Differences in lung cancer death rates by rural vs. urban status in comparison to all-cancer death rates — United States, 1999–2020

Abstract

Background

Differences in all-cancer mortality by rural vs. urban status exist; limited information exists regarding how lung cancer contributes to these differences. We describe the contribution of lung cancer to rural-urban differences in all-cancer death rates.

Methods

We used National Vital Statistics System data to calculate age-adjusted lung cancer death rates by rural vs. urban status, overall and by multiple subgroups. We calculated the average annual percent change in cancer death rates by rural vs. urban status between 1999–2020, and percentage contribution of lung cancer to excess all-cancer mortality in rural counties in 2020.

Results

In 2020, lung cancer death rates were higher in rural counties among females (33.5 vs. 25.7) and males (49.0 vs. 35.9). Between 1999–2020, larger declines in lung cancer death rates were generally observed in urban counties. In 2020, lung cancer contributed 44.4 % to the excess all-cancer mortality in rural counties.

Conclusions

Lung cancer death rates were generally higher in rural counties, and differences in death rates increased over time. In 2020, lung cancer contributed a large percentage to excess all-cancer mortality in rural counties. Implementation of interventions to improve lung cancer prevention, screening, and treatment might reduce rural-urban differences in cancer deaths.