Journal of the American Medical Association: U.S. Cancer Deaths Drop 20 Percent Over 30 Year Period

By  //  January 26, 2017

second-leading cause of death in the U.S.

A new comprehensive analysis of cancer death rates by U.S. county revealed that even as the cancer mortality rate nationwide continues to fall, Americans in certain struggling parts of the country are dying from cancer at rising rates.

A study recently published in the Journal of the American Medical Association focused on estimated death rates for cancer by U.S. counties revealed that the overall rate of cancer deaths has dropped by roughly 20 percent from 1980 to 2014.

The study’s results were based on death records from the National Center for Health Statistics, which show cancer is the second-leading cause of death in the U.S., right behind heart disease.

The Good News

The 20 percent decrease in cancer mortality rate represents a drop from 240 deaths to 192 deaths per 100,000 population.

The study estimates that 19 million people died during that 35-year period, with lung cancer being the biggest killer at 5.7 million, colon and rectal cancer was second with 2.5 million followed by breast cancer at 1.6 million.

This map of county level cancer mortality illustrates the wide disparity in 2014 cancer deaths per thousand and change in cancer mortality rates from 1980 to 2014 found in the recent research out of the University of Washington and published in the Journal of the American Medical Association (JAMA). The estimated 2014 cancer mortality rate in Brevard County is ~216/100,000 population, and the Brevard decrease in cancer mortality over the 35-year course of the study was found to be ~12 percent. (JAMA image)

The Bad News

However, the comprehensive analysis also showed that Americans in certain struggling parts of the country are dying from cancer at rising rates, even as the cancer death rate nationwide continues to fall.

In regions of the country that are relatively poor and have higher rates of obesity and smoking, cancer death rates rose nearly 50 percent, while healthier, wealthier pockets of the country saw death rates fall by nearly half.

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The picture was rosiest in the Colorado ski country, where cancer deaths per 100,000 residents dropped by almost half, from 130 in 1980 to just 70 in 2014; and bleakest in some eastern Kentucky counties, where they soared by up to 45 percent.

Better screening and treatment have contributed to the improvement in the nation as a whole — but the study underscores that not all Americans have benefited from these advances.

Comprehensive, Detailed Cancer Mortality Analysis By County

Previous research has exposed significant differences in regional cancer death rates, but this one stands out for providing detailed estimates for deaths from nearly 30 types of cancer in all 3,100 U.S. counties over 35 years.

The variations in county is at least partially explained by differences in risk factors, socioeconomic factors, and access to high-quality cancer management.

According to research published recently in the Journal of the American Medical Association, U.S. cancer death rates have steadily climbed in parts of the country struggling with obesity, heavy smoking and socioeconomic ills, a stark contrast with the national trend and improvements in wealthier pockets of the country.

For example, smoking rates have declined in the United States, but this decline varies by location.

For lung cancer deaths, which are directly related to smoking, four of the five counties with the highest 2014 rates were in eastern Kentucky, where adult smoking rates are the second highest in the country at 26.2 percent.

Similarly, while obesity, which has been well established as a risk factor for several cancers, has increased in recent years throughout the United States, the rate of increase varied widely.

Moreover, access to and the quality of available healthcare varies widely among states and different socioeconomic groups.

County Data Provides Critical Information For Future Improvement

The overall decrease in cancer deaths over the past 35 years is certainly to be celebrated, but there is, especially in certain parts of the country, some glaring deficiencies that must be addressed.

Because public health programs and policies are mainly designed and implemented at the local level, the county level data in this study will prove very valuable for identifying cancer hot spots that need more investigation to understand the root causes, and for healthcare clinicians to understand and better meet the care needs of the community with a focus on cancer prevention.


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