Cancer Deaths Decline Unevenly Across US

Between 1991 and 2019, U.S. cancer mortality decreased by approximately 32%, yet this improvement has not been consistent across all regions. New research reveals that urban and coastal counties, generally with higher incomes, have seen the most substantial reductions in cancer deaths. In contrast, rural and lower-income counties have experienced less significant declines, exacerbating existing health disparities.

The gap in cancer mortality improvements between affluent and impoverished areas widened considerably. By 2019, the top 10% of highest-income counties showed roughly seven times greater mortality improvement compared to the lowest-income counties. Major urban centers on the Atlantic and Pacific coasts consistently reported high rates of cancer improvement, while rural and smaller interior cities lagged behind.

Factors contributing to these declines include reduced tobacco use, enhanced cancer screenings, and improved treatments. For instance, Manhattan saw a 60% reduction in its lung cancer rate, falling from 49 per 100,000 in 1991 to 19.6 by 2019. Experts suggest that more aggressive preventive measures and accessible healthcare in wealthier areas play a crucial role.

However, the study acknowledges limitations, noting that county-level data may not reflect individual outcomes and that unmeasured factors like lifestyle and healthcare access can influence mortality. The varying pace of adopting life-saving interventions across different geographic locations may be producing these increasing disparities.