Interpreting Cancer Incidence Rates throughout the United States

In 2017, the American Cancer Society predicts that there will be nearly 1.7 million new cases of cancer in the United States. Cancer is the second leading cause of death in the US, causing 1 in 4 deaths. A study using information obtained by the Centers for Disease Control (CDC) recently named Kentucky as the U.S. state with the highest rates of cancer diagnoses.

This information, which was last analyzed in 2013 by the CDC, estimates that 511 for every 100,000 people in Kentucky are diagnosed with cancer. Kentucky also has the highest rate of cancer-related deaths in the nation, with 211 for every 100,000 people. This is far above the national average of 163 deaths for every 100,000 in the U.S.  The national average of diagnoses is 439 people for every 100,000.

In contrast, from the same last analysis in 2013, Utah has the lowest cancer death rate at 133 for every 100,000. And New Mexico has the lowest rate of diagnosis with 363 per 100,000. The entire Midwest has a much lower cancer incidence rate than the rest of the country.

Incidence of cancer varies widely across the United States. There are great variances between the states when comparing mortality rates, new cancer diagnoses and the number of Americans living with cancer. Some states sit much lower on the spectrum than others. Why is that? With society’s knowledge about cancer today, as well as targeted healthcare solutions and lifestyle awareness, why are there such variances across the map?

There are no clear reasons as to why there are variances across the United States but there are definite markers in each individual state that can help to clarify why the rates are what they are. 

Some Alarming Statistics

• According to a study conducted by the Journal of the American Medical Association, from 1980 to 2014, approximately 19.5 million Americans died from cancer.
• Lung cancer kills more people in the U.S. than any other form of cancer, and smoking is the leading cause of lung cancer incidence and mortality. More specifically, lung cancers are the top cause of death in 45 states and digestive system cancers are the leading cause in the remaining 5 states.
• According to the CDC, approximately 8.7% of American adults have been diagnosed with some form of cancer.
• In both men and women, breast cancer is expected to be the fastest growing diagnosis.
• The American Cancer Society predicts that lung, bronchial, prostate, colorectal, melanoma of the skin and urinary bladder cancers are the most common in America. Lung and bronchial cancers are predicted to be the most fatal. Skin cancer is the most common worldwide.
• The CDC reports that ageing is the most important risk factor.

Interpreting the Data with Contributing Factors

It is important to keep careful consideration of many factors in attempting to interpret this data across the different states. Some examples are:

• Differences in race and ethnicity: The racial make-up of a state must be taken into account when interpreting cancer incidence rates. For example, Caucasian women have a higher incidence rate of breast cancer than other ethnic populations. And African American men have a higher incidence rate of prostate cancer. New Mexico, reportedly with the lowest rate of diagnosis in the U.S., has a high number of Hispanics who have a lower cancer incidence rate than African Americans and Caucasians.
• Variations in healthcare: Some states have more government funded cancer screening programs than others, and subsequently more cancers are diagnosed in these states.
• Exposure to environmental carcinogens (substances that may cause cancer).
• Population behavior: Some states have more smokers than others, and subsequently there are more cases of lung and bronchial cancers in those states.
• Economic factors: States with lower poverty rates have higher access to healthier foods and more exercise opportunities. The poverty rates in the 10 states with the highest rates of cancer related deaths are significantly higher than the national poverty rate of 15.8%.
• The age of a population: Cancer incidence is much higher among an ageing population. Some states with a higher retirement community, for example, may show a higher number of cases.
• Many cases of cancer go undetected, sometimes unreported, or treatment may be sought outside of traditional medical practice, in which case these are not included in analyzed data.

Cancer Incidence and Smoking

In the state of Kentucky, where new cancer diagnoses as well as deaths due to cancer are the highest in the country, deaths related to tobacco are at 25.6%, the second highest of all the United States. Whereas, less than 10% of adults living in Utah report a history of tobacco use, which is the only state where the percentage of smokers does not exceed 10%.  9 of the 10 states with the highest death rates due to cancer also have the 10 highest percentages of smokers in the population.

Experts note that one million cases of cancer diagnosed in the US in 2015 would likely not have occurred if Americans had not smoked, had improved their diet and had exercised more. That being said, there are plenty of people who follow all the suggestions and maintain optimum health and are still diagnosed with cancer. Genetic disposition is a leading “cause” of cancer, which occurs in many cases where the patient is otherwise in good health.

The CDC estimates that 40% of cancer cases in the US are tobacco related and that cigarette smoking causes one-fifth of all annual deaths. Sadly, despite the fact that we know full-well how bad smoking is for our health, the number of tobacco-related deaths is projected to increase by 2030, according to the World Health Organization (WHO). They estimate the current 6 million deaths attributed to tobacco worldwide will rise to nearly 8 million over the next 13 years.

Interestingly, smoking costs the global economy more than $1 trillion a year and yet that cost far outweighs global revenues from tobacco taxes, which the WHO estimates at $269 billion (between 2013-2014). The study, conducted by the WHO and the U.S. National Cancer Institute, which was peer-reviewed by more than 70 scientific experts, found that tobacco is the single biggest preventable cause of death across the globe. Tobacco is responsible for over $1 trillion in healthcare costs and lost productivity each year.

Cancer Prevention

While there is still no cure for cancer, there are many ways in which we can try to prevent cancer. We can be much more proactive about our health, starting with the basics, such as:

• Avoid tobacco entirely. If you don’t smoke, don’t start. And if you do smoke, there are so many ways in which you can quit. Talk to your healthcare provider about a method that will work for you.
• Keep your weight under control. Obesity is a risk factor for many cancers. Control your weight through healthy eating and regular exercise. Keep in mind that what you eat also affects your levels of immunity. If you feel you are unable to do this on your own, there are many resources out there to support you. Again, speak to your healthcare provider.
• Exercise regularly. Science has shown us that physical activity can help to reduce the risk of several types of cancer. Find a workout that you enjoy and make it a part of your regular routine.
• Protect yourself from the sun. Use approved sunscreens as directed, stay in the shade whenever possible, wear lightweight clothing to keep your skin covered and always wear a hat.
• Eat a healthy diet. Studies have shown us that by eating a diet that is rich in fruits and vegetables, whole grains, fish or poultry, and healthy fats, you are lowering your risk of cancer. In contrast, eating processed foods and frequent red meat has been linked to an increase in developing some types of cancers.
• Reduce your alcohol intake.
• Get regular screenings to ensure that you catch cancer early, making it easier to treat and sometimes stop cancers from spreading.  

There are also some more obscure things to consider in our efforts to protect ourselves against cancer, such as:

• Limit the amount of food you barbecue on a grill. While there is no evidence that grilling alone causes cancer, cooking meats at high temperatures can create some of the compounds that have been known to cause cancer.
• In addition to minimizing exposure to the sun, limit exposure to radiation from things such as CT scans, dental X-rays and other medical imaging procedures. Speak to your healthcare provider about what is safe.  
• Ensure your air quality as excellent within your home – sometimes, it is worse than outdoors!
• Try to reduce stress in your daily life. Incorporate daily meditation, yoga practice or journaling if you feel it will help.
• Talk to your Human Resources Department in the workplace about setting up cancer awareness events, access to screening clinics, counselling services for those affected by cancer and prevention programs.

Some good news: According to the American Cancer Society, cancer death rates in the United States have been going down over the last few decades. There is still a lot that we can do to try and prevent cancer and we must do our part to raise awareness of this disease within our families and communities.

• All statistics taken from the Centers for Disease Control and Prevention, the World Health Organization and from the American Cancer Societywebsites. Information was also sourced from the 2013 U.S. Census Bureau survey.