Journal article
Rural patients are at risk for increased stage at presentation and diminished overall survival in osteosarcoma
Cancer epidemiology, Vol.61, pp.119-123
08/01/2019
DOI: 10.1016/j.canep.2019.05.012
PMID: 31212223
Abstract
Background: There is an undefined relationship between access to regional referral centers and whether the eventual oncologic outcomes are influenced by distance, travel time, or residence in a rural community.
Methods: We used the Surveillance, Epidemiology and End Results (SEER) Program Database to capture all cases of high-grade osteosarcoma from 1990 to 2014 in Iowa, Utah, and New Mexico. Using univariate, Kaplan Meier survival analysis, and multivariate Cox proportional hazards modeling we analyzed patient and tumor characteristics.
Results: A total of 476 patients met the study criteria. There was an increased incidence of metastases for patients residing in a county with a greater than 2 -h drive to the nearest comprehensive cancer center (p = 0.021). Individuals residing in "rural" counties and "very rural" counties showed decreased 5-year survival (p = 0.007 and 0.003, respectively) when compared to those living in areas of higher population density. A multivariate regression analysis showed that the presence of metastasis (HR = 2.78 [95% CI: 1.88-4.10], p < 0.0001) and rural status (HR = 1.58 [95% CI: 1.03-2.43], p = 0.037) were risk factors for mortality when controlling for size of the tumor.
Conclusion: The travel time to the nearest comprehensive center was associated with an increased incidence of metastasis on presentation in patients with osteosarcoma. Metastasis and rural status were independent risk factors for mortality. This investigation suggests that individuals living in rural counties may experience barriers to presentation, treatment, or surveillance that are not present in areas with a higher population density.
Details
- Title: Subtitle
- Rural patients are at risk for increased stage at presentation and diminished overall survival in osteosarcoma
- Creators
- Ryan Wendt - University of Iowa Hospitals and ClinicsYubo Gao - University of IowaBenjamin J. Miller - University of Iowa Hospitals and Clinics
- Resource Type
- Journal article
- Publication Details
- Cancer epidemiology, Vol.61, pp.119-123
- DOI
- 10.1016/j.canep.2019.05.012
- PMID
- 31212223
- NLM abbreviation
- Cancer Epidemiol
- ISSN
- 1877-7821
- eISSN
- 1877-783X
- Publisher
- Elsevier
- Number of pages
- 5
- Grant note
- P30CA086862 / NATIONAL CANCER INSTITUTE; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Cancer Institute (NCI) T35HL007485 / NATIONAL HEART, LUNG, AND BLOOD INSTITUTE; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Heart Lung & Blood Institute (NHLBI) T35HL007485 / National Heart, Lung, and Blood Institute of the National Institutes of Health; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Heart Lung & Blood Institute (NHLBI)
- Language
- English
- Date published
- 08/01/2019
- Academic Unit
- Orthopedics and Rehabilitation; Internal Medicine
- Record Identifier
- 9984304709202771
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