Appalachia continues to have higher cancer rates than the rest of US, but gap is narrowing

Appalachia, a region of the US that contains Pittsburgh (Appalachia stretches from New York to Mississippi and contains 25 million people), has higher cancer rates than the rest of the nation; contributing factors are higher tobacco use, lower socioeconomic status, and patient health care utilization.

In 2007, the CDC’s National Program of Cancer Registries (NPCR) published a study that showed higher cancer rates in Appalachia between 2001 and 2003; however, the study had some shortcomings.  A more thorough study was done between 2004 and 2011, and it contained data from both Appalachian populations and non-Appalachian populations.  This study was able to analyze 100% of the US population by using data from the National Program of Cancer Registries (NPCR) and data from the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) program.

The data from the Appalachian population was divided into three groups:

  • residents from three regions (counties in the north, central, and south Appalachia)
  • by gender, race (black and white)
  • by Appalachian Regional Commission-designated economic status (distressed, at-risk, transitional, competitive, and attainment

This was then compared with data on the non-Appalachian population, and the results showed that “the cancer incidence rates were elevated among Appalachians regardless of how they were categorized.”

Even though Appalachia has a higher incidence of cancer as compared to the rest of the country, the gap is narrowing (with the exceptions of cancers of the oral cavity and pharynx, larynx, lung and bronchus, and thyroid).  It is promising to note that the gap between Appalachia and non-Appalachia has narrowed since 2007.

This study is important because it shows the importance of screening for cancers and diseases for at-risk populations.  It also shows the importance of lifestyle.  For example, not using tobacco products will make you less at risk for cancer.  And if you do use tobacco products, it is important to be screened for cancers more regularly since you are more at risk.

The question I will pose is:  What initiatives can we take to decrease the rate of cancer in Appalachia?


Reda J. Wilson, A. Blythe Ryerson, Simple D. Singh, and Jessica B. King.Cancer Incidence in Appalachia, 2004–2011. Cancer Epidemiol Biomarkers Prev, February 2016 DOI: 10.1158/1055-9965.EPI-15-094

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