Adverse Health Outcomes Among Rural and Urban Breast Cancer Survivors: A Population-Based Cohort Study

Details

• Alternative Title:
  Cancer Epidemiol Biomarkers Prev
• Personal Author:
  Koric, Alzina ; Mark, Bayarmaa ; Chang, Chun-Pin ; Lloyd, Shane ; Dodson, Mark ; Deshmukh, Vikrant G. ; Newman, Michael ; Date, Ankita ; Gren, Lisa H. ; Porucznik, Christina A. ; Haaland, Benjamin ; Henry, N. Lynn ; Hashibe, Mia
• Description:
  Background:
  
  Limited population-based studies have focused on breast cancer survivors in rural populations. We sought to evaluate the risk of adverse health outcomes among rural and urban breast cancer survivors and to evaluate potential predictors for the highest risk outcomes.
  
  Methods:
  
  A population-based cohort of rural and urban breast cancer survivors diagnosed between 1997 and 2017 was identified in the Utah Cancer Registry (UCR). Rural breast cancer survivors were matched on year (±1 year) and age at cancer diagnosis (±1 year) with up to 5 urban breast cancer survivors (2,359 rural breast cancer survivors; 11,748 urban breast cancer survivors). Cox proportional hazards models were used to calculate hazard ratios (HRs) with 99% confidence intervals (CI) for adverse health outcomes overall, within 5 years, and >5 years after cancer diagnosis.
  
  Results:
  
  Compared to urban breast cancer survivors, rural breast cancer survivors had a 39% (HR = 1.39, 95%CI 1.02, 1.65) higher risk of heart failure (HF) within the 5 years of follow-up. Overall, there was no increase in the risk of other adverse health outcomes. A higher baseline body mass index and Charlson Comorbidity Index, family history of cardiovascular diseases, family history of breast cancer, and advanced cancer stage were risk factors for HF for rural and urban breast cancer survivors, with similar levels of HF risk.
  
  Conclusions:
  
  Rural residence was associated with an increased risk of HF among breast cancer survivors.
  
  Impact:
  
  Our study highlights the need for primary preventive strategies for rural cancer survivors at risk of heart failure.
  
  
• Subjects:
  Breast Neoplasms Cancer Survivors Cohort Studies Female Heart Failure Humans Outcome Assessment, Health Care Rural Population Urban Population
• Keywords:
  Adverse Outcomes Breast Cancer Cancer Survivorship Matched-cohort Rural Residence
• Source:
  Cancer Epidemiol Biomarkers Prev. 32(10):1302-1311
• Pubmed ID:
  37462723
• Pubmed Central ID:
  PMC10592280
• Document Type:
  Journal Article
• Funding:
  R21 CA185811/CA/NCI NIH HHSUnited States/ ; HHSN261201800016C/CA/NCI NIH HHSUnited States/ ; NU58DP007131/CC/CDC HHSUnited States/ ; HHSN261201800016I/CA/NCI NIH HHSUnited States/ ; R01 CA244326/CA/NCI NIH HHSUnited States/ ; R03 CA159357/CA/NCI NIH HHSUnited States/ ; S10 OD021644/OD/NIH HHSUnited States/ ; P30 CA042014/CA/NCI NIH HHSUnited States/
• Volume:
  32
• Issue:
  10
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha-512:0f9e0f1aabb2d494be3e65db0dddd86d4ae0376ad6a176517a2c9651a6ef7d05219df76b917f6b8a68cf12b9367d7711bd9ed8fe8e60afc3e2327feab5a3384a
• Download URL:
  https://stacks.cdc.gov/view/cdc/148849/cdc_148849_DS1.pdf
• File Type:
  [PDF - 461.83 KB ]