Lag in Progress Against Lung CA Mortality in Midwest, Appalachia

Findings based on rates among women versus steady decline seen nationally
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FRIDAY, March 30, 2018 (HealthDay News) -- In the Midwest and Appalachia there are areas where progress against lung cancer mortality among women is lagging compared with the rest of the nation, according to a study published March 30 in Cancer Epidemiology, Biomarkers & Prevention.

Katherine Ross, M.P.H., from Emory University in Atlanta, and colleagues used county-level lung cancer death rates among women from the National Center for Health Statistics mortality file and calculated relative changes from 1990-1999 to 2006-2015.

The researchers identified two distinct clusters of counties: 669 in Appalachia and the Midwest (Hotspot 1) and 81 in the northern Midwest (Hotspot 2). Death rates among women increased by 13 percent in Hotspot 1 and by 7 percent in Hotspot 2 counties from 1990-1999 to 2006-2015, while rates decreased by 6 percent in the non-hotspot United States. Over the entire study period, death rate ratios (RRs) for Hotspot 1 counties increased from 4 percent lower (RR, 0.96; 95 percent confidence interval [CI], 0.94 to 0.99) to 28 percent higher [RR, 1.28; 95 percent CI, 1.25 to 1.31]). For Hotspot 2 counties, the change was from 18 percent lower (RR, 0.82; 95 percent CI, 0.76 to 0.89) to unity (RR, 0.99; 95 percent CI, 0.93 to 1.05).

"Targeted tobacco control programs could reduce the excess burden of lung cancer among women living in hotspot counties and prevent widening geographic inequity," the authors write.

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