Jihye Park1, Brenna E Blackburn1, Kerry Rowe2, John Snyder2, Yuan Wan3, Vikrant Deshmukh4, Michael Newman5, Alison Fraser3, Ken Smith3, Kim Herget6, Lindsay Burt7, Theresa Werner8, David K Gaffney7, Ana Maria Lopez8, Kathi Mooney9, Mia Hashibe10. 1. Cancer Control and Population Science, Huntsman Cancer Institute, Salt Lake City, UT; Division of Public Health, Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, UT. 2. Intermountain Healthcare, Salt Lake City, UT. 3. Pedigree and Population Resource, Population Sciences, Huntsman Cancer Institute, Salt Lake City, UT. 4. University of Utah Health Sciences Center, Salt Lake City, UT. 5. Division of Public Health, Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, UT; University of Utah Health Sciences Center, Salt Lake City, UT. 6. Utah Cancer Registry, University of Utah, Salt Lake City, UT. 7. Department of Radiation Oncology, University of Utah School of Medicine, Salt Lake City, UT. 8. Division of Oncology, Department of Medicine, University of Utah, Salt Lake City, UT. 9. Cancer Control and Population Science, Huntsman Cancer Institute, Salt Lake City, UT; College of Nursing, University of Utah, Salt Lake City, UT. 10. Cancer Control and Population Science, Huntsman Cancer Institute, Salt Lake City, UT; Division of Public Health, Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, UT. Electronic address: mia.hashibe@utah.edu.
Abstract
PURPOSE: To investigate rural-metropolitan disparities in ovarian cancer survival, we assessed ovarian cancer mortality and differences in prognostic factors by rural-metropolitan residence. METHODS: The Utah Population Database was used to identify ovarian cancer cases diagnosed between 1997 and 2012. Residential location information at the time of cancer diagnosis was used to stratify rural-metropolitan residence. All-cause death and ovarian cancer death risks were estimated using Cox proportional hazard regression models. RESULTS: Among 1661 patients diagnosed with ovarian cancer, 11.8% were living in rural counties of Utah. Although ovarian cancer patients residing in rural counties had different characteristics compared with metropolitan residents, we did not observe an association between rural residence and risk of all-cause nor ovarian cancer-specific death after adjusting for confounders. However, among rural residents, ovarian cancer mortality risk was very high in older age at diagnosis and for mucinous carcinoma, and low in overweight at baseline. CONCLUSIONS: Rural residence was not significantly associated with the risk of ovarian cancer death. Nevertheless, patients residing in rural-metropolitan areas had different factors affecting the risk of all-cause mortality and cancer-specific death. Further research is needed to quantify how mortality risk can differ by residential location accounting for degree of health care access and lifestyle-related factors.
PURPOSE: To investigate rural-metropolitan disparities in ovarian cancer survival, we assessed ovarian cancer mortality and differences in prognostic factors by rural-metropolitan residence. METHODS: The Utah Population Database was used to identify ovarian cancer cases diagnosed between 1997 and 2012. Residential location information at the time of cancer diagnosis was used to stratify rural-metropolitan residence. All-cause death and ovarian cancer death risks were estimated using Cox proportional hazard regression models. RESULTS: Among 1661 patients diagnosed with ovarian cancer, 11.8% were living in rural counties of Utah. Although ovarian cancerpatients residing in rural counties had different characteristics compared with metropolitan residents, we did not observe an association between rural residence and risk of all-cause nor ovarian cancer-specific death after adjusting for confounders. However, among rural residents, ovarian cancer mortality risk was very high in older age at diagnosis and for mucinous carcinoma, and low in overweight at baseline. CONCLUSIONS: Rural residence was not significantly associated with the risk of ovarian cancer death. Nevertheless, patients residing in rural-metropolitan areas had different factors affecting the risk of all-cause mortality and cancer-specific death. Further research is needed to quantify how mortality risk can differ by residential location accounting for degree of health care access and lifestyle-related factors.
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