Abstract
INTRODUCTION: Poverty is associated with higher cancer rates, cancer risk factors such as tobacco use and obesity, and lack of access to cancer screening and treatment. This analysis examined differences in cancer outcomes and associated factors among the poorest counties and the most affluent counties in Ohio. METHODS: We compared cancer incidence and mortality rates and prevalence of selected cancer risk factors between the 12 poorest counties in Ohio and the 10 most affluent counties in Ohio from January 1, 2011, through December 31, 2015. We also compared stage at diagnosis of selected cancers and the health insurance and treatment status of people with cancer. RESULTS: The mortality rate for all cancers combined was 19% higher in the poorest counties (192.2 per 100,000) than in the most affluent counties (161.9 per 100,000). Cervical cancer and other smoking-related cancers had higher rates in the poorest counties, where they were more likely to be diagnosed at a late stage. The prevalence was significantly higher in Ohio's poorest counties for current tobacco smoking (25.6% vs 17.1%), obesity (32.7% vs 28.3%), and physical inactivity (29.7% vs 23.0%). Among people with cancer, a smaller percentage had private health insurance (42.9% vs 33.0%) and a greater percentage had no treatment (8.9% vs 10.4%) in the poorest counties. CONCLUSION: This study demonstrates disparities in cancer incidence, mortality, and stage, and differences in cancer risk factors, health insurance, and treatment status between Ohio's poorest and most affluent counties. This information may help to target public health interventions for the prevention, early detection, and control of cancer.