I was interested to see an article about the continuing declines in cancer death rates featured in the April 15 issue of The ASCO Post (page 94), as I have just published a paper on breast cancer mortality rates.1 Although overall breast cancer mortality rates have decreased significantly, a much smaller decline was seen in medically undeserved areas such as Appalachian counties (17.5%) compared with non-Appalachian counties in 13 Appalachian states (30.5%), and compared with non-Appalachian counties in the United States overall (28.3%). So I’d like to remind readers of The ASCO Post that there are probably enormous regional disparities in the decline of overall cancer mortality rates. ■
—Nengliang Yao, MS
Dept of Health Policy and Administration
College of Health and Human Development
Pennsylvania State University
University Park, Pennsylvania
Reference
1. Yao N, Lengerich EJ, Hillemeier MM: Breast cancer mortality in Appalachia. J Health Care Poor Underserved 23:715-725, 2012.