ArticleGynecologic oncology2021
Rural residence is related to shorter survival in epithelial ovarian cancer patients.
Article in Gynecologic oncology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers.
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Who cites it
17 citing papers in PubMed.
- Minimizing Travel Burden of Gynecologic Cancer Surveillance Through a Unique Multidisciplinary Telehealth Program.O&G open · 2025Article
- Health care access domains and treatment as mediators of ovarian cancer racial disparities in survival: a structural equation modeling analysis in SEER-Medicare.American journal of epidemiology · 2025Article
- Midwest Urban-Rural Differences in Cancer Prevalence.Mayo Clinic proceedings · 2025Article
- Rural-urban disparities in psychosocial functioning in epithelial ovarian cancer patients.Gynecologic oncology · 2024Article
- Role of neighborhood context in ovarian cancer survival disparities: current research and future directions.American journal of obstetrics and gynecology · 2023Review
- A Survey of Cancer Risk Behaviors, Beliefs, and Social Drivers of Health in New Hampshire and Vermont.Cancer research communications · 2023Article
- Preventive behaviors and behavioral risk factors among gynecologic cancer survivors: Results from the 2020 Behavioral Risk Factor Surveillance System Survey.Cancer medicine · 2023Article
- Healthcare Access Domains Mediate Racial Disparities in Ovarian Cancer Treatment Quality in a US Patient Cohort: A Structural Equation Modelling Analysis.Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology · 2023Article
- Patient Perspectives and Side-Effects Experience on Chemotherapy of Non-Small Cell Lung Cancer: A Qualitative Study.Cancer management and research · 2023Article
- Community access to primary care is an important geographic disparity among ovarian cancer patients undergoing cytoreductive surgery.Gynecologic oncology reports · 2022Article
- Reoperation rates of stress incontinence surgery in rural vs urban hospitals.AJOG global reports · 2022Article
- Cancer disparities in the context of rurality: risk factors and screening across various U.S. rural classification codes.Cancer causes & control : CCC · 2022Article
- Rural-Urban Disparities in Cancer Outcomes: Opportunities for Future Research.Journal of the National Cancer Institute · 2022Review
- Understanding the Experience of Canadian Women Living with Ovarian Cancer through the Every Woman StudyCurrent oncology (Toronto, Ont.) · 2022Article
- Disparity of ovarian cancer survival between urban and rural settings.International journal of gynecological cancer : official journal of the International Gynecological Cancer Society · 2022Article
- Association of Distance to Gynecologic Oncologist and Survival in a Rural Midwestern State.Women's health reports (New Rochelle, N.Y.) · 2022Article
- Succinct Cancer Clinical Trial Consent Forms in Rural Patients With Cancer: A Secondary Analysis of a Randomized, Double-Blinded study.Journal of patient experience · 2022Article
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10 authors.
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Abstract
objectiveRural residence has been related to health disparities and greater mortality risk in cancer patients, including gynecologic cancer patients. Lower survival rates for rural cancer survivors have been attributed to limited access to specialized healthcare, including surgery. Here, we examined whether a rural/urban survival gap existed in ovarian cancer patients receiving surgery at tertiary-care facilities, and potential causes for this gap, including educational attainment.
methodsRural and urban patients with high grade invasive ovarian cancer (n = 342) seeking treatment at two midwestern tertiary-care university hospitals were recruited pre-surgery and followed until death or censoring date. Rural/urban residence was categorized using the USDA Rural-Urban Continuum Codes. Stratified Cox proportional hazards regression analyses, with clinical site as strata, adjusting for clinical and demographic covariates, were used to examine the effect of rurality on survival.
resultsDespite specialized surgical care, rural cancer survivors showed a higher likelihood of death compared to their urban counterparts, HR = 1.39 (95% CI: 1.04, 1.85) p = 0.026, adjusted for covariates. A rurality by education interaction was observed (p = 0.027), indicating significantly poorer survival in rural vs. urban patients among those with trade school/some college education, adjusted HR = 2.49 (95% CI: 1.44, 4.30), p = 0.001; there was no rurality survival disparity for the other 2 levels of education.
conclusionsDifferences in ovarian cancer survival are impacted by rurality, which is moderated by educational attainment even in patients receiving initial care in tertiary settings. Clinicians should be aware of rurality and education as potential risk factors for adverse outcomes and develop approaches to address these possible risks.
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