Between 1980 and 2014, overall cancer mortality declined in the United States, though there were clusters of counties with high mortality, according to a study published in JAMA.1

In recent decades, overall cancer mortality rates declined in the United States, but disparities in cancer mortality persist.

To estimate age-standardized mortality rates by US county from 29 cancers, researchers analyzed data from de-identified deaths records from 1980 to 2014.

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There were 19,511,910 cancer-related deaths in the United States in the 35-year period, including 5,656,423 from cancers of the trachea, bronchus, and lung, 2,484,476 from colorectal cancer, 1,573,593 from breast cancer, 1,157,878 from pancreatic cancer, 1,077,030 from prostate cancer, 829,396 from non-Hodgkin lymphoma, 487,518 from liver cancer, 421,628 from kidney cancer, 209,314 from uterine cancer, and 13,927 from testicular cancer.

Cancer mortality declined by 20.1% between 1980 and 2014, from 240.2 to 192.0 deaths per 100,000 people. There were, however, differences in the mortality rate among counties throughout the study period.

In 1980, cancer-related mortality ranged from 130.6 per 100,000 in Summit County, Colorado, to 386.9 in North Slope Borough, Alaska. In 2014, cancer-related mortality ranged from 70.7 in Summit County, Colorado, to 503.1 per 100,000 in Union County, Florida.

Clusters of counties in the southern belt and along the Mississippi River had particularly high breast cancer-related mortality, while liver cancer-related mortality was high along the Texas-Mexico border.

Areas of high kidney cancer-related mortality were found in North and South Dakota and counties in Alaska, Illinois, Indiana, Louisiana, Ohio, Oklahoma, Texas, and West Virginia.

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The authors offered several explanations for the high rates of cancer-related mortality in particular regions and counties, including a combination of risk factor profiles and poor prevention/screening programs.


  1. Mokdad AH, Dwyer-Lindgren L, Fitzmaurice C, et al. Trends and patterns of disparities in cancer mortality among US counties, 1980-2014. JAMA. 2017;317(4):388-406.