Big Differences in Colorectal Cancer Deaths Among States

Colorectal screening rates are linked to changing colorectal cancer death rates, with death rates going down fastest in US states with the highest screening rates.

Between 1990 and 2007, the highest colorectal cancer death rates have moved from the Northeastern states to the South, particularly along the Appalachian mountain corridor.

Although death rates are declining in all states except Mississippi and Wyoming, drops range from 9 percent in Alabama to more than 33 percent in New York, Massachusetts, Rhode Island, and Alaska.

In the years between 1990 and 1994, national death rates from colorectal cancer were 29.7 per 100,000 people.  By 2004 through 2007, rates had fallen to 17.6 per 100,000.  Nationally, rates fell even more rapidly from 2003 through 2007, with declines of 3 percent a year, which researchers attribute to increases in colorectal cancer screening.

• In Massachusetts, rates fell from 27.2/1000 in the earlier period to 18.2/100,000 between 2003 and 2007.
• Rhode Island had a similar steep decline with rates falling from 26.3 to 17.1.
• In Mississippi and Wyoming, rates didn’t change.

Poverty and lack of insurance also probably played a role:

• 18 percent of people in Mississippi lack health insurance compared to 5 percent in Massachusetts
• While the national poverty rate is 13 percent, 20 percent of Mississippi residents live below the poverty line.

Dr. Ahmedin Jemal of the American Cancer Society, who led the study reported this week in Cancer Epidemiology, Biomarkers and Prevention said,

That’s a key point. Poverty affects not only access to screening and treatment but also prevalence of known risk factors for colorectal cancer, including smoking and obesity.

Dr. Jemal, Deepa Naishadham, and their colleagues concluded,

Progress in reducing CRC mortality varies across states, with the Northeast showing the most progress and the South showing the least progress.

SOURCE

Naishadham et al,  State Disparities in Colorectal Cancer Mortality Patterns in the United States,Cancer Epidemiology, Biomarkers, and Prevention,Volume 20, Issue 7, July 2011.  doi: 10.1158/1055-9965.EPI-11-0250