Geographic
Net survival rates for counties use patients’ home addresses from when they were diagnosed. Even if a patient moves after diagnosis, perhaps to be closer to a cancer treatment center, that patient’s outcome will be used for the net survival rate of his or her original county of residence.
A region’s net cancer survival rate reflects the population in the county: how often they screen for cancer, the prevalence of risky behaviors such as smoking, the prevalence of impoverished neighborhoods and access to quality treatment.
All cancers
Clear geographic disparities could be seen in Pennsylvania counties’ 5-year net cancer survival rates. Southwest and northeast Pennsylvania had most of the counties with the lowest 5-year net cancer survival rates. Philadelphia’s rate was also low. Many counties in the Southcentral and Southeast Health Districts had relatively high rates.
Two counties stood out from their neighbors. Centre County had a higher rate than surrounding counties, while Philadelphia had a lower rate than surrounding counties. In fact, Philadelphia had the lowest rate of all the counties.
Noteworthy sites
For any specific cancer type and specific county, few cases meet the requirements of this report. This weakens the accuracy of net survival estimates. Because of this, we cannot confidently compare the net survival rate in one county to another for any type of cancer. However, the maps can still show general geographic patterns.
Lung and bronchus cancer
Because of how deadly lung cancer can be, many patients do not survive 5 years past diagnosis. This prevented the calculation of age-adjusted 5-year net survival rates, so the three-year rates will be used for lung and bronchus cancer.
Philadelphia and Allegheny counties often have a heavy cancer burden compared to the rest of the state, but their net lung cancer survival rates were similar to those of their neighbors. The counties with poor rates for net lung and bronchus cancer survival fall along either the northern border of the state or in a swath from the Southwest to the Northwest corners.
These counties mostly lie far from metropolitan areas, according to the United States Department of Agriculture (2016). However, the metro areas surrounding Eerie, Wilkes-Barre, and Williamsport have poor net survival.
The reason for this disparity isn’t clear. Patients living in these counties may have fewer opportunities for screening; they may find it difficult to travel to appointments; they may not have enough money for better treatment; or there might be other personal and environmental influences on their health. Determining the causes and how much each one matters would need a thorough investigation.
Breast cancer
Net survival rates for breast cancer were also lower in non-metro counties. However, a group of north central counties did not have rates as low as other non-metro counties: McKean, Potter, Tioga, and Clinton.