Introduction: We sought to identify county-level cancer mortality hotspots for breast, colorectal, lung, and prostate cancers, as well as evaluate contributions of structural factors underlying racial/ethnic disparities, and social vulnerability index (SVI).
Methods: This ecological analysis included states selected to represent high (i.e., Massachusetts), medium (i.e., Ohio), and low (i.e., Mississippi) GDP categories. A cancer hotspot was defined as a county with elevated cancer mortality rates.
Results: Cancer hotspots in Mississippi consisted of higher SVI (breast: 95.9 vs. 82.8), lower median household income ($34,808 vs. $43,766), and predominantly Black populations (63.7 % vs. 35.1 %) (all p < 0.05). Ohio hotspots had higher rates of food insecurity (17 % vs. 13 %), smoking (lung: 29 vs. 23 %), and obesity (colorectal: 41 % vs. 38 %) (all p < 0.05). In Mississippi, disparities rooted in structural racism were more prominent, whereas socioeconomic disadvantage was more prominent in Ohio.
Conclusion: Cancer mortality hotspots are disproportionately concentrated in low-GDP states, driven by social vulnerability and economic disparities.
Keywords: Cancer mortality; Geospatial analysis; Hotspots; Racial disparities; Social vulnerability index (SVI); Socioeconomic disparities.
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