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Changing urbanization patterns in US lung cancer mortality, 1950-2007
Gopal K Singh1, Mohammad Siahpush, Shanita D Williams
1US Department of Health and Human Services, Health Resources and Services Administration, Maternal and Child Health Bureau, 5600 Fishers Lane, Room 18-41, Rockville, MD 20857, USA. gsingh@hrsa.gov
Journal of Community Health
|August 23, 2011
Summary
Lung cancer mortality rates in non-metropolitan areas were lower for men until the mid-1980s and women until the mid-1990s. By 2007, rural areas saw significantly higher lung cancer death rates for both sexes.
Area of Science:
- Epidemiology
- Public Health
- Cancer Research
Background:
- Lung cancer mortality rates have historically shown geographic disparities in the United States.
- Understanding these trends in metropolitan versus non-metropolitan areas is crucial for targeted public health interventions.
Purpose of the Study:
- To examine changes in lung cancer mortality rates between US metropolitan and non-metropolitan areas from 1950 to 2007.
- To identify temporal trends and reversals in rural-urban lung cancer mortality disparities.
Main Methods:
- Calculated annual age-adjusted lung cancer mortality rates for men and women in metropolitan and non-metropolitan areas.
- Employed log-linear regression to model changes in mortality rates over time.
- Utilized Poisson regression to estimate relative risks, adjusting for age, sex, deprivation, and urbanization.
Main Results:
- Initially, non-metropolitan men and older non-metropolitan men had lower lung cancer mortality rates.
- By the mid-1980s for men and mid-1990s for women, these disparities reversed, with rural areas experiencing higher rates.
- In 2007, non-metropolitan men and women faced significantly higher lung cancer mortality compared to their metropolitan counterparts, even after adjustments.
Conclusions:
- Rural-urban patterns in lung cancer mortality have dramatically reversed between 1950 and 2007.
- Faster reductions in metropolitan lung cancer mortality drove this reversal.
- Observed trends in rural-urban lung cancer mortality disparities align with historical smoking patterns.
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