TUESDAY, March 24, 2026 (HealthDay News) -- From 1969 to 2023, there was a shift in the highest all-cancer mortality rates from large metropolitan areas to nonmetropolitan areas with the smallest urban population, according to a study published online March 19 in the Journal of the National Cancer Institute.Farhad Islami, M.D., Ph.D., from the American Cancer Society in Atlanta, and colleagues used National Center for Health Statistics data to examine trends in age-standardized cancer mortality rates by urbanicity of county of residence.The researchers found that the highest all-cancer mortality rates shifted from large metropolitan areas to nonmetropolitan areas with the smallest urban population during 1969 to 2023. The crossover occurred in the 1990s and early 2000s in males and females, respectively; in subsequent years, the rural-urban mortality gap widened. For lung, colorectal, and breast cancer mortality, a similar pattern was observed."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," Islami said in a statement. "Unfortunately, these trends largely reflect growing inequalities in social determinants of health."Abstract/Full Text (subscription or payment may be required).Sign up for our weekly HealthDay newsletter