Investigators have shed light on the disparities that may be contributing to the high cancer burden of Appalachian Kentucky compared with the rest of the state and country, according to a new study published by Hudson et al in The Journal of Rural Health.
Kentucky currently ranks first in the nation for cancer incidence and mortality rates, and Appalachian Kentucky bears the state’s greatest cancer burden—driven by disparities in health behaviors like smoking and lower rates of cancer screenings.
Study Methods and Results
In the new study, the investigators examined several data sets including the annual incidence and mortality rates of lung cancer; colorectal cancer; cervical cancer; as well as oral cavity, pharyngeal, and laryngeal cancers going back to 1968. These cancer types have historically had elevated rates in Kentucky and are often responsive to prevention and screening interventions. The investigators discovered that in the past 50 years, cancer mortality rates decreased substantially throughout the United States, but this reduction was smaller and slower in Kentucky—with progress in Appalachian Kentucky even more limited.
After analyzing 5-year cancer incidence and mortality rates from 2014 to 2018 as well as comparing screening and risk factor data from 2016 to 2018 for the United States, Appalachian Kentucky, and non-Appalachian Kentucky, they found that all cancer types were more prevalent in Appalachian Kentucky compared with non-Appalachian regions of the state. The investigators also noted that Appalachian Kentucky had lower screening rates and higher rates of obesity and smoking than other parts of the state.
Conclusions
“The findings underscore the urgent need to further address Appalachian Kentucky’s persistent cancer disparities, which have created a wide gap between Appalachian Kentucky and the rest of the country,” stressed senior study author Nathan Vanderford, PhD, MBA, Associate Professor of Toxicology and Cancer Biology at the College of Medicine as well as Director of the Appalachian Career Training in Oncology Program and Assistant Director for Research and Education at the Markey Cancer Center at the University of Kentucky.
The investigators emphasized the importance of continued and expanded targeted interventions to address health behaviors and inequities in social determinants of health in Appalachian Kentucky—including efforts to further improve screening accessibility and participation.
"The results of the study should act as a call to action for researchers, physicians, and Kentucky residents,” highlighted first study author Lauren Hudson, BS, a student at the University of Kentucky College of Medicine. “A momentous first step to reducing this disparity could be increasing cancer education in the Appalachian region,” she concluded.
Disclosure: For full disclosures of the study authors, visit onlinelibrary.wiley.com.
