Cancer Death Rates Higher in Rural America Interview with:

Lisa C. Richardson, MD, MPH, Oncologist Director,Division of Cancer Prevention and Control CDC

Dr. Richardson

Lisa C. Richardson, MD, MPH, Oncologist
Director,Division of Cancer Prevention and Control
CDC What is the background for this study?

Response: This MMWR report is the first complete description of cancer incidence and mortality comparing rural and urban America.  From previous reports we know that rural residents are more likely to be older, have more comorbid conditions and participate in high risk behaviors that can lead to cancer. CDC researchers were interested in how these factors were related to new cancers and cancer deaths in rural counties compared to metropolitan counties.

Researchers found that rates of new cases for lung cancer, colorectal cancer, and cervical cancer were higher in rural America. In contrast, rural areas were found to have lower rates of new cancers of the female breast, and prostate. Rural counties had higher death rates from lung, colorectal, prostate, and cervical cancers. What are the main findings?

Response: During 2006-2015, cancer death rates were higher in rural areas (180 per 100,000 persons) than in urban areas (158 per 100,000 persons) and improved at a slower pace. While overall rates of new cancer cases were slightly lower in rural areas (442 cases per 100,000 persons) than in urban areas (457 cases per 100,000 person), rates of new cases were higher for several cancers, including those related to tobacco use such as lung cancer and those that can be prevented by screening such as colorectal and cervical cancer. While people living in rural areas have lower incidence of cancer than people in urban areas, they have higher cancer death rates, with differences in death rates between rural and urban areas getting worse over time. What should clinicians and patients take away from your report?

Response: The number of new cancer cases can be reduced by using strategies proven to help people adopt healthier lifestyles. The goal of these strategies is to help community members avoid tobacco, maintain a healthy weight, get appropriate vaccinations and cancer screenings, as well as make it easier for them to get care when they need it. What recommendations do you have for future research as a result of this study?

Response: The findings in this study point to where interventions for behavior change could be implemented. For example, using proven interventions in the right place at the right time could help more people with smoking cessation, obesity prevention, and cancer screening.  Another problem is ensuring that cancers or precancerous lesions found through screening are treated appropriately. A novel approach to overcome this challenge to healthcare access in rural areas is to use telehealth to deliver care to patients. Is there anything else you would like to add?

Response: Everyone, regardless of where they live, should be able to benefit from strategies proven to promote healthy behaviors, increase screening and vaccination rates, and receive timely and appropriate cancer care.

No disclosures Thank you for your contribution to the community.


Henley SJ, Anderson RN, Thomas CC, Massetti GM, Peaker B, Richardson LC. Invasive Cancer Incidence, 2004–2013, and Deaths, 2006–2015, in Nonmetropolitan and Metropolitan Counties — United States. MMWR Surveill Summ 2017;66(No. SS-14):1–13. DOI:

Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.