Three Large U.S. Hot Spots Have Excessive Colorectal Cancer Death Rates

Three Large U.S. Hot Spots Have Excessive Colorectal Cancer Death Rates (Reprinted from Medical News Today, July 8)

While most of the United States has experienced large declines in colorectal cancer death rates in recent years, progress in the Mississippi Delta and two other areas has lagged. The lower Mississippi Delta, encompassing 94 counties, was identified as the hot spot with the highest colorectal cancer death rates, followed by 107 counties in west central Appalachia, and 37 counties in eastern Virginia/North Carolina. The study is published in Cancer Epidemiology, Biomarkers & Prevention, a journal of the American Association for Cancer Research.
Siegel explained that over the past few decades we have learned how to prevent most colorectal cancer deaths, which has led to a drop in the U.S. colorectal cancer death rate by half. However, progress has not been equivalent in all states, and large differences exist among states, which she and her colleagues identified in a previous study. For this study, the researchers gathered and analyzed data at a more granular level because targeted interventions are often more feasible on a smaller scale, she said.

Geospatial Software Tool Used

Siegel and colleagues used a geospatial software tool to identify areas of very low rates of colorectal cancer deaths, called cold spots, and areas of very high rates, called hot spots. For areas identified as hot spots, death rates were plotted from 1970 to 2011 and rate ratios were calculated to compare trends over time between hot spots and the rest of the United States.
Using this spatial mapping, the researchers identified three distinct hot spots. The lower Mississippi Delta hot spot had colorectal cancer death rates that were 40 percent higher than the nonhot spot areas in the country during 2009-2011. Rates in the hot spots in west central Appalachia and eastern Virginia/North Carolina were 18 percent and 9 percent higher, respectively, than those of the nonhot spot areas in the country during this time period.

The colorectal cancer death rate increased steadily, by 3.5 percent per year, for black men in the lower Mississippi Delta between 1970 and 1990, and has since remained unchanged.


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