9A
THE DAILY ASTORIAN • WEDNESDAY, JANUARY 25, 2017
Dying from cancer: Could your location determine your fate?
By LINDSEY TANNER
Associated Press
CHICAGO — Americans
in certain struggling parts of
the country are dying from can-
cer at rising rates, even as the
cancer death rate nationwide
continues to fall, an exhaustive
new analysis has found.
In parts of the country that
are relatively poor, and have
higher rates of obesity and
smoking, cancer death rates
rose nearly 50 percent, while
wealthier pockets of the coun-
try saw death rates fall by
nearly half.
Better screening and treat-
ment have contributed to the
improvement in the nation as a
whole — but the study under-
scores that not all Americans
have benefited from these
advances.
“We are going in the wrong
direction,” said Ali Mokdad,
the study’s lead author and
a professor at the University
of Washington’s Institute for
Health Metrics and Evaluation.
“We should be going forward,
not backward.”
Stark differences
Stark differences in regional
cancer death rates have been
found in previous research,
but this one stands out for pro-
viding detailed estimates for
deaths from nearly 30 types of
cancer in all 3,100 U.S. coun-
ties over 35 years.
From 1980 to 2014, the
U.S. death rate per 100,000
people for all cancers com-
bined dropped from about 240
to 192 — a 20 percent decline.
More than 19 million Ameri-
cans died from cancer during
that time, the study found.
The picture was rosiest the
Colorado ski country, where
cancer deaths per 100,000 res-
idents dropped by almost half,
from 130 in 1980 to just 70
in 2014; and bleakest in some
eastern Kentucky counties,
where they soared by up to 45
percent.
“We all know this is unac-
ceptable … in a country that
spends more than anybody else
on health,” Mokdad said.
The Affordable Care Act
took effect in the study’s final
years and emphasized preven-
tion services including no-cost
screenings for breast, colorec-
tal and cervical cancers. Any
resulting benefits wouldn’t be
evident in the latest results,
since cancer takes years to
develop. It’s unknown whether
similar coverage will be part
of the replacement system the
Trump administration and con-
gressional Republicans are
seeking.
An editorial published
with the study by Stephanie
Wheeler, a University of North
Carolina health policy special-
ist and Dr. Ethan Basch, a Uni-
versity of North Carolina can-
cer specialist, notes that many
areas with the highest cancer
death rates also strongly sup-
ported Donald Trump, “raising
hopes that future policies devel-
oped by the incoming adminis-
tration will provide resources”
for these communities.
Researchers
estimated
county death rates using U.S.
government death records
and U.S. Census Bureau data.
Results were published Tues-
day in the Journal of the Amer-
ican Medical Association.
Better understanding
Ahmedin Jemal, an Ameri-
can Cancer Society researcher,
said better understanding vari-
ations in cancer death rates will
help target cancer prevention
and control.
Among the more striking
disparities:
—In counties with the high-
est 2014 cancer death rates, six
of the top 10 were in eastern
Kentucky. Six of the 10 low-
est rates were in the Colorado
Rockies.
—For lung cancer deaths,
four of the five counties with
the highest 2014 rates were in
eastern Kentucky, with rates
extremely effective, “almost
nobody should die of testicular
cancer,” Murray said.
The poor showing for east-
ern Kentucky contrasts with
wealthier parts of the state and
“is tremendously troubling,”
said Ben Chandler, presi-
dent of the Foundation for a
Healthy Kentucky , a nonpar-
tisan group that funds health
policy research and advocacy.
Chandler cited poor access
to health care and high smok-
ing rates and said the dispari-
ties highlight a need for state-
wide smoke-free laws. The
foundation funded a study that
found that Kentucky’s 2014
Medicaid expansion under the
Affordable Care Act covered
costs for many cancer-related
preventive health measures
including mammograms and
colon cancer screenings.
How that expanded access
will fare under with the health
care law’s expected repeal “has
been of great concern to us,”
Chandler said.
up to 80 percent higher than in
1980. Three of the five coun-
ties with the lowest 2014 rates
were in the Colorado Rockies,
where rates dropped by up to
60 percent.
—Death rates for breast and
colorectal cancers increased
in Madison County, Missis-
sippi, and in 2014 were at least
five times higher there than
in Summit County, Colorado,
where the rates fell. These are
among cancers that can be suc-
cessfully treated if detected
early.
Smoking, obesity, physi-
cal activity and income explain
many of the disparities, said
study co-author Dr. Christo-
pher Murray, also at the Uni-
versity of Washington.
