Where you live could shape your risk of cancer mortality, study suggests

While U.S. cancer deaths have been falling over the past couple of decades, certain parts of the country are seeing less improvement in those numbers.

New research published in the British Journal of Cancer assessed the differences in cancer mortality improvements across the country.

Researchers at Mississippi State’s Social Science Research Center, along with scientists at Oak Ridge National Laboratory, analyzed death certificates between 1981 and 2019 across nearly 3,000 U.S. counties.

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The data was drawn from WONDER (Wide-Ranging Online Data for Epidemiologic Research), which is operated by the CDC. More than 21.3 million cancer deaths were included in the records.

Overall, U.S. cancer mortality has declined by about 32% between 1991 and 2019, but not all areas experienced that level of improvement.

The highest rates of mortality decline and the biggest drop in excess deaths were seen in urban, coastal and higher-income counties, according to the study. Rural and lower-income counties had smaller declines in mortality.

“In a complex nation such as the U.S., we should not be too surprised that there are large differences in health outcomes shaped by the diversity and variety of local regions and groups,” Arthur G. Cosby, the study’s lead author, told Fox News Digital. He is a Giles Distinguished Professor Emeritus at Mississippi State. 

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“Cancer improvement over the last few decades certainly aligns with this perspective,” he said. 

The gap appeared to widen over time, researchers noted. By 2019, the top 10% highest-income counties had a roughly seven times greater mortality improvement than the lowest-income counties.

The large urban centers along both the Atlantic and Pacific coasts consistently had among the highest rates of cancer improvement, according to Cosby. Rural and smaller cities in the interior of the U.S. often had much lower rates.

“The magnitude of the mortality differences between coastal and inland regions, [and] the large differences between places with different income levels and rural/urban places, were larger than I anticipated,” Cosby said.

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“The link between improving health and increasing disparities is poorly understood. I am pursuing that question now,” he added.

The researchers pointed to several factors that could contribute to the declines in cancer mortality. These included a decline in tobacco use and improved cancer screenings and treatments.

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“Wealthy, metropolitan New York City has been aggressive in instituting tobacco control measures, and the results show,” Cosby noted. “Manhattan had a lung cancer rate of 49 per 100,000 in 1991. By 2019, it cut its rate to 19.6 — a 60% reduction.”

Dr. Marc Siegel, Fox News senior medical analyst, agreed that more aggressive preventive measures targeting smoking and alcohol use likely played a role in the sharper mortality decline in urban, affluent areas.

“More aggressive screening campaigns, including at major medical centers, can diagnose pre-cancers or cancers earlier,” Siegel, who was not involved in the study, told Fox News Digital.

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A focus on improved lifestyle habits and less exposure to environmental toxins could also play a role, he added.

The study had some limitations, as noted by the authors.

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Because the research was conducted at the county level, the results may not apply at the individual level. 

Also, unmeasured factors such as lifestyle behaviors and access to healthcare could impact mortality.

“There are many limitations associated with the use of death certificates in research, such as accuracy of cause of death, possible multiple causes and changes in medical explanation for death over time,” Cosby told Fox News Digital.

Based on the findings, the researchers are calling for more studies that take into account the significant variations that exist across the country.

“The varying speed of adoption of life-saving interventions between geographic places may produce increasing disparities,” Cosby said. “It is possible to have a situation where nearly all places are improving their cancer mortality, but at much different rates.”