Investigators recommend prioritized screening in certain pockets of the United States that have been statistically identified as colorectal cancer (CRC) death hotspots.

Although CRC death rates have declined by approximately 50% since 1970, advanced spatial analyses showed large geographical disparities in the United States with excessive deaths from CRC, according to an article published ahead of print in the Cancer Epidemiology Biomarkers & Prevention journal.

Researchers identified three distinct CRC “hotspots,” where death rates from 2009 to 2001 were 40% higher than non-hot spot rates.

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These occurred in Arkansas, Illinois, Kentucky, Louisiana, Mississippi, Missouri, and Tennessee (RR, 1,40; 95% CI, 1.34-1.46). Interestingly, rates in these areas were 18% lower than non-hotspot areas during 1970 to 1972 (RR, 0.82; 95% CI, 0.78-0.86).

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Rates among black men in the Delta area increased steadily by 3.5% per year from 1970 to 1990. West central Appalachia and eastern Virginia/North Carolina were 18% and 9% higher than non-hotspot areas in the United States during 2009 to 2011.


  1. Siegal RL, Sahar L, Robbins A, Jemal A. Where can colorectal cancer screening interventions have the most impact? Cancer Epidemiol Biom Prev. 2015. [epub ahead of print]. doi: 10.1158/1055-9965.EPI-15-0082.