Cancer Rates Are Falling in Appalachia, But Not Enough

Appalachia has a rich history and gorgeous landscapes, but it has also experienced rates of cancer incidence and death that outstrip those of much of the rest of America.

However, new data offer hope to the 26 million people living in the region: Cancer rates are falling, although not as steeply as elsewhere in America.

Still, “there are reasons for hope and opportunities to increase access to preventive care in at-risk populations throughout Appalachia,” said study senior author Dr. B. Mark Evers, who directs the Markey Cancer Center at the University of Kentucky.

He believes experts can “learn from this data where to focus on some of these problems that have been persistent for decades.”

The new data were published Feb. 6 in the Journal of the American College of Surgeons.

The research team defined Appalachia as 423 counties across 13 states near the eastern seaboard, from Mississippi to southern New York.

Evers and colleagues looked at data on cancer incidence and death for the region from 2004 through 2021. The data came from sources such as the U.S. Census Bureau, the U.S. Cancer Statistics Incidence Analytics Database and the National Center for Health Statistics.

Some of the findings were grim: For example, between 2017 and 2021, Americans living in Appalachia were 5.6% more likely to be diagnosed with cancer and 12.8% more likely to die from the disease, compared to folks living outside the region.

Those trends included tumors for which screening is available: breast, colorectal, cervical and lung cancers.

However, rates of cancer incidence and death are going down, if slowly, in Appalachia.

Rates of new cases in Appalachia have been declining by a third of a percentage point per year, the data showed, and rates of cancer death have dropped by an average of 1.39% annually.

Still, those rates of decline are below those seen in the rest of the nation, where the rate of cancer incidence is falling by 0.55% per year and the rate of cancer death is declining by 1.67% annually.

The researchers noted that Appalachia is also not a monolith, with cancer more of a threat in some areas than others.

“The experiences of people living in different regions of Appalachia, particularly in the coal mining areas of eastern Kentucky or West Virginia, are vastly different than it is for individuals in other places,” lead author Todd Burus, a data scientist at the Markey Cancer Center, noted.

Trends also varied greatly based on cancer type. For example, cases of certain liver/bile duct cancer cases rose about 3.8% per year between 2004 and 2021 in Appalachia, the data showed. That’s almost twice as fast as outside the region.

These types of tumors are closely tied to hepatitis C infection, which is often contracted through illicit intravenous drug use — a scourge that’s plagued the region for decades.

Appalachia may be lagging behind the rest of the country in cancer prevention for many reasons, the researchers said. Some longstanding issues include higher poverty rates, poorer access to care in rural communities and the aftereffects of coal mining and other hazardous industries.

Obesity rates are also relatively high (obesity is a risk factor for numerous cancers), the authors said, and rates of vaccination against HPV (linked to a number of tumor types) are lower than elsewhere in the country.

The new information is crucial to turning those trends around, however.

“Being able to understand where these disparities exist at the county level within Appalachia allows us to better focus our screening techniques and prevention strategies,” Evers said.

There’s real reason for hope, he added.

Evers pointed to recent efforts at boosting lung cancer screening in Kentucky, for example, which may have played a role in reducing lung cancer deaths in that state by 2.5%.

More information

Find out more about how you can help prevent cancer at the American Cancer Society.

SOURCE: American College of Surgeons, news release, Feb. 6, 2025

Source: HealthDay