Rural-Urban Differences in Cancer Incidence Trends in the United States

December 6, 2017

Drs. Aimee James and Graham Colditz are co-authors of a publication discussing the differences in cancer incidence and mortality rates throughout the United States.

Associate Professor, Department of Surgery, School of Medicine
Niess-Gain Professor of Surgery and Division Chief, Public Health Sciences, School of Medicine; Deputy Director, Institute for Public Health, Washington University in St. Louis

Cancer is among the leading causes of death worldwide. While there has been some progress in decreasing the burden of cancer throughout the United States, this decline in incidence and mortality is more apparent in urban communities as opposed to rural communities.

Rural communities are more likely to live in poverty and have less access to cancer screenings. These communities also engage in high-risk behaviors such as smoking and physical inactivity, and consequently exhibit higher rates of cancer mortality.  The authors of the study sought to better understand national rural-urban differences in cancer incidence and trends in order to improve policy strategies and interventions that may help reduce such cancer disparities.

Trends in annual age-adjusted incidence rates among persons of all ages for common cancers in nonmetropolitan and metropolitan counties, as studied by the CDC.

The authors analyzed population-based cancer incidence statistics from 46 states, as recorded by the North American Association of Central Cancer Registries’ public use dataset. They calculated age-adjusted incidence rates, rate ratios, and annual percentage change for all cancers.  Also, the authors examined cancers by those with screening mechanisms and/or modifiable risk factors, such as colorectal and cervical cancers, as well as cancers associated with tobacco use and human papillomavirus (HPV).

As a result, the authors found that rural populations had slightly lower overall cancer incidence than that of urban populations. However, the rural communities showed higher rates of tobacco-associated and HPV-associated cancers, as well as colorectal, cervical, lung, and bronchus cancers.

The disparities in cancer incidence are evident, and demonstrate the need for improved policy and interventions to better target rural populations.  Specifically, the findings suggest improvements in tobacco policy changes and promotion of both screening interventions and HPV vaccinations. In conclusion, the authors advocate for continued research on rural-urban cancer disparities in order to successfully reduce cancer incidence and mortality, and to ultimately promote health equity throughout the country.

Read the full study published July 27, 2017 by the American Association for Cancer Research.