Adverse health outcomes among rural prostate cancer survivors: A population-based study

Daren Huang; Chun-Pin Esther Chang; Michael Newman; Vikrant Deshmukh; John Snyder; Ankita Date; Carlos Galvao; Shane Lloyd; N Lynn Henry; Brock O'Neil; Mia Hashibe

doi:10.1016/j.canep.2023.102430

Adverse health outcomes among rural prostate cancer survivors: A population-based study

Cancer Epidemiol. 2023 Oct:86:102430. doi: 10.1016/j.canep.2023.102430. Epub 2023 Jul 19.

Authors

Affiliations

¹ Huntsman Cancer Institute, Salt Lake City, UT, United States; Division of Public Health, Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, UT, United States; Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, CA, United States.
² Huntsman Cancer Institute, Salt Lake City, UT, United States; Division of Public Health, Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, UT, United States. Electronic address: esther.chang@utah.edu.
³ Department of Health Sciences, University of Utah, Salt Lake City, UT, United States.
⁴ Intermountain Healthcare, Salt Lake City, UT, United States.
⁵ Pedigree and Population Resource, Population Sciences, Huntsman Cancer Institute, Salt Lake City, UT, United States.
⁶ Department of Radiation Oncology, University of Utah, Salt Lake City, UT, United States.
⁷ Department of Internal Medicine, University of Michigan, Ann Arbor, MI, United States.
⁸ Division of Urology, University of Utah, Salt Lake City, UT, United States.
⁹ Huntsman Cancer Institute, Salt Lake City, UT, United States; Division of Public Health, Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, UT, United States.

Abstract

Introduction: Rural cancer survivors experience considerable health disparities compared to urban cancer survivors for cancer treatment and survival. The objective of our study was to investigate the risk of developing diseases for rural compared to urban prostate cancer survivors in Utah.

Methods: We identified a cohort of 3575 rural prostate cancer survivors and 17,778 urban prostate cancer survivors from the Utah Cancer Registry. The Fine-Gray subdistribution hazards model was used to estimate hazard ratios and 95 % confidence intervals for diseases in major body systems among rural compared to urban prostate cancer survivors at > 1-5 years and > 5 years after prostate cancer diagnosis.

Results: Rural residence was associated with an increased risk of diseases of the respiratory system at > 5 years (HR: 1.16, 95 % CI: 1.01-1.32) after cancer diagnosis compared to urban residence among prostate cancer survivors in Utah. Decreased risks were observed in infectious and parasitic diseases, diseases of the blood and blood-forming organs, diseases of the nervous system and sense organs, and diseases of the skin and subcutaneous tissue for rural prostate cancer survivors between 1 and 5 years after cancer diagnosis.

Conclusions: Rural prostate cancer survivors in Utah were somewhat healthier compared to urban prostate cancer survivors. Further studies are needed to confirm whether these associations are also supported for rural prostate cancer survivors in other regions of the U.S.

Keywords: Comorbid disease; Health disparity; Prostate cancer survivors; Respiratory system; Rural health.

Publication types

Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.
Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

Cancer Survivors*
Humans
Male
Outcome Assessment, Health Care
Prostate
Prostatic Neoplasms* / epidemiology
Rural Population
Urban Population

Abstract

Publication types

MeSH terms

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