Disparities in cancer stage of diagnosis by rurality in California, 2015-2019

Details

• Alternative Title:
  Cancer Epidemiol Biomarkers Prev
• Personal Author:
  Oh, Debora L ; Wang, Katarina ; Goldberg, Debbie ; Schumacher, Karen ; Yang, Juan ; Lin, Katherine ; Gomez, Scarlett Lin ; Shariff-Marco, Salma
• Description:
  Background:
  
  Cancer rates in rural areas vary by insurance status, socioeconomic status, region, race, and ethnicity.
  
  Methods:
  
  California Cancer Registry data (2015-2019) were used to investigate stage of diagnosis by levels of rurality for the five most common cancers. Percent of residents in rural blocks within census tract aggregation zones was categorized into deciles up to 50%. Multivariable logistic regression was used to estimate associations with rurality, with separate models by cancer site, sex, race, and ethnicity (non-Hispanic White and Hispanic). Covariates included individual-level and zone-level factors.
  
  Results:
  
  Percent of late-stage cancer diagnosis was 28% for female breast, 27% for prostate, 77% for male lung, 71% for female lung, 60% for male colorectal, 59% for female colorectal, 7.8% for male melanoma, and 5.9% for female melanoma. Increasing rurality was significantly associated with increased odds of late-stage cancer diagnosis for female breast cancer (p-trend<0.001), male lung cancer (p-trend<0.001), female lung cancer (p-trend<0.001), and male melanoma (p-trend=0.01), after adjusting for individual-level and zone-level factors. Strength of associations varied by sex and ethnicity. For males with lung cancer, odds of late-stage diagnosis in areas with >50% rural population was 1.24 (95% CI (1.06-1.45)) for non-Hispanic White patients and 2.14 (95% CI (0.86-5.31)) for Hispanic patients, compared to areas with 0% rural residents.
  
  Conclusions:
  
  Increasing rurality was associated with increased odds for late-stage diagnosis for breast cancer, lung cancer, and melanoma, with the strength of associations varying across sex and ethnicity.
  
  Impact:
  
  Our findings will inform cancer outreach to these rural subpopulations.
  
  
• Subjects:
  Adult Aged California Female Healthcare Disparities Humans Male Middle Aged Neoplasms Neoplasm Staging Registries Rural Population

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• Keywords:
  Breast Cancer Colorectal Cancer Late-stage Cancer Disparities Lung Cancer Melanoma Prostate Cancer Rural Cancer Disparities
• Source:
  Cancer Epidemiol Biomarkers Prev. 33(11):1523-1531
• Pubmed ID:
  39141060
• Pubmed Central ID:
  PMC11530323
• Document Type:
  Journal Article
• Funding:
  HHSN261201800032I/CA/NCI NIH HHSUnited States/ ; 5NU58DP006344/Centers for Disease Control and Prevention (CDC)/ ; Safety Code Section 103885/California Department of Public Health (CDPH)/
• Volume:
  33
• Issue:
  11
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha-512:03ed3db1ee902f57ac30b9535967ff4293db241f6aeae34a6401231c96e67d400ed6f4360c105a8901f79a491756b9587aab12557a5a3143b37ce9c9c551c632
• Download URL:
  https://stacks.cdc.gov/view/cdc/168899/cdc_168899_DS1.pdf
• File Type:
  [PDF - 477.24 KB ]