Journal article
Rural-Urban Differences in Cancer Incidence and Trends in the United States
Cancer epidemiology, biomarkers & prevention, Vol.27(11), pp.1265-1274
11/2018
DOI: 10.1158/1055-9965.EPI-17-0430
PMCID: PMC5787045
PMID: 28751476
Abstract
Cancer incidence and mortality rates in the United States are declining, but this decrease may not be observed in rural areas where residents are more likely to live in poverty, smoke, and forego cancer screening. However, there is limited research exploring national rural-urban differences in cancer incidence and trends.
We analyzed data from the North American Association of Central Cancer Registries' public use dataset, which includes population-based cancer incidence data from 46 states. We calculated age-adjusted incidence rates, rate ratios, and annual percentage change (APC) for: all cancers combined, selected individual cancers, and cancers associated with tobacco use and human papillomavirus (HPV). Rural-urban comparisons were made by demographic, geographic, and socioeconomic characteristics for 2009 to 2013. Trends were analyzed for 1995 to 2013.
Combined cancers incidence rates were generally higher in urban populations, except for the South, although the urban decline in incidence rate was greater than in rural populations (10.2% vs. 4.8%, respectively). Rural cancer disparities included higher rates of tobacco-associated, HPV-associated, lung and bronchus, cervical, and colorectal cancers across most population groups. Furthermore, HPV-associated cancer incidence rates increased in rural areas (APC = 0.724,
< 0.05), while temporal trends remained stable in urban areas.
Cancer rates associated with modifiable risks-tobacco, HPV, and some preventive screening modalities (e.g., colorectal and cervical cancers)-were higher in rural compared with urban populations.
Population-based, clinical, and/or policy strategies and interventions that address these modifiable risk factors could help reduce cancer disparities experienced in rural populations.
Details
- Title: Subtitle
- Rural-Urban Differences in Cancer Incidence and Trends in the United States
- Creators
- Whitney E Zahnd - Office of Population Science and Policy, Southern Illinois University School of Medicine, Springfield, Illinois. wzahnd@siumed.eduAimee S James - Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, MissouriWiley D Jenkins - Office of Population Science and Policy, Southern Illinois University School of Medicine, Springfield, IllinoisSonya R Izadi - Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, MissouriAmanda J Fogleman - Office of Population Science and Policy, Southern Illinois University School of Medicine, Springfield, IllinoisDavid E Steward - Department of Internal Medicine, Southern Illinois University School of Medicine, Springfield, IllinoisGraham A Colditz - Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, MissouriLaurent Brard - Simmons Cancer Institute at SIU, Southern Illinois University School of Medicine, Springfield, Illinois
- Resource Type
- Journal article
- Publication Details
- Cancer epidemiology, biomarkers & prevention, Vol.27(11), pp.1265-1274
- DOI
- 10.1158/1055-9965.EPI-17-0430
- PMID
- 28751476
- PMCID
- PMC5787045
- NLM abbreviation
- Cancer Epidemiol Biomarkers Prev
- ISSN
- 1055-9965
- eISSN
- 1538-7755
- Grant note
- P20 CA192966 / NCI NIH HHS P20 CA192987 / NCI NIH HHS
- Language
- English
- Date published
- 11/2018
- Academic Unit
- Health Management and Policy
- Record Identifier
- 9984214809202771
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