Although in recent years the death rate from lung cancer among women in most of the United States has decreased significantly, the progress of women in the region, which covers the central part of the Appalachian Mountains and the southern and northern parts of the Midwest, is lagging behind.
The study is published in the journal Cancer Epidemiology, Biomarkers & Prevention, the journal of the American Association for Cancer Research, Katharine Ross, MA, PhD student of the Department of Epidemiology Rollins School of Public Health at Emory University in Atlanta.
Ross explained that the national death rate from lung cancer among women has been steadily declining since the mid-2000s. "We wanted to see whether the geographical variation in this reduction there, so that we can identify the places in the United States, where women could benefit from targeted programs on tobacco control and smoking cessation, and other activities aimed at reducing the lung cancer burden," - said, she said.
To conduct the study, Ross and her colleagues used data on the number of lung cancer deaths among women, obtained from the database of the National cancer surveillance, epidemiology and end results of the National Cancer Institute (SEER) for the calculation of age-standardized mortality rates from lung cancer for each county contiguous United States from 1990 to 1999 and from 2006 to 2015. They then calculated the absolute change and relative change in mortality rates between the two periods for each county.
The researchers used ArcGIS software tool for identifying clusters of counties with an increase or a slight decrease in lung cancer mortality between the two periods, called hot spots.
They found that from 1990-1999 for 2006-2015, mortality from lung cancer has increased by 13 percent among women in the covering 669 counties in 21 states in Central Appalachia and the southern parts of the Midwest. In the same period in the second hotspot that spans 81 county in four states in the upper Midwest, lung cancer mortality among women increased by 7 percent. The rest of the contiguous United States from lung cancer mortality decreased by 6 percent among women.
The researchers compared death rates from lung cancer among women in each of these regions, including among women in the rest of the United States. In 1990, the mortality rate in the largest point was 4 percent lower than the mortality rate in the regions not associated with it, but it was 28 percent higher than in 2015. For the second "hot spot" mortality was 18 percent lower than the mortality rate in other regions in 1990.
"We know that experiencing an imbalance in mortality in the countries of the Midwest and Appalachia have the highest prevalence of smoking among women and the lowest percentage reduction in smoking in recent years, which is probably why it is not surprising that we found that women in these areas from the lung cancer - Ross said. "This geographical inequality can grow if we do not specifically aim to reduce tobacco use among women in these hot spots.
"There are a number of effective tobacco control policies, such as the increase in excise duties on tobacco and comprehensive smoke-free laws banning smoking in the workplace, in restaurants and bars" - continued Ross. "However, many of our state in the identified regions or do not comply with these measures."