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      Cancer death rates in US congressional districts.

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          Abstract

          Knowledge of the cancer burden is important for informing and advocating cancer prevention and control. Mortality data are readily available for states and counties, but not for congressional districts, from which representatives are elected and which may be more influential in compelling legislation and policy. The authors calculated average annual cancer death rates during 2002 to 2011 for each of the 435 congressional districts using mortality data from the National Center for Health Statistics and population estimates from the US Census Bureau. Age-standardized death rates were mapped for all sites combined and separately for cancers of the lung and bronchus, colorectum, breast, and prostate by race/ethnicity and sex. Overall cancer death rates vary by almost 2-fold and are generally lowest in Mountain states and highest in Appalachia and areas of the South. The distribution is similar for lung and colorectal cancers, with the lowest rates consistently noted in districts in Utah. However, for breast and prostate cancers, while the highest rates are again scattered throughout the South, the geographic pattern is less clear and the lowest rates are in Hawaii and southern Texas and Florida. Within-state heterogeneity is limited, particularly for men, with the exceptions of Texas, Georgia, and Florida. Patterns also vary by race/ethnicity. For example, the highest prostate cancer death rates are in the West and north central United States among non-Hispanic whites, but in the deep South among African Americans. Hispanics have the lowest rates except for colorectal cancer in Wyoming, eastern Colorado, and northern New Mexico. These data can facilitate cancer control and stimulate conversation about the relationship between cancer and policies that influence access to health care and the prevalence of behavioral and environmental risk factors.

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          Author and article information

          Journal
          CA Cancer J Clin
          CA: a cancer journal for clinicians
          American Cancer Society
          1542-4863
          0007-9235
          July 25 2015
          : 65
          : 5
          Affiliations
          [1 ] Director, Surveillance Information, Surveillance and Health Services Research, Intramural Research Department, American Cancer Society, Atlanta, GA.
          [2 ] Director, Evaluation Informatics, Statistics and Evaluation Center, Intramural Research Department, American Cancer Society, Atlanta, GA.
          [3 ] Managing Director, Statistics and Evaluation Center, Intramural Research Department, American Cancer Society, Atlanta, GA.
          [4 ] National Vice President, Intramural Research Department, American Cancer Society, Atlanta, GA.
          [5 ] Vice President, Surveillance and Health Services Research, Intramural Research Department, American Cancer Society, Atlanta, GA.
          Article
          10.3322/caac.21292
          26208318

          Congress, cancer mortality, geography, legislation

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