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

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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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Authors and Affiliations

  1. Department of Family & Preventive Medicine, University of Utah, 375 Chipeta Way, Suite A, Salt Lake City, UT, 84108, USA

    Charles R. Rogers, Brenna E. Blackburn, Matthew Huntington & Mia Hashibe

  2. Department of Medicine, University of Utah, Salt Lake City, USA

    Karen Curtin

  3. Program for Research on Men’s Health, Hopkins Center for Health Disparities Solutions, Johns Hopkins University, Baltimore, USA

    Roland J. Thorpe Jr.

  4. Intermountain Healthcare, Salt Lake City, USA

    Kerry Rowe & John Snyder

  5. CMIO Office, University of Utah Health Care, Salt Lake City, USA

    Vikrant Deshmukh & Michael Newman

  6. Department of Family & Consumer Studies, University of Utah, Salt Lake City, USA

    Alison Fraser

  7. Department of Population Sciences, Huntsman Cancer Institute, Salt Lake City, USA

    Ken Smith

  8. Utah Cancer Registry, Salt Lake City, USA

    Mia Hashibe

  9. Huntsman Cancer Institute, Salt Lake City, USA

    Mia Hashibe

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  1. Charles R. Rogers
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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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