Cancer Death Rates Vary Across Congressional Districts

Cancer death rates are declining all over the United States, but the first analysis of cancer death rates across congressional districts reveals large geographical differences.

Across all congressional districts in the nation, there was an overall decrease in cancer deaths during the past 25 years, with most districts showing a 20%-45% decline among males and a 10%-40% decline among females.

The decrease in death rates, however, was not uniform. The highest declines were observed in regions along the southern coast and border while the smallest drop in rates was in the Midwest and in some areas of the South, including Appalachia.

Disparities in cancer death rates were also observed when examined by race and ethnicity.

The study, published online May 9 in the journal Cancer, comes from researchers with the American Cancer Society (ACS) in Atlanta.

"The good news is overall cancer death rates declined for both men and women in all congressional districts," said lead author Farhad Islami, MD, PhD, senior scientific director for cancer disparity research at the ACS, in a statement. "However, we saw substantial disparities in progress against cancer mortality across congressional districts."

He pointed out that although the decline in death rates from cancer was most pronounced for Black men, overall cancer mortality continues to remain substantially higher among Black people compared with other populations. "We also found the number of districts with the greatest relative declines in overall cancer death rates was larger among Hispanic people than White people," Islami said. "But paradoxically, Hispanic people also had the largest number of districts with no or smallest relative declines in rates."

Commenting on the study, Lisa A. Lacasse, president of the American Cancer Society Cancer Action Network (the nonprofit arm of the ACS), said this analysis "shows how critical public policy interventions are to reduce persistent disparities nationwide."

"Elected officials play a very important role in helping to reduce the cancer burden, and further progress requires lawmakers to advance policies that help close these gaps and improve access to prevention and early detection services," she said in a statement. This includes advocating for increased federal and state funding for the National Breast and Cervical Cancer Early Detection Program and tobacco control programs, expanding Medicaid in the 10 remaining states that have not done so, and passing the federal Prostate-Specific Antigen Screening for High-Risk Insured Men Act.

"Taking these steps will bring us closer to our vision of ending cancer as we know it, for everyone," Lacasse stated.

Study Details

Islami and colleagues looked at cancer mortality and population data for 436 congressional districts using data from the National Center for Health Statistics to estimate relative change in age-standardized cancer death rates from 1996-2003 to 2012-2020. The authors noted that this is the first published study to look at disparities in reducing cancer death rates by congressional district as well as providing data for four common causes of cancer death and by race/ethnicity.

The team also broke down data by the four most common cancer types:

• Lung cancer: The biggest reduction in death rates due to lung cancer were among males across all congressional districts, with declines ranging from 21%-72% since 1996. Regions with weaker tobacco control laws, such as the Midwest and South, showed smaller reductions. The latest data show the highest lung cancer deaths among both men and women are clustered in the Midwest and South.

• Colorectal cancer: Historically, death rates from colorectal cancer were generally scattered in the Northeast, South, and lower Midwest, but a shift over the past quarter century now shows the highest associated death rates are found around the Mississippi River Valley in the South and in Appalachia.

• Breast cancer: Death rates from female breast cancer have dropped across the country, ranging from 13.6% to 57.7%. The congressional districts along the East Coast and southern US, which traditionally had the highest death rates, showed the largest decrease in mortality. Conversely, districts in the South and East North-Central section of the Midwest are now showing higher death rates.

• Prostate cancer: Similar to what was seen with breast cancer in women, the districts which had previously seen the highest death rates from prostate cancer — those along the East Coast and in the South — saw the largest declines. Relative decreases across the US ranged from 25% to more than 68% in some areas, and those with the highest death rates currently are concentrated in the South and West.

The study was funded by the American Cancer Society. All authors are employed by the American Cancer Society. Islami reports travel funding from the International Society of Oncology Pharmacy Practitioners.

Cancer. Published online  May 9, 2023. Abstract

Roxanne Nelson is a registered nurse and an award-winning medical writer who has written for many major news outlets and is a regular contributor to Medscape.

For more from Medscape Oncology, join us on Twitter and Facebook

Medscape Medical News © 2023  WebMD, LLC

Send news tips to news@medscape.net.

Cite this: Cancer Death Rates Vary Across Congressional Districts - Medscape - May 12, 2023.