Rural–Urban Disparities in Cancer Care—Analyzing Routinely Collected Patient-Reported Outcomes. A Cross-Sectional Study

IF 2.9 2区医学 Q2 ONCOLOGY

Cancer Medicine Pub Date : 2025-04-15 DOI:10.1002/cam4.70437

Dominik J. Ose, Bayarmaa Mark, Krista Ocier, Emmanuel Adediran, Belinda Taylor, Kim Svoboda, Wallace Akerly, Brock O'Neil, Norah Lynn Henry, Mia Hashibe

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Abstract

Objective

Rural–urban disparities in cancer care are well documented. However, research on rural–urban disparities regarding patient-reported outcomes (PROs) is still developing. This study analyzed rural–urban disparities in patients with cancer with respect to anxiety, depression, fatigue, pain interference, and physical function.

Methods

This study was conducted at the University of Utah Huntsman Cancer Institute. We integrated data from electronic health records, Cancer Registry, and PRO questionnaires. We assessed the association between rurality status (rural vs. urban) in patients with cancer and PRO scores using multiple linear regression models and t-tests.

Results

The cohort included 7271 patients. The mean age was 59.1 years at cancer diagnosis and 48.2% (n = 3505) were female. Across all cancer types, significant differences (Rural vs. Urban) were found for fatigue (53.6 vs. 54.1; p < 0.05) and physical function (45.5 vs. 45.1; p < 0.05). With respect to specific cancer types, there were differences in patients with oral cavity and pharynx cancer for depression (47.9 vs. 50.6; p < 0.01), fatigue (51.6 vs. 54.8; p < 0.05), pain interference (52.8 vs. 55.4; p < 0.05), and physical function (48.0 vs. 44.6; p < 0.01), colorectal cancer for fatigue (56.8 vs. 54.7; p < 0.05), pain interference (56.0 vs. 53.7; p < 0.05), and physical function (42.2 vs. 44.4; p < 0.05), uterus cancer for depression (47.5 vs. 50.5; p < 0.05) and fatigue (51.6 vs. 54.7; p < 0.05), and lung cancer for physical function (37.6 vs. 39.3; p < 0.05).

Conclusions

Across all cancer types, as well as specific cancers, this study found mostly limited rural–urban differences regarding PROs. Except for colorectal and lung/bronchus cancer, patients living in rural areas reported similar or better PRO scores for all cancer types. Results support the hypothesis that improving access can help to level rural–urban disparities regarding cancer care outcomes, because all patients were treated in the same comprehensive cancer center, had similar access to care, and had similar PRO scores.

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癌症治疗的城乡差异——分析常规收集的患者报告的结果。横断面研究

目标癌症治疗中的城乡差异已得到充分证实。然而，有关患者报告结果（PROs）的城乡差异研究仍在发展中。本研究分析了癌症患者在焦虑、抑郁、疲劳、疼痛干扰和身体功能方面的城乡差异。方法本研究在犹他大学亨茨曼癌症研究所进行。我们整合了来自电子健康记录、癌症登记和 PRO 问卷的数据。我们使用多元线性回归模型和 t 检验法评估了癌症患者的农村状况（农村与城市）与 PRO 评分之间的关系。结果该群组包括 7271 名患者。癌症确诊时的平均年龄为 59.1 岁，48.2%（n = 3505）为女性。在所有癌症类型中，疲劳（53.6 vs. 54.1; p <0.05）和身体功能（45.5 vs. 45.1; p <0.05）存在显著差异（农村 vs. 城市）。就具体癌症类型而言，口腔癌和咽癌患者在抑郁（47.9 vs. 50.6; p < 0.01）、疲劳（51.6 vs. 54.8; p < 0.05）、疼痛干扰（52.8 vs. 55.4; p < 0.05）和身体功能（48.0 vs. 44.6; p < 0.01）方面存在差异，结直肠癌患者在疲劳（56.8 vs. 54.7; p < 0.05）、疼痛干扰（56.0 vs. 53.7; p < 0.05）和身体功能（42.2 vs. 44.4; p < 0.05），子宫癌的抑郁（47.5 vs. 50.5; p < 0.05）和疲劳（51.6 vs. 54.7; p < 0.05），以及肺癌的身体功能（37.6 vs. 39.3; p < 0.05）。结论在所有癌症类型和特定癌症中，本研究发现城乡居民在PROs方面的差异大多有限。除结直肠癌和肺癌/支气管癌外，居住在农村地区的患者在所有癌症类型中的PRO评分都相似或更高。由于所有患者都在同一综合癌症中心接受治疗，获得治疗的机会相似，PRO 评分也相似，因此研究结果支持了这一假设，即改善获得治疗的机会有助于消除癌症治疗结果方面的城乡差异。

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来源期刊

Cancer Medicine ONCOLOGY-

CiteScore

5.50

自引率

2.50%

发文量

907

审稿时长

19 weeks

期刊介绍： Cancer Medicine is a peer-reviewed, open access, interdisciplinary journal providing rapid publication of research from global biomedical researchers across the cancer sciences. The journal will consider submissions from all oncologic specialties, including, but not limited to, the following areas: Clinical Cancer Research Translational research ∙ clinical trials ∙ chemotherapy ∙ radiation therapy ∙ surgical therapy ∙ clinical observations ∙ clinical guidelines ∙ genetic consultation ∙ ethical considerations Cancer Biology: Molecular biology ∙ cellular biology ∙ molecular genetics ∙ genomics ∙ immunology ∙ epigenetics ∙ metabolic studies ∙ proteomics ∙ cytopathology ∙ carcinogenesis ∙ drug discovery and delivery. Cancer Prevention: Behavioral science ∙ psychosocial studies ∙ screening ∙ nutrition ∙ epidemiology and prevention ∙ community outreach. Bioinformatics: Gene expressions profiles ∙ gene regulation networks ∙ genome bioinformatics ∙ pathwayanalysis ∙ prognostic biomarkers. Cancer Medicine publishes original research articles, systematic reviews, meta-analyses, and research methods papers, along with invited editorials and commentaries. Original research papers must report well-conducted research with conclusions supported by the data presented in the paper.