Could where you live determine your fate? Dying from cancer

By LINDSEY TANNER

AP Medical Writer

CHICAGO

Americans in certain struggling parts of the country are dying from cancer at rising rates, even as the cancer death rate nationwide continues to fall, an exhaustive new analysis has found.

In parts of the country that are relatively poor, and have higher rates of obesity and smoking, cancer death rates rose nearly 50 percent, while wealthier pockets of the country saw death rates fall by nearly half.

Better screening and treatment have contributed to the improvement in the nation as a whole – but the study underscores that not all Americans have benefited from these advances.

“We are going in the wrong direction,” said Ali Mokdad, the study’s lead author and a professor at the University of Washington’s Institute for Health Metrics and Evaluation. “We should be going forward, not backward.”

Stark differences in regional cancer death rates have been found in previous research, but this one stands out for providing detailed estimates for deaths from nearly 30 types of cancer in all 3,100 U.S. counties over 35 years.

From 1980 to 2014, the U.S. death rate per 100,000 people for all cancers combined dropped from about 240 to 192 – a 20 percent decline. More than 19 million Americans died from cancer during that time, the study found.

The picture was rosiest in Colorado ski country, where cancer deaths per 100,000 residents dropped by almost half, from 130 in 1980 to just 70 in 2014; and bleakest in some eastern Kentucky counties, where they soared by up to 45 percent.

The Affordable Care Act took effect in the study’s final years and emphasized prevention services including no-cost screenings for breast, colorectal and cervical cancers. Any resulting benefits wouldn’t be evident in the latest results, since cancer takes years to develop. It’s unknown whether similar coverage will be part of the replacement system the Trump administration and Congressional Republicans are seeking.

An editorial published with the study by Stephanie Wheeler, a University of North Carolina health policy specialist and Dr. Ethan Basch, a University of North Carolina cancer specialist, notes that many areas with the highest cancer death rates also strongly supported Donald Trump, “raising hopes that future policies developed by the incoming administration will provide resources” for these communities.

Researchers estimated county death rates using U.S. government death records and U.S. Census Bureau data. Results were published in the Journal of the American Medical Association.