Cancer Death Rates Vary Greatly Among US Counties

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The death rate from cancer is more than 7 times higher in Union County, Florida (503 deaths per 100,000 people in 2014) than it is in Summit County, Colorado (71 deaths per 100,000 people). That’s just one example from a scientific analysis of the death rate from 29 cancer types in every county in the United States between 1980 and 2014.

Researchers in Seattle focused on death rates by county because most public health programs and policies are designed and carried out at the local level. Most previous studies focused on the state level – and found that cancer deaths vary among states – at least partly because of differences in risk factors, socioeconomic factors, and access to high quality treatment. The county-by-county study was published January 24 in the Journal of the American Medical Association.  

Trends in cancer death rates

From 1980 to 2014, about 19.5 million Americans died of cancer, according to the study. The overall death rate from cancer fell by 20%, but the rates varied significantly depending on the county and the cancer type. In 160 counties, the cancer death rates actually increased. The study authors say this raises concerns about access to cancer screening and treatment.

The study also found:

  • Lung cancer death rates fell by 21% from 1980 to 2014 overall. But the rates are more than 20 times higher in some parts of the country than others. Lung cancer kills more people in the US than any other cancer, and smoking is the leading cause of lung cancer incidence and mortality. Although fewer Americans smoke today than in previous decades, parts of the South and rural areas still have high rates of smoking. The highest death rate was found in Union County, Florida and the lowest was found in Summit County, Colorado.
  • Nationally, liver cancer death rates increased by almost 88% from 1980 to 2014. They increased in almost every county. Clusters of counties with the highest increases were found in California, Oregon, Washington, New Mexico, and Texas.
  • Breast cancer death rates decreased in most counties, but counties with higher death rates were in the South and clustered along the Mississippi River. The highest death rate was found in Madison County, Mississippi and the lowest was found in Summit County, Colorado.
  • Although prostate cancer death rates declined by about 22% overall, high death rates from prostate cancer were clustered in groups of counties in Alabama, Mississippi, Georgia, South Carolina, and Virginia. The highest death rate was found in Madison County, Mississippi and the lowest was found in Summit County, Colorado.
  • National death rates from kidney cancer remained relatively stable from 1980 to 2014. The highest death rates from kidney cancer were found in counties along the Mississippi River, as well as Oklahoma and Texas. Certain areas in Alaska and North and South Dakota with large Native American populations also had higher than average rates.

Look up more results by county.

Lifestyle changes can lower your risk

The study authors suggest the reason for high rates of cancer deaths in certain counties may be partly due to higher levels of certain risk factors – including smoking, poor eating habits, and obesity – combined with lack of access to screening and prevention programs.

No matter where you live, you can make lifestyle changes to help lower your risk for cancer.

  • Avoid tobacco. Tobacco use is responsible for nearly 1 out of every 5 deaths in the US – about 480,000 early deaths each year. About 80% of lung cancer deaths and 30% of all cancer deaths are caused by tobacco use. If you don’t use tobacco products, don’t start. If you do, quit. For help, visit, or call the American Cancer Society at 1-800-227-2345.
  • Get to and stay at a healthy weight. Being overweight or obese is a risk factor for many cancers. You can control your weight through regular exercise and healthy eating.
  • Exercise regularly. Physical activity has been shown to lower the risk of several types of cancer.
  • Adults should get at least 150 minutes of moderate-intensity activity (equal to a brisk walk) or 75 minutes of vigorous activity (activity that makes your heartbeat and breathing faster, and makes you sweat) each week, preferably spread throughout the week.
  • Eat a healthy diet. Studies show that eating a lot of different vegetables and fruits, whole grains, and fish or poultry is linked with a lower risk of developing certain cancers. On the other hand, eating more processed and red meat is linked with a higher risk of developing certain cancers.
  • Limit alcohol. Research has shown that alcohol can increase your risk for certain kinds of cancer. Men should have no more than 2 drinks a day and women no more than 1. One drink is equal to about 12 ounces of beer, 5 ounces of wine, or 1.5 ounces of 80-proof liquor.
  • Get regular cancer screening tests. Regular screening tests can catch some cancers early, when they’re easier to treat – and even stop some cancers from developing in the first place. 

The American Cancer Society medical and editorial content team
Our team is made up of doctors and master's-prepared nurses with deep knowledge of cancer care as well as journalists, editors, and translators with extensive experience in medical writing.

Trends and Patterns of Disparities in Cancer Mortality Among US Counties, 1980-2014. Published January 24, 2017 in the Journal of the American Medical Association. First author Ali H. Mokdad, PhD, University of Washington, Seattle. 

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