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Cancer Incidence and Deaths Still Higher in Appalachia Despite Progress

Greater risk of cancer: from 2017 to‌ 2021, people living in the Appalachian region were 5.6% more ‍likely to be diagnosed with cancer and 12.8% more likely to die from⁢ cancer compared to those in other ⁤regions.

PDF Health Disparities in‍ Appalachia: Mortality‌ (PDF: 6.5 MB)

• In ⁣85 percent of Appalachian counties, cancer mortality rates are higher than the ⁢national average.
• In Central ⁣Appalachia, 81 of ⁤the subregion’s 82 counties have cancer mortality‌ rates higher than the national rate.
• The cancer mortality rate for the Appalachian ⁤Region’s rural counties is ⁤15 percent higher.

Lung and Colorectal Cancer Disparities in Appalachian‌ Kentucky: Spatial

• The 2021 Kentucky Cancer Needs Assessment‌ reported that age-adjusted cancer incidence was substantially higher in the Appalachian Kentucky population relative to Kentucky for colorectal and lung cancer, with increases of 12.2% and⁣ 18.4%,respectively.

Within Appalachia,the Central subregion – predominately eastern Kentucky with parts of⁤ Virginia,Tennessee,and West Virginia – had the highest rates of cancer incidence and deaths,highlighting the need to ‍increase outreach and research in these areas to better⁢ understand and reduce these disparities,researchers said.

Concerning upticks in liver and late-stage cervical cancers:

• Between 2004 and 2021, the number of people diagnosed with liver and intrahepatic bile duct cancers dramatically increased ⁢in Appalachia⁣ – by about 3.77% per year, which is almost twice as fast as outside ⁤of the Appalachian region. These ‍cancers are associated with chronic hepatitis C, a liver disease associated with intravenous drug use.
• Rates of late-stage ⁢cervical⁢ cancer incidence,⁢ which is moast frequently enough caused by the⁢ human papillomavirus (HPV) and is largely preventable with routine screening and vaccination, also increased by 0.51% per year in the Appalachian region ‌while remaining static in other parts of the U.S.

Some progress, but ⁢not enough:

• Overall rates of cancer incidence (-0.33%) and deaths (-1.39%) are decreasing in Appalachia, but they aren’t declining⁢ as fast as areas outside of Appalachia.
• In⁣ regions outside of ​Appalachia, cancer incidence rates⁣ decreased by ​0.55% from 2004 to 2021 and death⁢ rates decreased by 1.67% from 2004 to 2020.

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Targeted‍ strategies can improve⁤ care

Reasons for these‍ disparities are complex, stemming from limited access to care in rural⁣ regions, ancient occupational risks from coal mining and other hazardous industries, and⁣ higher‍ poverty rates, the authors noted. Other factors, such as higher prevalence ⁤of obesity, smoking, and lower HPV vaccination rates, also likely contribute to the widening disparities. Although the disparities are concerning, great strides can be made to close these​ gaps and improve care, they added.

“from a clinical⁢ standpoint,its vital for us‌ to ⁤understand the differences in cancer care and overall rates depending upon ‍the region of Appalachia,” said‍ B. Mark Evers, MD, FACS, senior​ author of the study and director of the Markey ​Cancer Center.”Being able ⁤to understand where these disparities exist ‌at the county level within Appalachia allows ⁤us to better focus our screening techniques and prevention strategies.”

Dr. Evers cited recent public⁣ health initiatives⁢ that helped boost lung cancer screening rates in ​Kentucky above the​ national average, which is associated with the advent of lung cancer⁤ screening recommendations from the⁢ U.S. Preventive services Task Force, according to the JACS paper.These positive trends demonstrate the influence that public health ⁢campaigns and targeted interventions can have on at-risk populations,Dr. Evers added.

“There are reasons ‍for hope and opportunities to increase access to preventive care in at-risk populations throughout Appalachia, especially as we learn from this data where⁢ to focus ‌on some of these problems that have been persistent for decades,” Dr. Evers said.

Study coauthors​ with Dr. Evers and Mr. Burus are: Pamela C.Hull, PhD; Krystle A. lang Kuhs, PhD, MPH; Tianyan Gao, PhD; and ‍Christine F.Brainson, PhD.