| Popis: |
BACKGROUND: Rural populations rank poorly on numerous health indicators, including cancer outcomes, when compared to urban populations. We examined the relationship of rural residence with stage and treatment among patients with prostate cancer, the second most common malignancy in men. METHODS: Using the Pennsylvania Cancer Registry, we identified all individuals diagnosed with prostate cancer between 2009 and 2015. Patients were classified as residing in rural, large town, or urban areas using the Rural-Urban Commuting Area (RUCA) classification. Our primary outcomes included indicators of prostate cancer treatment and treatment types; we also examined stage and mortality. We used Chi-square tests to assess differences between groups and estimated multivariable logistic regression models to assess the association between rural residence and treatment. RESULTS: We identified 51,024 men diagnosed with either localized or metastatic prostate cancer between 2009 and 2015. The overall incidence of prostate cancer decreased over the study period from 416 to 304 per 100,000 men, while incidence of metastatic disease increased from 336 to 538 per 100,000. Rural residents were less likely to undergo treatment compared to urban residents, even when stratified by low- (adjusted odds ratio [aOR] 0.77; 95% confidence interval [CI] 0.64–0.91), intermediate- ([aOR] 0.71; [CI] 0.58–0.89), and high-risk disease ([aOR] 0.68; [CI] 0.53–0.89). Rural status did not affect receipt of radiation therapy compared to other treatment types. CONCLUSION: Prostate cancer treatment differs between urban and rural residents: rural residents are less likely to receive treatment even when stratified by disease risk. |
