Vinayak Muralidhar1, Paul L Nguyen2, Reginald D Tucker-Seeley3. 1. Department of Medicine, Brigham and Women's Hospital, Boston, MA 02115, United States. Electronic address: vmuralidhar@partners.org. 2. Department of Radiation Oncology, Dana-Farber Cancer Institute and Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, United States. Electronic address: pnguyen@LROC.harvard.edu. 3. Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health/Center for Community Based Research, Dana-Farber Cancer Institute, United States. Electronic address: retucker@hsph.harvard.edu.
Abstract
OBJECTIVE: To determine the impact of recent relocation prior to a cancer diagnosis on cancer-specific outcomes. METHODS: We identified 272,718 patients with two different entries in the Surveillance, Epidemiology, and End Results database within 3years of each other. Those who had relocated to a different county between entries were identified and we determined the risk of stage IV disease or cancer-specific mortality among relocators and non-relocators after adjusting for other patient-specific demographic and clinical factors. RESULTS: A total of 4639 (1.7%) patients relocated to a new county within 3years prior to a second cancer diagnosis and 268,079 (98.3%) patients did not. Patients who had relocated to a new area were more likely to be diagnosed with stage IV cancer (25.2% vs. 20.8%; adjusted odds ratio=1.27; 95% confidence interval [CI], 1.18-1.37; P<0.001), and had an increased risk of 10-year cancer-specific mortality (20.9% vs. 17.9%; adjusted hazard ratio 1.26; 95% CI, 1.17-1.36; P<0.001). CONCLUSION: These results suggest that recent relocation to a new county prior to a cancer diagnosis is associated with an increased risk of late-stage presentation and worse cancer-specific mortality.
OBJECTIVE: To determine the impact of recent relocation prior to a cancer diagnosis on cancer-specific outcomes. METHODS: We identified 272,718 patients with two different entries in the Surveillance, Epidemiology, and End Results database within 3years of each other. Those who had relocated to a different county between entries were identified and we determined the risk of stage IV disease or cancer-specific mortality among relocators and non-relocators after adjusting for other patient-specific demographic and clinical factors. RESULTS: A total of 4639 (1.7%) patients relocated to a new county within 3years prior to a second cancer diagnosis and 268,079 (98.3%) patients did not. Patients who had relocated to a new area were more likely to be diagnosed with stage IV cancer (25.2% vs. 20.8%; adjusted odds ratio=1.27; 95% confidence interval [CI], 1.18-1.37; P<0.001), and had an increased risk of 10-year cancer-specific mortality (20.9% vs. 17.9%; adjusted hazard ratio 1.26; 95% CI, 1.17-1.36; P<0.001). CONCLUSION: These results suggest that recent relocation to a new county prior to a cancer diagnosis is associated with an increased risk of late-stage presentation and worse cancer-specific mortality.
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