Where should the cancer control interventions target: A geospatial hotspot analysis for major cancer mortality 2018-2022 in the U.S.

BACKGROUND

Identifying changes in geographical disparities of cancer mortality reveals locations where cancer prevention and control efforts should be focused/targeted. We use recent cancer surveillance data to demonstrate the geographical disparity of major cancer mortality rates in the US and its shift compared to previous data.

METHODS

This cross-sectional study used the 2018-2022 county-level mortality rates of colorectal, lung, breast and prostate cancer from the CDC mortality data. Counties with suppressed death counts were imputed by spatial regression models. Getis-Ord Gi* statistics were used to evaluate spatial clustering of county mortality. Identified hotspot counties were visualized and compared with literature for hotspot pattern change.

RESULTS

A total of 3108 US mainland counties were included. Cancer mortality rates were significantly higher in 244 counties for colorectal, 456 for lung, 147 for breast and 180 for prostate. Hotspot areas were central Appalachia (for colorectal and lung), Lower Mississippi Delta (colorectal, breast and prostate), Midwest (colorectal and lung), north Michigan/Wisconsin (lung and prostate), north Florida (lung), and the West (prostate).

CONCLUSIONS

West central Appalachia and Lower Mississippi Delta continue to be hotspots for major cancer types, while previously identified eastern North Carolina/Virginia hotspots shrunk, east Oklahoma and north Florida emerged as the new hotspot for lung cancer, and several hotspots emerged in the West for prostate cancer.

IMPACT

This study updated the analyses for geospatial disparity in major cancers' mortality since 2018-illustrating recent changes in the disparity pattern and pinpointing areas that cancer prevention and control efforts should target.