Incidence and prognosis of gastroesophageal cancer in rural, urban, and metropolitan areas of the United States
Open Access
- 20 August 2013
- Vol. 119 (22), 4020-4027
- https://doi.org/10.1002/cncr.28313
Abstract
BACKGROUND The objective of this study was assess differences in the incidence, late‐stage diagnosis, and prognosis of squamous cell carcinoma of the esophagus (SCCE), adenocarcinoma of the esophagus (AE), and adenocarcinoma of the gastric cardia (AGC) in metropolitan, urban, and rural areas in the United States. METHODS The authors identified 29,527 patients with SCCE, AE, or AGC who were reported to the Surveillance, Epidemiology, and End Results Program between 2004 and 2009. Incidence estimates for each malignancy were compared across metropolitan, urban, and rural areas. Multivariable logistic regression models were applied to evaluate the association between residential setting and late (distant‐stage) diagnosis, and the results were reported as adjusted odds ratios and 95% confidence intervals (CIs). Cox proportional hazard models were used to examine the association between residential setting and cause‐specific survival. RESULTS When residential setting was analyzed using metropolitan population centers as the reference category, the incidence of AE was higher in urban areas (rate ratio [RR], 1.13; 95% CI, 1.06‐1.20) and rural areas (RR, 1.15; 95% CI, 1.05‐1.25), whereas the incidence of SCCE was lower in rural areas (RR, 0.80; 95% CI, 0.70‐0.91). Rural patients were less likely to be diagnosed with stage IV AE compared with patients residing in metropolitan areas (odds ratio, 0.79; 95% CI, 0.65‐0.97). No differences in prognosis were observed when patients from large metropolitan centers were compared with their rural counterparts. CONCLUSIONS The current findings indicated that preconceptions regarding disparities in the time of diagnosis and survival between patients from metropolitan and rural areas in the United States are either unwarranted or out of date, at least with respect to gastroesophageal cancers. Cancer 2013;119:4020–4027. © 2013 American Cancer Society.This publication has 20 references indexed in Scilit:
- The Effect of Age on Delay in Diagnosis and Stage of Breast CancerThe Oncologist, 2012
- Temporal Trends in Long-Term Survival and Cure Rates in Esophageal Cancer: A SEER Database AnalysisJournal of Thoracic Oncology, 2012
- Adenoid cystic carcinoma of the head and neckCancer, 2012
- Gender and Ethnic Disparities in Incidence and Survival of Squamous Cell Carcinoma of the Oral Tongue, Base of Tongue, and Tonsils: A Surveillance, Epidemiology and End Results Program-Based AnalysisOncology, 2011
- Differences in Late‐Stage Diagnosis, Treatment, and Colorectal Cancer‐Related Death Between Rural and Urban African Americans and Whites in GeorgiaThe Journal of Rural Health, 2011
- Impact of Postoperative Radiation after Esophagectomy for Esophageal CancerJournal of Thoracic Oncology, 2010
- Changes in Incidence and Survival of Ewing Sarcoma Patients Over the Past 3 DecadesJournal of Pediatric Hematology/Oncology, 2008
- Rural, Suburban, and Urban Variations in Alcohol Consumption in the United States: Findings From the National Epidemiologic Survey on Alcohol and Related ConditionsThe Journal of Rural Health, 2007
- Outcome Results of the 1996-1999 Patterns of Care Survey of the National Practice for Patients Receiving Radiation Therapy for Carcinoma of the EsophagusJournal of Clinical Oncology, 2005
- Differential correlates of physical activity in urban and rural adults of various socioeconomic backgrounds in the United StatesJournal of Epidemiology and Community Health, 2003