• Posted March 23, 2026

Rural Residents Have Highest Cancer Death Rates, Researchers Say

Rural residents face an increasingly larger share of cancer deaths in the U.S., with the gap continuing to widen between them and their urban brethren, a new study says.

Rural areas had the highest cancer death rates in 2021 to 2023, while large cities had the lowest rates, researchers reported March 19 in the Journal of the National Cancer Institute.

This represents a huge long-term shift in cancer death trends, researchers said.

Between 1969 and 1971, large cities had the highest overall cancer death rates, followed by small- to medium-sized cities, researchers found.

“Differences in cancer risk factors, and in access to early detection and treatment, are likely major contributors to this shift in the high cancer burden from urban to rural areas,” said lead researcher Dr. Farhad Islami, senior scientific director of cancer disparity research at the American Cancer Society.

“Unfortunately, these trends largely reflect growing inequalities in social determinants of health,” Islami added in a news release.

For the new study, researchers analyzed data from nearly 28 million cancer deaths that occurred in the U.S. between 1969 and 2023, using records provided by the U.S. National Center for Health Statistics.

Results found evidence of this shift even when looking at specific cancers like lung, colon and breast cancers.

For example, lung cancer deaths among men in rural areas was lower by 26% compared to city dwellers in 1969 to 1971, but higher by 55% in 2021 to 2023.

The crossover occurred in the 1990s for men and the early 2000s for women, researchers said. After that, the urban-rural death gap has continued to widen.

This higher risk among rural folks is likely driven by limited access to heath care, lower cancer screening rates, higher poverty, more smoking and other lifestyle and environmental factors, researchers said.

Previous studies have shown that rural cancer survivors have poorer health and are less likely to seek care, compared to people living in cities, researchers noted.

“All people — no matter where they live — should have a fair and just opportunity to prevent, detect, treat and survive cancer,” said Lisa Lacasse, president of the American Cancer Society Cancer Action Network, the advocacy affiliate of the American Cancer Society.

“This  study highlights the need for lawmakers to support policies that help improve access to comprehensive, affordable health care and ensure health plans maintain strong and robust networks, so patients have access to the health care professionals and treatments they need. Doing so will help reduce the cancer burden for everyone,” added Lacasse, who was not involved in the study.

More information

The U.S. Centers for Disease Control and Prevention has more on rural health.

SOURCE: American Cancer Society, news release, March 18, 2026