Rural and Urban Differences in Prostate Cancer Recurrence

Area of Science:

• Oncology
• Epidemiology
• Health Services Research

Background:

• Rural patients face unique challenges in accessing high-quality cancer care.
• Existing research has not sufficiently determined if these disparities lead to poorer clinical outcomes.

Purpose of the Study:

• To investigate differences in biochemical recurrence rates for prostate cancer between rural and urban men.
• To identify potential disparities in prostate cancer outcomes based on geographic residence.

Main Methods:

• A population-based cohort study of newly diagnosed prostate cancer patients in North Carolina (2011-2013).
• Patients were categorized as rural or urban using the Rural-Urban Continuum Code.
• Biochemical recurrence was assessed via prostate-specific antigen testing, analyzed using Cox proportional hazard models.

Main Results:

• Rural residence was significantly associated with a higher rate of biochemical recurrence (HR, 1.74; P = .03) after multivariable adjustment.
• Radiation therapy showed an inverse association with recurrence (HR, 0.51; P = .01).
• Factors like NCCN risk group and prior biopsies also influenced recurrence rates.

Conclusions:

• Rural patients with prostate cancer exhibit higher rates of biochemical recurrence.
• The underlying causes are likely multifactorial, potentially involving socioeconomic status, care delays, and access to multidisciplinary care.
• Further research is needed to address these disparities and improve outcomes for rural cancer patients.