Map shows how death rates have declined over past 20 years in every congressional district

No matter red or blue, cancer rates are falling in every one of America’s congressional districts.

Researchers at the American Cancer Society found the deadly disease is causing less deaths now than it did in the 1990s in all of the nation’s 435 districts. 

The areas that experienced the biggest declines were around New York City, Miami New Orleans and Honolulu.

Among the congressional districts, the biggest drops were around the areas that surround major blue cities and urban environments where cancer care is more easily accessible and people tend to have more money.

Scientists pointed to lower smoking rates and better cancer screening to explain the trends.

A report from the American Cancer Society has found that cancer fatality rates have dropped across all 435 congressional districts of America since the 1990s (map of % drop) 

The above map shows the percentage change in cancer deaths among men since the 1990s

The above map shows the percentage change in cancer deaths among men since the 1990s

This map shows the percentage change in cancer deaths among women since the 1990s

This map shows the percentage change in cancer deaths among women since the 1990s

Urban areas also tended to see bigger slides in cancer mortality rates, which may be linked to them having lower obesity rates — a key risk factor.

Rural areas, on the other hand, tended to see smaller changes in their cancer fatality rates.

Among men overall, the drop was by 20 to 45 percent per district, while among women fatalities dipped by 10 to 40 percent.

Lung, colorectal and breast cancer in women and prostate cancer in men saw the sharpest declines.

About 600,000 Americans die from cancer every year, the second biggest killer in the country behind only heart disease.

Lung and bronchus cancer is the biggest killer in the group, behind 127,000 fatalities per year. The second most common is colorectal cancer, behind nearly 53,000 deaths.

Officials have put an increased focus on reducing cancer fatality rates in recent years and boosted efforts to curb smoking, which is now near all-time lows.

Last year US President Joe Biden also announced his $1billion ‘Cancer Moonshot’ program, aiming to halve US cancer deaths over the next 25 years.

For the study, published this week in the journal Cancer, scientists analyzed data from the National Center for Health Statistics, which collects figures on cancer deaths from across the US.

Data were split into three eight-year date periods: 1996 to 2003, 2004 to 2011 and 2012 to 2020.

A fatality rate for each district was then calculated and standardized by age to allow for comparisons.

Data were based on the boundaries for the 116th Congress of the US, which ran from January 2019 to January 2021. It included 435 seats in the House of Representatives plus one non-voting seat for the District of Columbia.

Cancer fatality rates fell most sharply in Washington D.C., down 60 percent, and congressional districts in Hawaii near Honolulu, down 58 percent.

Within many individual states, the places that experienced the smaller drops were rural or located near cities.

They included rural parts of Kentucky, Nebraska and Missouri, as well as areas near Oklahoma City and Kansas City.

Overall, the study found that cancer death rates were highest across the South of the country in the early 1990s.

But by the year 2020, these had shifted to the Midwest, East and West South-Central areas of the country.

The team led by Dr Farhad Islami, a cancer researcher at the society, said fewer Americans smoking was one of the main factors driving lower rates.

About 63 percent of American adults smoked cigarettes in 1996, but two decades later this had fallen to below 12 percent.

More screening programs — to detect cancer early and when it is easier to treat — were also behind the dip.

These included breast cancer, with women asked to come for screening every two years, and colorectal cancer, with screenings every decade.

Advances in cancer treatments were also suggested to be behind the dip, but these were only patchily applied to districts.

This was because of wealth disparities and the fact that ten states have not expanded Medicaid coverage. These are Wyoming, Kansas, Texas, Wisconsin, Tennessee, Mississippi, Alabama, Georgia, South Carolina and Florida.

Of the top 20 districts with the smallest improvement in cancer fatalities, three were in these states.

The above map shows the cancer death rate by Congressional district from 1996 to 2003 (left) and from 2012 to 2020. It reveals how rates have dipped across the country

This map shows how cancer fatalities per 100,000 people were concentrated in the south of the US in the late 1990s

This map shows how cancer fatalities per 100,000 people were concentrated in the south of the US in the late 1990s

But by the 2010s rates had dropped drastically — by up to 60 percent compared to the 1990s — which researchers said was down to lower smoking rates and early screening

But by the 2010s rates had dropped drastically — by up to 60 percent compared to the 1990s — which researchers said was down to lower smoking rates and early screening 

By ethnic group and gender, researchers found the greatest improvement in cancer fatalities among black men — although their rates remained higher than those in other groups.

Dr Islami heralded the results from the report as ‘good news’ for the nation because of declining cancer death rates.

He also explained that the data was calculated by congressional districts to help put pressure on politicians to boost cancer survival rates in their state.

Lisa Lacasse, the president of the ACS’s Cancer Action Network, said that the data showed the country was being taken ‘closer to our vision of ending cancer as we know it’.

She called on politicians to take more action to drive down America’s cancer death rates by improving access to early detection services, expanding Medicaid and approving funding for prostate cancer screening.

Her words came after a federal judge said in March that insurers did not have to continue to cover the costs of some preventive care, such as cancer screenings.

US District Judge Reed O’Connor struck down recommendations made by the US Preventive Services Task Force since 2010, which provides guidance on best practice for screening for illnesses.

The above map shows the cancer death rate for women in 1996 to 2003 (left) and 2012 to 2020. It also reveals a sharp dip in the rate, especially in the south of the country 

The above map shows the cancer death rate per 100,000 people by US congressional district in the years 1996 to 2003

The above map shows the cancer death rate per 100,000 people by US congressional district in the years 1996 to 2003

And this map shows the rates per congressional district from 2012 to 2020

And this map shows the rates per congressional district from 2012 to 2020

Among women, Hawaii’s second district saw the biggest drop in cancer deaths (-56 percent), alongside Hawaii’s first and the District of Columbia. 

New York’s 15th and 13th and Florida’s 27th also saw reductions above 50 percent.

Among men, the district of Columbia saw the biggest drop (64.9 percent), alongside Hawaii’s second and first (-60.5 and -59.1 percent).

Louisiana’s second, New York’s 13th, 12th and 10th, New Jersey’s 10th and eighth, Florida’s 27th, 24th and 26th, Pennsylvania’s second and third, Virginia’s fourth, North Carolina’s first, Maryland’s seventh and Georgia’s fifth also saw declines above 50 percent.

Lower fatality rates in the District of Columbia were, in part, attributed to changes in demographics in the area — with an influx of wealthier individuals behind the drop.

In southern areas of Texas, the shift was also attributed to more people from Hispanic backgrounds arriving in the area who have a lower risk of death from certain cancers.

Lung cancers tend to be less common in the group, because they are historically less likely to smoke, as well as colon cancers, which has previously been linked to the group having a diet rich in fruit, vegetables and fiber.

Dr Islami said: ‘The good news is overall cancer death rates declined for both men and women in all congressional districts.

However, we saw substantial disparities in progress against cancer mortality across congressional districts. 

‘Moreover, while the decline in death rates from cancer was most pronounced for Black men, overall cancer mortality remains substantially higher among Black people compared to other populations. 

‘We also found the number of districts with the greatest relative declines in overall cancer death rates was larger among Hispanic people than white people. 

‘But paradoxically, Hispanic people also had the largest number of districts with no or smallest relative declines in rates.’

It comes after a separate report found a ‘truly formidable’ 33 percent reduction in cancer death rates since 1991.

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