Cancer Death Rates Continue to Decline, but Socioeconomic Gaps Widen
The continuous decline in cancer deaths over the past 25 years was attributed to improvements in screening, treatment.
However, in addition to racial disparities, this year's report also examined socioeconomic disparities, where the gap in cancer mortality is widening. The report noted that socioeconomic deprivation was actually linked with lower cancer mortality prior to the mid-1980s for 2 main reasons: lack of effective treatments overall and greater risk for lung and colorectal cancers among those in better socioeconomic situations.
In this year's report, the overall death rate was about 20% greater among people in the poorest counties compared with the most affluent counties. The biggest gaps were found across cancers that are considered the most preventable, Siegel noted.
“For example, the death rate for colorectal cancer used to be 20% lower in people living in poor counties in the early 1970s, but today is 30% higher,” Siegel said. “The gap for cervical cancer is even larger; death rates in women in poor counties are double those of women in affluent counties.”
These gaps reflect differences in access to preventive care, which includes lifestyle modification that might be discussed with primary care physicians, as well as screening, Siegel said.
Commenting on the study, American Society of Clinical Oncology President Monica M. Bertagnolli, MD, said the results were both encouraging and concerning.2
"Unfortunately, too many patients can't access high quality cancer care or contribute to research that increases our understanding of the disease,” Dr Bertagnolli said in a prepared statement. “The findings in this report reflect the sad truth that where a patient lives often dictates their chances of surviving cancer for a wide range of reasons. For example, ASCO's 2018 National Cancer Opinion Survey found that rural patients typically spend 50 minutes traveling one way to see their cancer doctor compared to 30 minutes for non-rural patients. This extra hardship is compounded in poorer counties where something as simple as a full gas tank can make the difference in a person's ability to get the care they need.”
- Siegel RL, Miller KD, Jemal A. Cancer statistics, 2019 [published online January 8, 2019]. CA Cancer J Clin. doi: 10.3322/caac.21551
- American Society of Clinical Oncology. Statement from American Society of Clinical Oncology (ASCO) President Monica M. Bertagnolli, MD, FACS, FASCO, on the American Cancer Society Cancer Facts and Figures 2019 Report [press release]. https://www.asco.org/advocacy-policy/asco-in-action/statement-american-society-clinical-oncology-asco-president-monica-m. Published January 9, 2019. Accessed February 6, 2019.