Trends in cancer incidence and mortality in the United States (1999-2021): A retrospective cohort study of health disparities and regional variations.

Abstract

Objective: Analyze cancer incidence and mortality in the U.S. 1999-2021, focusing on variations by sex, race, cancer type, and state. The study aims to identify disparities in cancer rates and highlight regions and populations most affected, to inform public health policies and interventions.

Methods: Age-adjusted rates were analyzed by race, cancer type, sex, and state. Bayesian statistical techniques were employed for accurate trend estimation, and cancer hotspots were identified using the Getis-Ord Gi* statistic. Joinpoint regression was used to estimate the Average Annual Percent Change (AAPC) in cancer rates. The analysis was conducted using R.

Results: The overall trend was noted reduction in aggregate cancer rate (AAPC =-0.007) and mortality (AAPC =-0.004). Regional and racial disparities are still prevalent with outcomes showing that Kentucky, West Virginia, and Mississippi have the highest prevalence of both. Cancer incidence was reduced most significantly among Black or African American individuals (AAPC=-0.008) and mortality in (AAPC=-0.021) but their rates are still higher. Hotspot analyses identified high cancer incidence and mortality clusters, particularly in the Midwestern and Southern regions of the United States.

Discussion: The implications arising from these results suggest that focused public health campaigns need to be directed toward cancer, smoking, and access to care services for effective health promotion. These findings therefore call for innovative public health measures to reduce the burden of cancer and disparity in the future. More sophisticated studies of the social, environmental, and genetic causes of these trends are required to improve the efficacy of cancer control.