Impact of Rurality on Stage IV Ovarian Cancer at Diagnosis: A Midwest Cancer Registry Cohort Study

Details

• Alternative Title:
  J Rural Health
• Personal Author:
  Weeks, Kristin S. ; Lynch, Charles F. ; West, Michele ; McDonald, Megan ; Carnahan, Ryan ; Stewart, Sherri L. ; Charlton, Mary
• Corporate Authors:
  Ovarian Cancer Treatment Study
• Description:
  Purpose:
  
  We aim to understand if rurality impacts patients’ odds of presenting with stage IV ovarian cancer at diagnosis independent of distance to primary care provider and the socioeconomic status of a patient’s residential census tract.
  
  Methods:
  
  A cohort of 1,000 women with ovarian cancer in Iowa, Kansas, and Missouri were sampled and analyzed from the cancer registries’ statewide population data. The sample contained those with a histologically confirmed primary ovarian cancer diagnosis in 2011–2012. All variables were captured through an extension of standard registry protocol using standardized definitions and abstraction manuals. Chi-square tests and a multivariable logistic regression model were used.
  
  Findings:
  
  At diagnosis, 111 women in our sample had stage IV cancer and 889 had stage I-III. Compared to patients with stage I-III cancer, patients with stage IV disease had a higher average age, more comorbidities, and were more often living in rural areas. Multivariate analysis showed that rural women (vs metropolitan) had a greater odds of having stage IV ovarian cancer at diagnosis (odds ratio = 2.41 and 95% confidence interval = 1.33–4.39).
  
  Conclusion:
  
  Rural ovarian cancer patients have greater odds of having stage IV cancer at diagnosis in Midwestern states independent of the distance they lived from their primary care physician and the socioeconomic status of their residential census tract. Rural women’s greater odds of stage IV cancer at diagnosis could affect treatment options and mortality. Further investigation is needed into reasons for these findings.
  
  
• Subjects:
  Article Cancer Stage Cohort Studies Epidemiology Female Geographic Disparities Health Disparities Humans Ovarian Cancer Ovarian Neoplasms Registries Rural Population Social Class

  More +
• Source:
  J Rural Health. 36(4):468-475
• Pubmed ID:
  32077162
• Pubmed Central ID:
  PMC7852624
• Document Type:
  Journal Article
• Funding:
  U01 DP006299/DP/NCCDPHP CDC HHSUnited States/ ; P30 ES005605/ES/NIEHS NIH HHSUnited States/ ; P30 CA086862/CA/NCI NIH HHSUnited States/ ; HHSN261201800012C/CA/NCI NIH HHSUnited States/ ; T32 GM007337/GM/NIGMS NIH HHSUnited States/ ; HHSN261201800012I/CA/NCI NIH HHSUnited States/ ; U01DP006299/ACL/ACL HHSUnited States/ ; U58DP006299-01/02/Department of Health and senior services, MissouriInternational/ ; 200-2014-61258/CC/CDC HHSUnited States/ ; CC999999/ImCDC/Intramural CDC HHSUnited States/
• Volume:
  36
• Issue:
  4
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:594cc11147962c9c43a38b59bb2c1f184464032cf466aea939ad179c135666bc
• Download URL:
  https://stacks.cdc.gov/view/cdc/101808/cdc_101808_DS1.pdf
• File Type:
  [PDF - 85.67 KB ]