Rural-urban differences in surgical treatment, regional lymph node examination, and survival in endometrial cancer patients

Whitney E Zahnd; Katherine S Hyon; Paula Diaz-Sylvester; Sonya R Izadi; Graham A Colditz; Laurent Brard

doi:10.1007/s10552-017-0998-4

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Rural-urban differences in surgical treatment, regional lymph node examination, and survival in endometrial cancer patients

Journal article

Peer reviewed

Rural-urban differences in surgical treatment, regional lymph node examination, and survival in endometrial cancer patients

Whitney E Zahnd, Katherine S Hyon, Paula Diaz-Sylvester, Sonya R Izadi, Graham A Colditz and Laurent Brard

Cancer causes & control, Vol.29(2), pp.221-232

02/2018

DOI: 10.1007/s10552-017-0998-4

PMCID: PMC6311991

PMID: 29282582

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https://www.ncbi.nlm.nih.gov/pmc/articles/6311991View

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Abstract

Endometrial cancer (EC) is the most common gynecological malignancy and one of few cancers with an increasing US mortality rate. Rural patients may have less access to specialty care affecting their receipt of surgery and adequate lymphadenectomy (AL). We sought to assess rural-urban differences in EC surgery, lymphadenectomy, and survival. We analyzed data from the Surveillance Epidemiology and End Results database on EC patients (2004-2013). We performed univariate analyses to compare rural and urban patients on demographic and clinical characteristics and receipt of nodal examination and AL. We assessed rural-urban differences in trends of receipt of AL, performed logistic regression to evaluate differences in receipt of surgery, nodal examination, and AL, and performed survival analysis. Rural patients were less likely to have any lymph nodes removed, had a smaller median number removed, and a smaller proportion had AL. Even after controlling for established risk factors, rural patients had lower odds of lymph node examination and adequate AL than urban patients and also had poorer survival. Future research should continue to assess the association between access to care and disparities in surgical care and the effect of these disparities on survival.

Aged

Endometrial Neoplasms - surgery

Female

Humans

Logistic Models

Lymph Node Excision

Lymph Nodes

Middle Aged

Rural Population - statistics & numerical data

Survival Analysis

Urban Population - statistics & numerical data

Details

Title: Subtitle: Rural-urban differences in surgical treatment, regional lymph node examination, and survival in endometrial cancer patients
Creators: Whitney E Zahnd - Office of Population Science and Policy, Southern Illinois University School of Medicine, 201 E. Madison St Rm. 235, PO Box 19664, Springfield, IL, 62794-9664, USA. wzahnd@siumed.edu
Katherine S Hyon - Department of Obstetrics and Gynecology, Southern Illinois University School of Medicine, Springfield, IL, USA
Paula Diaz-Sylvester - Center for Clinical Research, Southern Illinois University School of Medicine, Springfield, IL, USA
Sonya R Izadi - Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, MO, USA
Graham A Colditz - Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, MO, USA
Laurent Brard - Simmons Cancer Institute at SIU, Springfield, IL, USA
Resource Type: Journal article
Publication Details: Cancer causes & control, Vol.29(2), pp.221-232
DOI: 10.1007/s10552-017-0998-4
PMID: 29282582
PMCID: PMC6311991
NLM abbreviation: Cancer Causes Control
ISSN: 0957-5243
eISSN: 1573-7225
Grant note: P20 CA192966 / NCI NIH HHS P20 CA192987 / NCI NIH HHS
Language: English
Date published: 02/2018
Academic Unit: Health Management and Policy
Record Identifier: 9984214787602771

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