Overall cancer mortality decreased in the United States between 1980 and 2014. Important changes in trends, patterns, and differences in mortality rates occurred in different counties in the United States during this time period.1

Cancer results in high economic burden and is a leading cause of mortality and morbidity in the United States.

For this study, researchers examined de-identified death records from the National Center for Health Statistics (NCHS) and population counts from the Census Bureau, the NCHS, and the Human Mortality Database. All data were from 1980 to 2014. Using county of residence as the exposure in this study, they analyzed age-standardized cancer mortality rates by county, year, sex, and type of cancer. The study results involve a total of 29 different types of cancer.

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Between 1980 and 2014, 19,511,910 deaths from cancer were recorded in the United States. Of these, 5,656,423 deaths were due to tracheal, bronchus, and lung cancer; 2,484,476 were due to colon and rectum cancer; 1,573,593 were due to breast cancer; 1,077,030 were due to prostate cancer; 1,157,878 were due to pancreatic cancer; 209,314 were due to uterine cancer; 421,628 were due to kidney cancer; 487,518 were due to liver cancer; 13,927 were due to testicular cancer; and 829,396 were due to non-Hodgkin lymphoma.

Cancer mortality decreased by 20.1% (95% CI, 18.2-21.4) between 1980 and 2014. In 1980, cancer deaths occurred in 240.2 (95% CI, 235.8-244.1) per 100,000 persons. By 2014, the rate had declined to 192.0 (95% CI, 188.6-197.7) per 100,000 persons.

Large differences in mortality rates were seen among counties. For example, in 1980, cancer mortality rate in Summit County, Colorado, was 130.6 per 100,000 persons, whereas it was 386.9 per 100,000 persons in North Slope Borough, Alaska. In 2014, cancer mortality rate was 70.7 per 100,000 persons in Summit County, Colorado, but 503.1 per 100,000 persons in Union County, Florida.

In addition, rates for many cancers exhibited distinct clusters in counties with particularly high mortality rates.

“For many cancers, there were distinct clusters of counties with especially high mortality. The location of these clusters varied by type of cancer and were spread in different regions of the United States,” wrote the investigators.

“Clusters of breast cancer were present in the southern belt and along the Mississippi River, while liver cancer was high along the Texas-Mexico border, and clusters of kidney cancer were observed in North and South Dakota and counties in West Virginia, Ohio, Indiana, Louisiana, Oklahoma, Texas, Alaska, and Illinois.”


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 Jan 24. doi: 10.1001/jama.2016.20324