But the study also raises
questions. For example, rel-
atively high rates of testicu-
lar cancer were found in parts
of Southern California and
far southern Texas for reasons
that are unclear. Since treat-
ments for this rare cancer are
Oscars go gaga for ‘La La Land’ with record-tying 14 nominations
Musical a hit
with viewers
and critics
By JAKE COYLE
Associated Press
The candy-colored love let-
ter to musicals “La La Land”
landed a record-tying 14 Acad-
emy Award nominations on
Tuesday, while a notably more
diverse field of nominees
brushed off two straight years
of “OscarsSoWhite” backlash.
“La La Land” matched
“Titanic” and “All About Eve”
for most nominations ever,
earning nods for best picture,
stars Emma Stone and Ryan
Gosling, its jazz-infused songs
and its 32-year-old writer-direc-
tor, Damien Chazelle.
In stark contrast to the last
two years of all-white acting
nominees, seven actors of color
were nominated out of the 20
actors. A record six black actors
were nominated (“Fences” stars
Denzel Washington and Viola
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Davis, Mahershala Ali and
Naomie Harris of “Moonlight,”
Ruth Negga of “Loving” and
Octavia Spencer of “Hidden
Figures”), as was Dev Patel, the
British-Indian star of “Lion.”
A trio of acclaimed films led
the overhaul, foremost among
them Barry Jenkins’ luminous
coming-of-age portrait “Moon-
light.” Its eight nominations,
including best picture, tied for
the second most nods. Denzel
Washington’s fiery August Wil-
son adaptation “Fences” and
Theodore Melfi’s crowd-pleas-
ing African American mathe-
matician drama, “Hidden Fig-
ures,” were also showered with
nominations, including best
picture.
Jenkins, who was nomi-
nated for directing and adapted
screenplay, said the nomina-
tions for “Moonlight” and other
films showed that people were
eager to put themselves in the
shoes of others.
“I love the American film
industry and to see it this year,
I feel, really reflect the world
that we all live and work in, it
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receiving any of the preceding
services, please contact the
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1-877-382-4357
Dale Robinette/Lionsgate
Ryan Gosling, right, and Emma Stone in a scene from, “La
La Land.” The film was nominated for an Oscar for best
picture on Tuesday. The 89th Academy Awards will take
place on Feb. 26.
gives me hope,” Jenkins said by
phone from Amsterdam.
Best picture
Nine films out of a pos-
sible ten were nominated for
best picture. The others were:
Denis Villeneuve’s cerebral
alien thriller “Arrival,” Ken-
neth Lonergan’s New England
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3-day garage sale
Thursday, Friday and Saturday
(Jan 26th-28th) 10am-4pm.
antiques, collectibles, christmas
decor, new costume jewelry,
much more.
1889 SE 3rd Street, Astoria
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Best actors
Best actor favorites Wash-
ington, Gosling and Casey
Affleck (“Manchester by the
Sea”) were joined by Garfield
and Viggo Mortensen (“Captain
Fantastic”). Along with Ali and
Patel, the best supporting actor
nominees are Lucas Hedges
(“Manchester by the Sea”),
Michael Shannon (“Noctur-
nal Animals”) and Jeff Bridges
(“Hell or High Water”).
Viola Davis, the supporting
actress front-runner for her per-
formance in “Fences,” notched
the expected nomination. Also
up for the category are Har-
ris, Spencer, Nicole Kidman
(“Lion”) and Michelle Williams
(“Manchester by the Sea”).
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family drama “Manchester by
the Sea,” the West Texas heist
thriller “Hell or High Water,”
the “Lion,” and Mel Gibson’s
World War II drama “Hacksaw
Ridge.”
The biggest surprise of the
morning was the strong boost
of support for Gibson, who
had long been shunned in Hol-
landed her 20th nomination.
Her performance in “Florence
Foster Jenkins” was among
the best actress nominees that
included Stone, Natalie Port-
man (“Jackie”), Ruth Negga
(“Loving”) and Isabelle Hup-
pert (“Elle”). Also left out was
Annette Bening for “20th Cen-
tury Women.”
lywood since an anti-Semitic
tirade while being arrested for
drunk driving in 2006 and a
2011 conviction for domestic
violence. Along with the best
picture nod, Gibson scored an
unexpected best director nom-
ination. Gibson, whose ninth
child was born Friday, said in
a statement that nothing was
more exciting than hearing the
nominations read while holding
my newborn son.”
Andrew Garfield, who was
nominated for best actor for
his performance in “Hacksaw
Ridge,” said Gibson deserved
the moment.
“I think finally people are
remembering who Mel actually
is, not what the tabloids (said),”
said Garfield by phone. “I’m so,
so proud of him.”
“Arrival” tied “Moonlight”
for the second most nominees
with eight nods. Yet its five-time
nominated star, Amy Adams,
was left out of the competitive
best actress category.
Instead, Meryl Streep,
whom President Donald Trump
recently derided as “overrated,”
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are not, or if you are a contractor who wishes to register, call Construction Contractor's Board in Salem, OR 1-503-378-4621.