What We Can Do about Cancer Disparities in Utah

We live in a rural and increasingly diverse state in Utah. We have the 12th highest percentage of Hispanic residents in the United States. More than 96% of the area in Utah is considered rural (fewer than 100 people per square mile) or frontier (fewer than 7 people per square mile), with more than 330,000 people living in those areas. Rural residents are less likely to get cancer, but they are 10% more likely to die from it compared to residents of urban areas.

That’s just one example of a health disparity Utahns face. Health disparities, which includes cancer disparities, are when people have worse health outcomes because of economic, social, cultural, environmental, and geographic disadvantages. Like many other states, Utah sees health disparities in rural residents, people of color, people living in poverty, and other groups.

Utah keeps track of information about cancer cases, such as cancer type and number of cancer deaths. The data includes anonymous info about patients, such as age, gender, race, and ethnicity. This information helps us understand which groups of people suffer from cancer disproportionately. We first need to know what the disparities are before we can address them. The ultimate goal is to have health equity.

What are some groups in Utah who have cancer disparities?

Rural residents and the Hispanic population are two of the biggest groups who experience cancer disparities in Utah.

Researchers at Huntsman Cancer Institute found rural cancer patients in Utah had lower survival rates than non-rural for brain cancer, endometrial cancer, oral/throat cancer, and kidney cancer. Rural residents were also diagnosed at later stages. This may contribute to the 10% increase in the risk of death for rural residents with cancer (even when accounting for age and other factors).

Hispanic individuals have a higher likelihood of developing lung, kidney, and pancreatic cancers. The likelihood of dying from lung and pancreatic cancers is about the same for Hispanic and non-Hispanic patients. But it is notably higher for kidney cancer.

Why do these disparities exist?

We don’t yet know the reasons for these disparities. But one place to start is by looking at differences in factors that can contribute to cancer burden:

• Income level. Rural residents in Utah experience more poverty than urban residents.
• Education level. Rural Utahns and Hispanic Utahns tend to have less education.
• In Utah, people in rural areas tend to be older than urban residents. Hispanic Utahns tend to be younger than non-Hispanic Utahns.
• Tobacco use. Rural Utahns and Hispanic Utahns use tobacco more.
• Cancer screening rates. Both groups have lower rates of cancer screening.
• Access to health care. Rural residents have to travel farther to get to doctors and clinics.
• Language or cultural barriers. Hispanic Utahns may not seek health care because of language or cultural differences. 
• Health insurance. Fewer rural Utahns and Hispanic Utahns have health insurance, or they are underinsured.

What can we do to reduce cancer disparities?

We need more in-depth research studies to fully understand the reason for cancer disparities. But we do know how to address some of the factors listed above through cancer prevention programs. These are some examples:

• Community Outreach and Prevention Education program builds capacity for collaboration across research and clinical care in communities throughout Utah. Bilingual community health educators bring cancer resources and education to community groups and help build longstanding community partnerships to improve community health.
• At the Center for Health Outcomes and Population Equity (HOPE), researchers and community partners help people quit smoking. This dramatically reduces their risk for lung cancer and other cancers.
• Huntsman Cancer Institute is home to the Intermountain West HPV Vaccination Coalition, which focuses on improving HPV vaccination rates in Latinas and other populations. This helps reduce the higher likelihood of cervical cancer for those women.
• The Cancer Screening and Education Bus brings screening services, such as mammography, to rural areas and underserved urban areas.

These efforts are making a difference, but we will not stop addressing disparities until we achieve health equity for all.