Colorectal cancer outcome inequalities: association between population density, race, and socioeconomic status
Citation: Fitzgerald TL, Lea CS, Brinkley J, Zervos EE. Colorectal cancer outcome inequalities: association between population density, race, and socioeconomic status. Rural and Remote Health (Internet) 2014; 14: 2668. Available: http://www.rrh.org.au/articles/subviewnew.asp?ArticleID=2668 (Accessed 17 October 2017)
Introduction: Conflicting data exists regarding the influence of population density on colorectal cancer (CRC) outcomes; to better understand this, the present study evaluated outcomes along an urban–rural continuum.Key words: colon cancer, inequality, race, socioeconomic status, survival.
Methods: Colorectal patients aged ≥40 years from 1992 to 2002 were identified in the SEER (Surveillance, Epidemiology, and End Results) Registries of the National Cancer Institute in the USA.
Results: A total of 176 011 patients were identified, with median age 71; most lived in populous counties and were white (90%). Patients from large metropolitan counties were more often African-American, and those in rural counties were more likely to be white and have low socioeconomic status (SES). Patients from large metropolitan (>1 million) and rural counties were more likely to have metastatic disease and decreased survival compared to smaller metropolitan counties (<1 million). Late stage of presentation and diminished survival were also associated with African-American race, male sex and lower SES.
Conclusions: Metropolitan counties with populations <1 million had superior CRC outcomes, in part secondary to race and SES.
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