Disparities in cancer survival and incidence by metropolitan versus rural residence in Utah

Published on Apr 1, 2018in Cancer Medicine4.452
· DOI :10.1002/CAM4.1382
Mia Hashibe76
Estimated H-index: 76
(UofU: University of Utah),
Anne C. Kirchhoff27
Estimated H-index: 27
(UofU: University of Utah)
+ 8 AuthorsKathi Mooney27
Estimated H-index: 27
(HCI: Huntsman Cancer Institute)
Sources
Abstract
: Cancer disparities in rural and frontier communities are an important issue in Utah because much of Utah is sparsely populated. The aims of this study were to investigate whether there are differences in the cancer incidence and 5-year survival rates in Utah by metropolitan/rural residence and to investigate disparities in distributions of cancer risk factors. We used cancer registry records to identify patients diagnosed with a first primary cancer in Utah between 2004 and 2008. We estimated 5-year survival and incidence rates. The Cox proportional hazards model was used to estimate hazard ratios (HRs) for the risk of death. There were 32,498 (86.9%) patients with cancer who lived in metropolitan counties and 4906 (13.1%) patients with cancer who lived in rural counties at the time of cancer diagnosis. Patients with cancer from rural counties were more likely to be older, American Indian/Alaskan Native, non-Hispanic, male, and diagnosed at higher stage. Rural residents had a five-year relative survival that was 5.2% lower than metropolitan residents and a 10% increase in risk of death (HR = 1.10, 95% CI = 1.03, 1.18) after adjustment for multiple factors. Overall, the cancer incidence rates in rural counties were lower by 11.9 per 100,000 per year (449.2 in rural counties vs. 461.1 in metropolitan counties). Cancer patients living in rural counties of Utah had different demographic characteristics as well as differences in incidence and survival rates. Further studies with individual-level data are necessary to investigate the reasons behind these differences in cancer incidence and survival to reduce disparities.
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References5
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#1Brynn Fowler (HCI: Huntsman Cancer Institute)H-Index: 8
#2N. Jewel Samadder (HCI: Huntsman Cancer Institute)H-Index: 16
Last. Anne C. Kirchhoff (UofU: University of Utah)H-Index: 27
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Purpose Little is known about disparities in colorectal cancer (CRC) incidence and mortality by community-level factors such as metropolitan status. Methods This analysis utilized data from the Surveillance, Epidemiology, and End Results (SEER) program from Utah. We included patients diagnosed with CRC from 1991 to 2010. To determine whether associations existed between metropolitan/nonmetropolitan county of residence and CRC incidence, Poisson regression models were used. CRC mortality was asse...
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#1Nengliang Yao (UVA: University of Virginia)H-Index: 13
#2Héctor E. Alcalá (UVA: University of Virginia)H-Index: 15
Last. Rajesh Balkrishnan (UVA: University of Virginia)H-Index: 69
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#1S. Jane HenleyH-Index: 50
#2Robert N. Anderson (National Center for Health Statistics)H-Index: 20
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Obesity and components of energy imbalance, that is, excessive energy intake and suboptimal levels of physical activity, are established risk factors for cancer incidence. Accumulating evidence suggests that these factors also may be important after the diagnosis of cancer and influence the course of disease, as well as overall health, well-being, and survival. Lifestyle and medical interventions that effectively modify these factors could potentially be harnessed as a means of cancer control. H...
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