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CHICAGO — Americans in certain struggling parts of the country are dying from cancer 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 country saw death rates fall by nearly half.

Better screening and treatment have contributed to the improvement in the nation as a whole — but the study underscores 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.’’

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Stark differences in regional cancer death rates 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 US counties over 35 years.

From 1980 to 2014, the US death rate per 100,000 people for all cancers combined dropped from about 240 to 192 — a 20 percent decline. More than 19 million Americans died from cancer during that time, the study found.

The picture was rosiest the Colorado ski country, where cancer deaths per 100,000 residents dropped 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 unacceptable . . . 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 prevention services including no-cost screenings for breast, colorectal, and cervical cancers. Any benefits wouldn’t be evident in the latest results, since cancer takes years to develop.

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