Resumen de Outlier in Analysis of Cancer Mortality by US County—Reply
Ali H. Mokdad, Christopher J. L. Murray, Laura Dwyer Lindgren
Our study on trends and patterns of cancer mortality among US counties highlighted substantial variation in cancer mortality rates among counties in the United States. Although we did not directly consider the drivers of this variation, there are likely many different factors at play.
Dr Hall and colleagues describe an important driving force behind the exceptionally high cancer mortality rates observed in Union County, Florida: the presence of a state prison complex containing a medical hospital and cancer treatment center that serves inmates from all of Florida. This hospital draws a large number of cancer patients—who are at much higher risk of dying of cancer compared with individuals with no cancer diagnosis—to Union County, increasing the observed mortality rate.
