Cancer incidence and deaths remain higher in Appalachia despite progress

Cancer incidence and deaths remain higher in Appalachia despite progress

Fewer people are being diagnosed and dying from cancer than before in Appalachia and cancer mortality rates.

The results, published in theJournal of the American College of Surgeons (JACS)Reflect the most current cancer data from the Appalachian region and include detailed analysis in Appalachia by county.

The Appalachian region, consisting of 423 counties along the eastern coast from Mississippi to southern New York, includes a population of more than 26 million. Unfortunately, the region's rich folk culture and natural landscape also include significant differences in cancer rates in recent decades. However, previous research has not focused on detailed county-level data, the authors said.

The Appalachian region is so large that to think of it as monolithic is probably short-sighted. The experiences of people living in different regions of Appalachia, particularly the coal-mining regions of eastern Kentucky or West Virginia, differ greatly from those of individuals in other locations. With this research, we sought to understand these unique regional differences to learn how we can better improve cancer screening and treatment strategies. “

Todd Burus, MAS, data scientist at the University of Kentucky Markey Cancer Center and lead author of theJACSstudy

Some progress, but not enough

Using data from the U.S. Census Bureau, the U.S. Cancer Statistics Incidence Analysis Database, and the National Center for Health Statistics, the authors examined overall cancer trends from 2017 to 2021 and 2004 to 2021. Some of their key findings. was:

• Ein höheres Krebsrisiko: Von 2017 bis 2021 wurden in der Region Appalachian leben mit 5,6% höherer Wahrscheinlichkeit an Krebs diagnostiziert und 12,8% häufiger an Krebs sterben als bei Menschen außerhalb der Appalachenregion.
• Höhere Sterblichkeitsraten von Krebserkrankungen, die routinemäßig untersucht werden: Obwohl sich die Region bei den Screening -Raten verbessert hat, sterben immer noch mehr Menschen an Krebsarten, die in Appalachia im Vergleich zu anderen US -Regionen außerhalb von Appalachia früh an Krebsarten sterben können (Brust, kolorektal, zervikal und lunge).
• Variationen zwischen Appalachen -Subregionen: 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, Forscher sagten.
• In Bezug auf den Anstieg in Leber und im späten Stadium zervikaler Krebserkrankungen: Zwischen 2004 und 2021 nahm die Anzahl der Personen, bei denen Krebserkrankungen von Leber und intrahepatischen Gallengang diagnostiziert wurden, bei Appalachia dramatisch zu – um etwa 3,77% pro Jahr, was fast doppelt so schnell ist wie außerhalb der Appalachian -Region. Diese Krebsarten sind mit chronischer Hepatitis C verbunden, einer Lebererkrankung, die mit dem intravenösen Drogenkonsum verbunden ist. Die Raten der Inzidenz des Gebärmutterhalses im späten Stadium, die am häufigsten durch das menschliche Papillomavirus (HPV) verursacht wird und durch Routine-Screening und -impfung weitgehend vermeidbar ist, erhöhte sich in der Appalachian-Region ebenfalls um 0,51% pro Jahr, während sie in anderen Teilen der statisch statisch bleiben UNS
• Einige Fortschritte, aber nicht genug: Die Gesamtquoten der Krebsinzidenz (-0,33%) und die Todesfälle (-1,39%) sinken bei Appalachia, sinken jedoch nicht so schnell wie Gebiete außerhalb von Appalachia. In Regionen außerhalb von Appalachia gingen die Krebsinzidenzraten von 2004 bis 2021 um 0,55% und die Sterblichkeitsraten von 2004 bis 2020 um 1,67% zurück.

Targeted strategies can improve care

Reasons for these disparities are complex and arise from limited access to care in rural areas, historical occupational risks from coal mining and other hazardous industries, and higher rates of poverty, the authors noted. Other factors, such as higher prevalence of obesity, smoking, and lower HPV vaccination rates, also likely contribute to the widened disparities. Despite the differences, great strides can be made to close these gaps and improve care.

"From a clinical standpoint, "If we are able to understand where these county-level disparities exist within Appalachia, we can better focus our screening techniques and prevention strategies."

Dr. Evers cited recent public health initiatives that have helped boost Kentucky's lung cancer screening rates above the national average for at-risk patients. Lung cancer mortality rates in Appalachia have decreased by 2.5% and late-stage lung cancer rates have decreased by about 2.2%, with the advent of lung cancer screening recommendations tied to the U.S. Task ForceJACSPaper. These positive trends demonstrate whether public health campaigns and targeted interventions can have a positive impact on vulnerable populations, added Dr. Evers added.

“There are reasons for hope and opportunities to increase access to preventive care in vulnerable populations in Appalachia, particularly as we learn from this data where we can focus on some of these problems that have existed for decades,” said Dr. Evers.

Study co-author 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.

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