Young Americans living in rural and impoverished areas are more likely to die from colon cancer, a study suggests.
Doctors in the United States have already had difficulty detecting colorectal cancer in young people, since they are not normally at risk for the disease.
But in rural and poor areas, the problem is even worse, as residents have fewer doctors, longer wait times and are more likely to have unhealthy lifestyles, all of which increase the risk of developing cancer.
In the new study, researchers at Augusta University in Georgia looked at nearly 60,000 patients with early-onset colorectal cancer, meaning those under age 50.
Comparing federal data on cancer and poverty, the team found that Americans aged 20 to 49 were up to one and a half times more likely to die from colorectal cancer if they lived in poverty-stricken rural areas than people in wealthier urban areas.
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Other recent research has also shown that people living in wealthier, more densely populated areas are more likely to detect their disease earlier, making it easier to treat.
With these findings in mind, DailyMail.com compiled interactive data on colorectal cancer rates in young people across the United States by state and county, although county-by-county data is limited.
The maps reveal that young people in states such as Kentucky, West Virginia and Louisiana had the highest number of cases of early-onset colorectal cancer, and rural counties in Florida, Arkansas and West Virginia had the highest incidences.
Meanwhile, counties in states like California, New York and the Northeast coast, which tend to have higher incomes, had lower rates of early-onset colorectal cancer.
This form of cancer, in particular, is thought to be strongly influenced by diet, alcohol consumption and sedentary lifestyles.
Rural areas are also more likely to be food deserts, resulting in a lack of fruits, vegetables and high-fiber foods that have been shown to reduce the risk of obesity and colon cancer.
The study, published Wednesday in JAMA Network OpenThey analyzed cancer incidence data from 2006 to 2015 from the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) database.
The team tracked colorectal cancer rates and deaths in 58,200 patients aged 20 to 49.
About 43 percent of the patients were between 40 and 49 years old and 53 percent were men.
Additionally, one in five lived in rural areas with persistent poverty, according to USDA data, putting them at risk of developing the disease or not detecting it in time.
The team found that overall, the five-year survival rate for colorectal cancer in young patients was highest in those living in non-impoverished urban areas, at 72 percent.
Meanwhile, the rate in impoverished rural and urban areas fell to 67 percent.
And for the youngest group of patients, aged 20 to 29, in poverty-stricken rural areas, the survival rate fell to 64 percent.
The researchers found that overall, young colorectal cancer patients “living alone in rural areas had a 1.1- to 1.4-fold increased risk of death from CRC compared with those living in nonrural areas.”
And patients living in rural and impoverished areas were up to one and a half times more likely to die from colorectal cancer than their urban counterparts.
Although researchers did not name specific locations, federal data sheds light on areas most at risk.
Jill MacDonald (left) is a stage 4 colorectal cancer patient living in Missouri, where one in three residents live in rural areas. Dr. Dan Bockmann was living in Texas when he was diagnosed, where one in six residents live in rural neighborhoods.
The chart above shows that colon cancer cases among those under 50 rose by more than 5,500 in 20 years. There is a drop in 2020 because the Covid pandemic caused fewer people to come forward for screening.
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According to the latest NCI county-by-county data, Union County, Florida, had the highest incidence of early-onset colorectal cancer, with 32 cases per 100,000 residents under age 50.
The rural county southwest of Jacksonville also topped the list for the highest number of early-onset cancers overall in a separate analysis.
Rural areas, with just 15,000 inhabitants, have also historically led the country in terms of lung, mouth and skin cancers.
Health officials believe this could be due to high smoking rates and a lack of funding for health care in the area, as well as the fact that one in six residents lives in poverty.
USDA data shows the median household income in the area is about $55,000, about a quarter below the national average of $75,000.
The county’s life expectancy is also just 67 years, well below the national average of 76, according to US News and World Report.
Ouachita County, Arkansas, had the second-highest rate of early-onset colorectal cancer, with 25 cases per 100,000 residents. The southwestern county has just 22,000 residents, and according to USDA data, its median household income is about $44,000 — roughly 40 percent below the national average.
Mingo County in West Virginia also recorded 25 cases per 100,000 residents. The area, which is also home to about 22,000 residents, has a household income of about $35,000 — less than half the national average.
In terms of state data, West Virginia also led the nation in early-onset colorectal cancer, with 11 per 100,000 people.
Experts have suggested that the Mountain State’s high rates could be a product of a high prevalence of obesity, as obesity can create excess inflammation that leads to the growth of cancer cells.
West Virginia also has the highest smoking rate in the country, a known risk factor for colorectal cancer because it disrupts the gut microbiome.
Arlington County, Virginia, had the fewest cases of early-onset colorectal cancer, with 4.9 cases per 100,000 people. According to USDA data, household income in the urban area is $128,000, nearly 40 percent above the national average.
