Rural–urban disparities in colorectal cancer survival and risk among men in Utah: a statewide population-based study

Abstract

Rural areas of the U.S. experience disproportionate colorectal cancer (CRC) death compared to urban areas. The authors aimed to analyze differences in CRC survival between rural and urban Utah men and investigate potential prognostic factors for survival among these men. A cohort of Utah men diagnosed with CRC between 1997 and 2013 was identified from the Utah Cancer Registry. Survival and prognostic factors were analyzed via 5-year CRC survival and Cox proportional hazards models, stratified by rural/urban residence. Among 4,660 men diagnosed with CRC, 15.3% were living in rural Utah. Compared with urban men, rural CRC patients were diagnosed at older ages and in different anatomic subsites; more were overweight, and current smokers. Differences in stage and treatment were not apparent between rural and urban CRC patients. Compared with urban counterparts, rural men experienced a lower CRC survival (Hazard Ratio 0.55, 95% CI 0.53, 0.58 vs. 0.58, 95% CI 0.56, 0.59). Race and cancer treatment influenced CRC survival among men living in both urban and rural areas. Factors of CRC survival varied greatly among urban and rural men in Utah. The influence of social and environmental conditions on health behaviors and outcomes merits further exploration.

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Acknowledgments

The research team extends gratitude to Eleanor Mayfield for editorial assistance.

Funding

This study was funded by National Cancer Institute (Grant Nos. K01CA234319 (CRR), R21 CA185811 (MH), and R03 CA159357 (MH)). RJT was supported by the National Institute on Aging (K02AG059140) and National Institute on Minority Health And Health Disparities (U54MD000214). Funding also stemmed from the Huntsman Cancer Institute Cancer Control and Population Sciences Program (P30CA042014) and National Center for Research Resources (R01 RR021746). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

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Correspondence to Charles R. Rogers.

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Rogers, C.R., Blackburn, B.E., Huntington, M. et al. Rural–urban disparities in colorectal cancer survival and risk among men in Utah: a statewide population-based study. Cancer Causes Control 31, 241–253 (2020). https://doi.org/10.1007/s10552-020-01268-2

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Keywords

  • Colonic neoplasms
  • Health status disparities
  • Men’s health
  • Rural health
  • Survival
  • Urban health