Cancer death rates in rural America slower to decline compared to urban areas

By Dr. Ananya Mandal, MDJul 6 2017

According to the CDC, the cancer death rates nationwide have been on the decline. The reduction in these rates however is much slower in the rural areas than in other regions.

The figures came into notice at the CDC’s Morbidity and Mortality Weekly Report that is part of the series of MMWR studies on rural heath. It showed that while reduction rates for cancer deaths in 1.6% for urban areas, it is 1% in the rural areas. This report is the first complete report on cancer occurrence (incidence or new cases diagnosed) as well as deaths due to it comparing rural and urban America.

The report notes that rates of new cases for some cancers such as lung, colorectal and cervical were higher among residents of rural America. Breast cancers and prostate cancer incidence was however found to be lower among rural residents. Deaths due to lung, colorectal, prostate, and cervical cancers were higher among rural dwellers compared to their urban counterparts found the report.

Results revealed that deaths in the rural areas were higher than those in urban areas being 180 deaths and 158 deaths per 100,000 persons respectively. Further the rates of these deaths were slower to reduce in rural areas. Coming to the new cancer detection or incidence of cancer, the rates were lower in rural areas compared to urban areas with 442 cases and 457 cases per 100,000 persons respectively. Tobacco related cancers were noticeably higher among rural residents including lung cancers. Preventable cancers such as cervical cancers and colorectal cancers were also higher among rural residents the report noted.

CDC Acting Director Anne Schuchat, M.D. explained that cancer incidence cannot be predicted just by geography but how the cancer is being diagnosed, managed at early and later stages and how cancers are prevented differs in different regions. This discrepancy is a “significant public health problem in the U.S.” she added. There are several preventive measures that can be adopted by public health programmes that can reduce the incidence of cancers as well as deaths due to it in both rural and urban Americans and thereby bridge this gap she said.

For this report the analysts at the CDC looked at cancer incidence data from CDC’s National Program of Cancer Registries and the National Cancer Institute’s Surveillance, Epidemiology, and End Results program. Similarly they looked at cancer deaths in all regions from CDC’s National Vital Statistics System. Each of the counties were assessed and then classified according to their population size and degree of urbanization.

According to Lisa C. Richardson, M.D., oncologist and director of CDC’s Division of Cancer Prevention and Control, cancer detection, prevention and management is complicated and a team effort that includes several healthcare professionals as well as friends and family members. Community level interventions for preventing cancer are also a similar joint effort she explained. She emphasized that these numbers can be brought down and discrepancies may be done away with only if there are good partnerships and collaboration between different parties.

For the rural areas, the researchers suggest that some of the interventions that might help reduce cancer incidence and prevent it include reduction in use of tobacco and related products. Reduction of tobacco initiation and maintenance rates and stopping secondhand smoke exposure can go a long way say experts. Excessive sun exposure can be stopped with adequate health awareness and this may help reduce the risk of skin cancers. Physical activity and healthy eating should be fostered as that can prevent not only cancers but several other disease conditions as well. Another intervention that public health programmes can target is adequate vaccinations where possible. Examples include vaccination against cancer-related infectious diseases such as HPV and hepatitis B virus. Routine tests including Pap smears and colonoscopy are recommended for early detection of the cancers.