ArticleBMC public health2021
The need to study rural cancer outcome disparities at the local level: a retrospective cohort study in Kansas and Missouri.
Article in BMC public health, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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Who cites it
13 citing papers in PubMed.
- Redefining rurality: adopting an identity-based and community-engaged approach to defining rural cancer disparities.Journal of the National Cancer Institute · 2026Article
- How did exposure to critical access hospitals change Medicare's effect on cancer survival?Cancer causes & control : CCC · 2026Article
- Overall survival of oral cancer from the population-based cancer registries of the Konkan area, Maharashtra, India.BMC cancer · 2026Article
- The Need for Community-Based Multimodal Screening for Chronic Disease and Cancer in Rural Kansas.International journal of general medicine · 2026Article
- Minimizing Travel Burden of Gynecologic Cancer Surveillance Through a Unique Multidisciplinary Telehealth Program.O&G open · 2025Article
- Racial and urban-rural disparities in lung cancer care: Insight from a Latent Class Growth Analysis.Journal of cancer policy · 2025Article
- Geographic Disparities in Oral Cancer Survival From 10 Population-Based Cancer Registries in India.JAMA network open · 2025Article
- Disparities Between Rural and Urban Patients With Prostate Cancer in Nebraska.Cancer medicine · 2025Article
- Cancer prevalence and its determinants in Hungary: Analyzing data from the 2009, 2014, and 2019 European Health Interview Surveys.PloS one · 2025Article
- Rural-urban disparity in cancer burden and care: findings from an Indian cancer registry.BMC cancer · 2024Article
- Geographic differences in community oncology provider and practice location characteristics in the central United States.The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association · 2022Article
- Rural-Urban Disparities in Health Access Factors Over Time: Implications for Cancer Prevention and Health Equity in the Midwest.Health equity · 2022Article
- Urban-Rural Disparities in the Lung Cancer Surgical Treatment Pathway: The Paradox of a Rich, Small Region.Frontiers in surgery · 2022Article
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Abstract
backgroundRural residence is commonly thought to be a risk factor for poor cancer outcomes. However, a number of studies have reported seemingly conflicting information regarding cancer outcome disparities with respect to rural residence, with some suggesting that the disparity is not present and others providing inconsistent evidence that either urban or rural residence is associated with poorer outcomes. We suggest a simple explanation for these seeming contradictions: namely that rural cancer outcome disparities are related to factors that occur differentially at a local level, such as environmental exposures, lack of access to care or screening, and socioeconomic factors, which differ by type of cancer.
methodsWe conducted a retrospective cohort study examining ten cancers treated at the University of Kansas Medical Center from 2011 to 2018, with individuals from either rural or urban residences. We defined urban residences as those in a county with a U.S. Department of Agriculture Urban Influence Code (UIC) of 1 or 2, with all other residences defines a rural. Inverse probability of treatment weighting was used to create a pseudo-sample balanced for covariates deemed likely to affect the outcomes modeled with cumulative link and weighted Cox-proportional hazards models.
resultsWe found that rural residence is not a simple risk factor but rather appears to play a complex role in cancer outcome disparities. Specifically, rural residence is associated with higher stage at diagnosis and increased survival hazards for colon cancer but decreased risk for lung cancer compared to urban residence.
conclusionMany cancers are affected by unique social and environmental factors that may vary between rural and urban residents, such as access to care, diet, and lifestyle. Our results show that rurality can increase or decrease risk, depending on cancer site, which suggests the need to consider the factors connected to rurality that influence this complex pattern. Thus, we argue that such disparities must be studied at the local level to identify and design appropriate interventions to improve cancer outcomes.
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