美国的第二大死因是癌症，阿巴拉契亚肯塔基州的疾病负担也很高，部分原因是健康行为和社会卫生决定因素的不平等。本研究旨在评估阿巴拉契亚肯塔基州的癌症负担相对于非阿巴拉契亚肯塔基州以及肯塔基州相对于美国其他州（除肯塔基州外）的情况。分析了以下数据：从1968年到2018年的每年全因和全癌症死亡率；从2014年到2018年的5年全癌和特定癌症的患病率和死亡率；2016年到2018年的美国（除肯塔基州外）、肯塔基州、非阿巴拉契亚肯塔基州和阿巴拉契亚肯塔基州的筛查和风险因素汇总数据；以及2018年美国和肯塔基州的性别人类乳头瘤病毒疫苗接种普及率。自1968年以来，美国的全因和癌症死亡率减少很多，但在肯塔基州减少得较少且较慢，阿巴拉契亚肯塔基州的减少率更低更慢。相比于非阿巴拉契亚肯塔基州，阿巴拉契亚肯塔基州患癌症的整体发病率和死亡率更高，特定部位癌症的发病率也更高。造成这种现象的原因包括筛查率不平等和肥胖和吸烟率增加。阿巴拉契亚肯塔基州的癌症不平等一直存在，包括50年来升高的全因和癌症死亡率，扩大了该地区与美国其他地区之间的差距。除了解决社会卫生决定因素外，增加改善健康行为和增加医疗卫生资源获取渠道的努力也可以帮助缩小这种差距。©2023年全国农村卫生协会。

Cancer is the second leading cause of death in the United States, and the disease burden is elevated in Appalachian Kentucky, due in part to health behaviors and inequities in social determinants of health. This study's goal was to evaluate Appalachian Kentucky's cancer burden compared to non-Appalachian Kentucky, and Kentucky compared to the United States (excluding Kentucky).The following data were analyzed: annual all-cause and all-site cancer mortality rates from 1968 to 2018; 5-year all-site and site-specific cancer incidence and mortality rates from 2014 to 2018; aggregated screening and risk factor data from 2016 to 2018 for the United States (excluding Kentucky), Kentucky, non-Appalachian Kentucky, and Appalachian Kentucky; and human papilloma virus vaccination prevalence by sex from 2018 for the United States and Kentucky.Since 1968, the United States has experienced a large decrease in all-cause and cancer mortality, but the reduction in Kentucky has been smaller and slower, driven by even smaller and slower reductions within Appalachian Kentucky. Appalachian Kentucky has higher overall cancer incidence and mortality rates and higher rates for several site-specific cancers compared to non-Appalachian Kentucky. Contributing factors include screening rate disparities and increased rates of obesity and smoking.Appalachian Kentucky has experienced persistent cancer disparities, including elevated all-cause and cancer mortality rates for 50+ years, widening the gap between this region and the rest of the country. In addition to addressing social determinants of health, increased efforts aimed at improving health behaviors and increased access to health care resources could help reduce this disparity.© 2023 National Rural Health Association.