Cancer mortality risk higher among those residing outside metropolitan areas

November 17, 2023

2 min read

Key takeaways:

Socioeconomic disparities are a major contributor to racial disparities in U.S. cancer mortality rates.
Significant disparities occurred according to geographic location, particularly among younger individuals.

Cancer-related mortality and leading causes of cancer death occurred more frequently in nonmetropolitan areas and among individuals with limited education, according to biennial report from the American Cancer Society.

The 2023 version of the American Cancer Society’s report on the status of cancer disparities in the United States — published in CA: A Cancer Journal for Clinicians — also showed that Black and American Indian/Alaska Native individuals continued to bear a disproportionately higher burden of cancer-associated deaths.

Chicago cityscape — City dwellers had lower all-cancer mortality rates than their nonmetropolitan counterparts.
*Source: Adobe Stock.*

Farhad Islami

“Our research suggests a major role for socioeconomic disparities in racial disparities in cancer mortality,” Farhad Islami, MD, PhD, senior scientific director in cancer disparity research at the American Cancer Society, said in a press release. “It also shows substantial disparities in cancer occurrence and outcomes by geographic location, especially in younger ages.”

Current report

The society’s first biennial report, published in 2021, focused on the status of cancer disparities in the United States.

In the current report, experts provided an update on racial, ethnic, socioeconomic and geographic disparities in cancer occurrence and outcomes, as well as contributing factors to these disparities between 2016 and 2020.

Experts additionally reviewed programs that have reduced cancer disparities and suggested policy recommendations to further mitigate these inequalities.

Findings

Results showed higher rates of mortality from all cancers and leading causes of cancer death among individuals residing in nonmetropolitan areas compared with metropolitan areas.

For example, researchers observed 23% higher colorectal cancer mortality rates among men and 21% higher among women residing in nonmetropolitan areas vs. large metropolitan areas.

Moreover, results showed between 18% and 19% higher overall cancer mortality rates among Black and American Indian/Alaska Native men compared with white men.

Researchers observed a 16% higher rate among American Indian/Alaska Native women and a 12% higher rate among Black women compared with white women, despite a 7% lower incidence rate among American Indian/Alaska Native women and a 9% lower rate among Black women.

In addition, results showed between 60% and 180% higher cancer mortality rates among both Black and white men and women with 12 or fewer years of education vs. those with 16 or more years of education. Disparities in overall cancer mortality within each educational attainment between Black vs. white individuals ranged between 3% and 50% higher among the Black population, with the most significant disparities observed among those with 16 or more years of education.

Researchers additionally reported greater racial and geographic disparities in cancer mortality among those aged 65 years or younger vs. those aged 65 years or older.

Implications

“Many of the observed racial, socioeconomic and geographic disparities in cancer mortality align with disparities in exposure to risk factors and access to cancer prevention, early detection and treatment, which are largely rooted in fundamental inequities in social determinants of health,” Ahmedin Jemal, DVM, PhD, senior vice president of the department of surveillance and health equity science at the American Cancer Society, said in the release.

Ahmedin Jemal

“Overcoming these disparities will require equitable policies at all levels of government and broad interdisciplinary engagement to address fundamental inequities in social determinants of health,” Jemal added. “In the meantime, broad and equitable implementation of evidence-based interventions, such as comprehensive tobacco control programs in each state, can further mitigate cancer disparities in the U.S.”

References:

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Sources/Disclosures

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Disclosures:
Islami and Jemal report no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.