March 23, 2026- Where a person lives in the United States increasingly shapes their chances of developing and surviving cancer. A new large nationwide study by researchers at the American Cancer Society (ACS) reports a long-term shift in the high cancer burden from urban to rural areas in the U.S. The findings show that the mortality gap between urban and rural areas continues to widen. The study is to be published today in the Journal of the National Cancer Institute (JNCI).
Higher cancer mortality rates for rural residents in the U.S. are largely driven by limited access to care, lower screening rates, higher poverty, and higher prevalence of smoking and several other factors that cause cancer. Understanding long-term trends in cancer mortality across rural and urban areas can provide additional insight into the factors contributing to rural-urban disparities and inform public policy.
Social determinants of health are the environmental conditions where people are born, live, learn, work, play, worship, and age that significantly affect health, functioning, and quality-of-life outcomes.
For the study, researchers analyzed data from 27,710,318 cancer deaths. They examined trends in cancer mortality rates overall and in three leading causes of cancer death in each sex (lung, colorectal, female breast, and prostate) by the urbanicity of county of residence in the U.S. from 1969 through 2023, using records from the National Center for Health Statistics spanning 55 years.