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 23 February 2018

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News

Disparities in cancer mortality among counties in the USA

This week's issue of the Journal of the American Medical Association examined the trends and differences in cancer mortality rates among United States counties from 1980 to 2014.

News image

Cancer is a leading cause of morbidity and mortality in the United States and results in a high economic burden.

Dr Christopher Murray and colleagues estimated age-standardized mortality rates by US county from 29 cancers.

The team performed a population-based modeling study of deidentified death records from the National Center for Health Statistics (NCHS), and population counts from the Census Bureau, the NCHS, and the Human Mortality Database from 1980 to 2014. 

Validated small area estimation models were used to estimate county-level mortality rates from 29 cancers, including the lip and oral cavity, nasopharynx, other pharynx, esophageal, stomach, colon and rectum, liver, gallbladder and biliary, and pancreatic.

The team's main outcomes were age-standardized cancer mortality rates by county, year, sex, and cancer type.

The research team found that a total of 19,511,910 cancer deaths were recorded in the United States between 1980 and 2014, including 2,484,476 due to colon and rectum cancer, 1,157,878 due to pancreatic cancer, and 487,518 due to liver cancer.

Liver cancer was high along the Texas-Mexico border
Journal of the American Medical Association
The researchers observed that cancer mortality decreased by 20% between 1980 and 2014, from 240 to 192 deaths per 100,000 population. 

There were large differences in the mortality rate among counties throughout the period.

The research team found that in 1980, cancer mortality ranged from 131 per 100?000 population in Summit County, Colorado, to 387 in North Slope Borough, Alaska, and in 2014 from 71 in Summit County, Colorado, to 503 in Union County, Florida. 

For many cancers, the team observed distinct clusters of counties with especially high mortality. 

The researchers report that the location of these clusters varied by type of cancer and were spread in different regions of the United States. 

For example, the team found that liver cancer was high along the Texas-Mexico border.

Dr Murray's team comments, "Cancer mortality declined overall in the United States between 1980 and 2014."

"Over this same period, there were important changes in trends, patterns, and differences in cancer mortality among US counties."

"These patterns may inform further research into improving prevention and treatment."

JAMA 2017; 317(4): 388-406
27 January 2017

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