Timothy L Fitzgerald1, C S Lea2, Jason Brinkley3, Emmanuel E Zervos4. 1. East Carolina Uinversity, Greenville, North Carolina, USA. fitzgeraldt@ecu.edu. 2. East Carolina Uinversity, Greenville, North Carolina, USA. leac@ecu.edu. 3. East Carolina Uinversity, Greenville, North Carolina, USA. brindleyj@ecu.edu. 4. East Carolina Uinversity, Greenville, North Carolina, USA. zervose@ecu.edu.
Abstract
INTRODUCTION: Conflicting data exists regarding the influence of population density on colorectal cancer (CRC) outcomes; to better understand this, the present study evaluated outcomes along an urban-rural continuum. METHODS: Colorectal patients aged ≥40 years from 1992 to 2002 were identified in the SEER (Surveillance, Epidemiology, and End Results) Registries of the National Cancer Institute in the USA. RESULTS: A total of 176 011 patients were identified, with median age 71; most lived in populous counties and were white (90%). Patients from large metropolitan counties were more often African-American, and those in rural counties were more likely to be white and have low socioeconomic status (SES). Patients from large metropolitan (>1 million) and rural counties were more likely to have metastatic disease and decreased survival compared to smaller metropolitan counties (<1 million). Late stage of presentation and diminished survival were also associated with African-American race, male sex and lower SES. CONCLUSIONS: Metropolitan counties with populations <1 million had superior CRC outcomes, in part secondary to race and SES.
INTRODUCTION: Conflicting data exists regarding the influence of population density on colorectal cancer (CRC) outcomes; to better understand this, the present study evaluated outcomes along an urban-rural continuum. METHODS: Colorectal patients aged &#8805;40 years from 1992 to 2002 were identified in the SEER (Surveillance, Epidemiology, and End Results) Registries of the National Cancer Institute in the USA. RESULTS: A total of 176 011 patients were identified, with median age 71; most lived in populous counties and were white (90%). Patients from large metropolitan counties were more often African-American, and those in rural counties were more likely to be white and have low socioeconomic status (SES). Patients from large metropolitan (>1 million) and rural counties were more likely to have metastatic disease and decreased survival compared to smaller metropolitan counties (<1 million). Late stage of presentation and diminished survival were also associated with African-American race, male sex and lower SES. CONCLUSIONS: Metropolitan counties with populations <1 million had superior CRC outcomes, in part secondary to race and SES.
Authors: Whitney E Zahnd; Aimee S James; Wiley D Jenkins; Sonya R Izadi; Amanda J Fogleman; David E Steward; Graham A Colditz; Laurent Brard Journal: Cancer Epidemiol Biomarkers Prev Date: 2017-07-27 Impact factor: 4.254
Authors: Smita Bhatia; Wendy Landier; Electra D Paskett; Katherine B Peters; Janette K Merrill; Jonathan Phillips; Raymond U Osarogiagbon Journal: J Natl Cancer Inst Date: 2022-07-11 Impact factor: 11.816
Authors: Jamaica R M Robinson; Amanda I Phipps; Wendy E Barrington; Philip M Hurvitz; Lianne Sheppard; Rachel C Malen; Polly A Newcomb Journal: Cancer Epidemiol Biomarkers Prev Date: 2021-05-04 Impact factor: 4.254
Authors: Joseph M Plummer; Pierre-Anthony Leake; Doreen Ferron-Boothe; Patrick O Roberts; Derek I Mitchell; Michael E McFarlane Journal: Ann Med Surg (Lond) Date: 2016-01-21
Authors: Elaine Ruth Carnegie; Greig Inglis; Annie Taylor; Anna Bak-Klimek; Ogochukwu Okoye Journal: Int J Environ Res Public Health Date: 2022-02-24 Impact factor: 3.390
Authors: Peter S Liang; Jonathan D Mayer; Jon Wakefield; Chau Trinh-Shevrin; Simona C Kwon; Scott E Sherman; Cynthia W Ko Journal: Clin Transl Gastroenterol Date: 2020-03 Impact factor: 4.396