US sEES GAINS IN CANCER MORTALITY, BUT NOT EVERYWHERE

By Kelly Young. NEJM. 

Cancer deaths have dropped substantially in the U.S. over the past 30 years, but not every area of the country has benefited, according to new estimates in JAMA. Using data from the National Center for Health Statistics and the Census Bureau, researchers tracked county-level trends in cancer mortality from 1980 to 2014.

Overall, cancer mortality rates fell 20%, from 240 to 192 deaths per 100,000 population, but there was substantial geographic variability. Among the findings:

• Summit County, Colorado, had the lowest cancer mortality rate in 2014, at 71 deaths per 100,000. 
• Union County, Florida, had the highest rate, 503 per 100,000. Union saw 39% and 52% increases in testicular cancer and pancreatic cancer mortality and had the highest colorectal cancer mortality rate.
• Liver cancer mortality increased 88% nationwide.
• Clusters of high breast and lung cancer mortality occurred in the South and Appalachia. 

Editorialists conclude that without evidence-based interventions with local stakeholder buy-in, these geographic trends "are likely to persist, leaving millions of people without the benefits of proven anticancer strategies to continue to experience unnecessarily high morbidity and mortality from cancer."

JAMA article (Free)

JAMA editorial (Subscription required)

Background: Physician's First Watch coverage of drop in cancer mortality(Free)