decision-makers have the evidence they need to make informed decisions about how to allocate resources to best improve population health. For more information, visit http://www.healthdata.org .
JAMA