Rural vs urban inequalities in stage at diagnosis for lung cancer

• Published in: Cancer treatment and research communications Vol. 29; p. 100495
• Main Authors: Shah, Bashir Daud, Tyan, Chung-Chun, Rana, Masud, Goodridge, Donna, Hergott, Christopher A., Osgood, Nathaniel D., Manns, Braden, Penz, Erika D.
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 2021; Elsevier
• Subjects: Aged; Diagnosis; Female; Humans; Lung cancer; Lung Neoplasms - epidemiology; Lung Neoplasms - mortality; Male; Neoplasm Staging; Rural; Rural Population; Saskatchewan; Stage; Survival Analysis; Urban; Urban Population; Rural; Urban; Stage; Diagnosis; Saskatchewan; Lung cancer
• ISSN: 2468-2942; 2468-2942
• DOI: 10.1016/j.ctarc.2021.100495

•Relationship between geographic residence and stage of lung cancer at time of diagnosis was measured among Saskatchewan residents using a comprehensive cancer registry.•Compared to urban patients, rural north Saskatchewan lung cancer patients were more likely to be male, younger and have lower socioeconomic status as defined by income quintile.•Rural patients had higher incidence proportion and were more likely to be diagnosed with advanced stage non-small cell lung cancer compared to urban patients. Early diagnosis of lung cancer increases the chance of survival. The aim of this study was to measure the relationship between geographic residence in Saskatchewan and stage of lung cancer at the time of diagnosis. Retrospective cohort analysis of 2,972 patients with a primary diagnosis of either non-small cell cancer (NSCLC) or small cell lung cancer (SCLC) between 2007 and 2012 was performed. Incidence proportion of early and advanced stage cancer, and relative risk of being diagnosed with advanced-stage lung cancer relative to early-stage was calculated. Compared to urban Saskatchewan, rural Saskatchewan lung cancer patients had a higher relative risk of advanced stage NSCLC (relative risk [RR] = 1.11, 95% confidence interval [CI]: 1.01–1.22). Rural Saskatchewan was further subdivided into north and south. The relative risk of advanced stage NSCLC in rural north Saskatchewan compared to urban Saskatchewan was even greater (RR = 1.17, 95% CI: 1.03–1.31). Although not statistically significant, there was a trend for a higher incidence of advanced stage SCLC in rural and rural north vs urban Saskatchewan (RR = 1.16, 95% CI: 0.95–1.43 and RR = 1.22; 95% CI: 0.94–1.58, respectively). There was a higher incidence proportion of advanced stage NSCLC in rural areas relative to urban (31.6–34.4 vs 29.5 per 10,000 people). Patients living in rural Saskatchewan have higher incidence proportion of and were more likely to present with advanced stage NSCLC in comparison to urban Saskatchewan patients at time of diagnosis. This inequality was even greater in rural north Saskatchewan.