CHICAGO (AP) — A big new analysis finds that U.S. cancer death rates have steadily climbed in parts of the country struggling with obesity, heavy smoking and other ills. That’s a stark contrast with the national trend and improvements in wealthier pockets of the country.

In parts of Appalachia and the Deep South, the rates have soared as much as they have fallen elsewhere.

Stark regional differences in cancer deaths have been found in previous research, but this one stands out for providing detailed estimates for deaths from nearly 30 types of cancer in all 3,100 U.S. counties over 35 years.

Better cancer screening and treatment have contributed to the improvement. The study underscores that not all Americans have benefited from those advances, and gaps exist down to the most local level.

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