ASPO Abstracts
Trends in premature cancer mortality in the USA by race/ethnicity and county-level demographic factors
Category: Cancer Health Disparities, Lifestyles Behavior, Energy Balance & Chemoprevention
Conference Year: 2018
Abstract Body:
PURPOSE: Cancer is the leading cause of premature mortality in the USA, accounting for >25% of all deaths among persons aged 25-64. We aimed to describe trends in premature cancer mortality rates by race/ethnicity and county-level socioeconomic attributes. METHODS: The study included deaths from 1999-2014. Death certificate data and population denominators were from the US National Center for Health Statistics and Census Bureau, respectively. We estimated the age-adjusted premature cancer mortality rate per 100,000 person-years and the annual percent change (APC) in these rates by race/ethnicity (white, black, Hispanic, and Asian/Pacific Islander [API]) and quintiles of county-level attributes (median income, % unemployed, % Bachelor’s degree). RESULTS: Premature cancer mortality rates varied significantly by race/ethnicity with highest rates among blacks (114/100,000 in 2014) and lowest among APIs (52/100,000). Racial/ethnic groups with higher mortality had more rapid improvements in mortality (e.g., APCs: blacks -2.30%/year, [95% confidence interval: -2.38, -2.22] vs. API: -1.55%/year [-1.82,-1.27]). Within black and white sub-populations, persons living in the most advantaged counties had the lowest mortality rates and the most rapid declines in mortality. For example, among whites the premature cancer mortality rates in the highest and lowest income counties were 69 and 106/100,000 in 2014, and the APCs were 2.47%/year [-2.56,-2.37] and -0.94%/year [-1.05,-0.82]. Among blacks, the premature cancer mortality rates in the highest and lowest educated counties were 101 and 125/100,000 in 2014 and the APCs were -2.67%/year [-2.80, -2.53] and -2.11%/year [-2.32,-1.90]. CONCLUSIONS: Premature cancer mortality rates among persons aged 25-64 declined during 1999-2014 and racial/ethnic mortality differences narrowed. Within race/ethnicities, however, county-level differences in premature cancer mortality grew, as the most advantaged counties improved at a faster rate than the least advantaged. Despite widespread cancer mortality declines, there remain substantial and growing disparities between counties with high and low socioeconomic attributes within racial/ethnic groups.
Keywords: Cancer mortality; trends; race/ethnicity; county-level trends