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A Bioluminescent and Fluorescent Orthotopic Syngeneic Murine Model of Androgen-dependent and Castration-resistant Prostate Cancer
Published on: March 6, 2018
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Rurality Status and Cardiovascular Events/Survival in Older Men With Prostate Cancer.
Stephanie Jiang1, Vraj Patel1, Nickolas Stabellini2,3,4,5
1School of Medicine, Medical College of Georgia at Augusta University, Augusta, GA.
Journal of the National Comprehensive Cancer Network : JNCCN
|March 12, 2025
Summary
Living in rural areas increases prostate cancer patients' risk of cardiovascular disease (CVD) and mortality. Care from nonmetropolitan providers further elevates these risks, highlighting disparities in rural healthcare access.
Area of Science:
- Oncology
- Cardiovascular Medicine
- Health Services Research
Background:
- Rural populations exhibit higher cardiovascular disease (CVD) incidence and mortality.
- The influence of rurality on prostate cancer (PC) patient outcomes, including CVD, is not well understood.
Purpose of the Study:
- To investigate the impact of patient and provider rurality on CVD development and mortality in older men with prostate cancer.
- To analyze risks for post-prostate cancer CVD, cardiovascular mortality (CVDm), prostate cancer-specific mortality (PCSm), and all-cause mortality.
Main Methods:
- Retrospective cohort study using the SEER-Medicare database (2009-2017).
- Analysis of males aged ≥65 years diagnosed with PC.
- Assessment of patient rurality (metropolitan, urban, rural) and patient-provider rurality.
- Multivariable Fine-Gray and extended Cox models to evaluate outcomes.
Main Results:
- Rural patients had a 28% higher risk of PCSm and 15% higher risk of all-cause mortality compared to metropolitan patients.
- Rural patients faced a 7% higher risk of CVD compared to urban patients.
- Rural patients receiving care from nonmetropolitan providers showed increased risks for PCSm and all-cause mortality.
Conclusions:
- Rurality is linked to elevated risks of CVD, PCSm, and all-cause mortality in prostate cancer patients.
- Provider location (nonmetropolitan vs. metropolitan) exacerbates these risks, indicating significant rural health disparities.
- Improving healthcare access and quality in rural areas is crucial for mitigating these disparities.
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