ArticleJournal of community health2012
Cancer mortality rates in Appalachia: descriptive epidemiology and an approach to explaining differences in outcomes.
Article in Journal of community health, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 34 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
34 citing papers in PubMed.
- Evaluating the effects of nicotine concentration on the appeal and nicotine delivery of oral nicotine pouches among rural and Appalachian adults who smoke cigarettes: A randomized cross-over study.Addiction (Abingdon, England) · 2024Trial
- A Group Randomized Trial to Reduce Obesity among Appalachian Church Members: The Walk by Faith Study.Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology · 2018Trial
- Results of a Multilevel Intervention Trial to Increase Human Papillomavirus (HPV) Vaccine Uptake among Adolescent Girls.Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology · 2016Trial
- Effectiveness of a primary care practice intervention for increasing colorectal cancer screening in Appalachian Kentucky.Preventive medicine · 2014Trial
- Who is benefiting from the dramatic decline in U.S. cancer mortality? Place-based evidence of disparities in rates of improvement.British journal of cancer · 2026Article
- Patient, facility, and community determinants of timely follow up after abnormal screening mammograms in Appalachia: A multilevel analysis.The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association · 2026Article
- Differential extracellular matrix proteomic signatures in colorectal tumors from Appalachian and non-Appalachian patients.Oncology letters · 2025Article
- Examining Geographic Disparity: Variation in Cancer Outcomes Within Appalachia.Journal of the American College of Surgeons · 2025Article
- Appalachia's worsening disparities in cancer mortality should be viewed as a regional manifestation of widening global disparities in health outcomes rather than a uniquely American phenomena.Lancet regional health. Americas · 2024Article
- The paradox of high greenness and poor health in rural Central Appalachia.Environmental research · 2024Article
- Investigation of spatial pattern of apnea disorder using geographic information system (GIS)-case study of Kermanshah metropolis.Journal of public health research · 2023Article
- Perceptions of oral nicotine pouches & their marketing among Ohio Appalachia smokers and smokeless tobacco users.PloS one · 2023Article
- Associations Between Surface Mining Airsheds and Birth Outcomes in Central Appalachia at Multiple Spatial Scales.GeoHealth · 2022Article
- Challenges and Opportunities in Designing and Deploying Remote Health Monitoring Technology for Older Adults With Cancer.Innovation in aging · 2022Article
- Epidemiology of acute myeloid leukemia in Virginia: Excellent survival outcomes for patients in rural Appalachia.Cancer reports (Hoboken, N.J.) · 2021Article
- Assessing health disparities in breast cancer incidence burden in Tennessee: geospatial analysis.BMC women's health · 2021Article
- Factors Contributing to Delay in Specialist Care After Colorectal Cancer Diagnosis in Kentucky.The Journal of surgical research · 2021Article
- Nonadherence to Standard of Care for Locally Advanced Colon Cancer as a Contributory Factor for High Mortality Rates in Kentucky.Journal of the American College of Surgeons · 2020Article
- Skin Cancer and UV Exposure-Related Behaviors Among Appalachian and Non-Appalachian Adults.Journal of Appalachian health · 2020Article
- Challenges of using nationally representative, population-based surveys to assess rural cancer disparities.Preventive medicine · 2019Article
Corrections and comments
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Authors and funding
3 authors.
Funding
Abstract
Cancer is a leading cause of death in the Appalachian region of the United States. Existing studies compare regional mortality rates to those of the entire nation. We compare cancer mortality rates in Appalachia to those of the nation, with additional comparisons of Appalachian and non-Appalachian counties within the 13 states that contain the Appalachian region. Lung/bronchus, colorectal, female breast and cervical cancers, as well as all cancers combined, are included in analysis. Linear regression is used to identify independent associations between ecological socioeconomic and demographic variables and county-level cancer mortality outcomes. There is a pattern of high cancer mortality rates in the 13 states containing Appalachia compared to the rest of the United States. Mortality rate differences exist between Appalachian and non-Appalachian counties within the 13 states, but these are not consistent. Lung cancer is a major problem in Appalachia; most Appalachian counties within the 13 states have significantly higher mortality rates than in-state, non-Appalachian counterparts. Mortality rates from all cancers combined also appear to be worse overall within Appalachia, but part of this disparity is likely driven by lung cancer. Education and income are generally associated with cancer mortality, but differences in the strength and direction of these associations exist depending on location and cancer type. Improving high school graduation rates in Appalachia could result in a meaningful long term reduction in lung cancer mortality. The relative importance of household income level to cancer outcomes may be greater outside the Appalachian regions within these states.
Indexed as
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.