According to a new report from the Centers for Disease Control and Prevention (CDC), rates of cancer-related deaths are higher for people living in rural regions of America, compared with rates for those living in urban areas (180 deaths vs. 158 deaths per 100,000 people).
While disparities in cancer incidence could arise from risk factors such as obesity, smoking, and a lack of physical activity, the researchers noted that the observed disparities in cancer mortality are likely associated with limited access to health care – contributing to a lack of timely diagnosis and treatment.
The researchers analyzed data from the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) program to calculate the average age-adjusted annual incidence rates for 2004-2013, and data from the National Vital Statistics System to calculate average annual age-adjusted death rates for 2011-2015 (the most recent 5-year period for which data were available).
They found that nonmetropolitan rural areas had lower average annual age-adjusted cancer incidence rates than urban areas (442.4 vs. 455.0 per 100,000 persons). However, rural-dwellers had higher cancer-related death rates (180.4 vs. 177.2 per 100,000 persons). Also, the annual age-adjusted mortality rates "decreased at a slower pace in nonmetropolitan areas (-1.0% per year) than in metropolitan areas (-1.6% per year), increasing the differences in these rates," the authors added.
A higher percentage of rural Americans also lack health insurance, further limiting their access to preventative care.
"While geography alone can't predict your risk of cancer, it can impact prevention, diagnosis, and treatment opportunities – and that's a significant public health problem in the United States," the CDC's acting director, Anne Schuchat, said in a statement addressing the report's findings. "Many cancer cases and deaths are preventable, and with targeted public health efforts and interventions, we can close the growing gap between rural and urban Americans."
Sources: Henley SJ, Anderson RN, Thomas CC, et al. Invasive cancer incidence, 2004–2013, and deaths, 2006–2015, in nonmetropolitan and metropolitan counties â€” United States. Surveillance Summaries. 2017;66:1-13; The Washington Post, July 6, 2017.