Urban and rural differences in outcomes of head and neck cancer

Kim, Jason D.; Firouzbakht, Aryan; Ruan, Jenny Y.; Kornelsen, Emily; Moghaddamjou, Ali; Javaheri, Khodadad Rasool; Olson, Robert; Cheung, Winson Y.

doi:10.1002/lary.26836

Cited by 22 publications

(33 citation statements)

References 49 publications

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“…This group proposed that Canada's distributed model of care across geographic catchment areas may be effective in minimizing urban-rural disparities. 6 Further comparative studies may elucidate political and economic factors that impact access to care for this population.…”

Section: Discussionmentioning

confidence: 99%

“…In contrast to prior studies, Kim et al found no difference in overall survival between urban and rural head and neck cancer patients in their cohort in British Columbia. This group proposed that Canada's distributed model of care across geographic catchment areas may be effective in minimizing urban–rural disparities 6 . Further comparative studies may elucidate political and economic factors that impact access to care for this population.…”

Section: Discussionmentioning

confidence: 99%

“…2,3 As in these other cancers, there is some evidence that rurality may be associated with poorer survival in oral cavity cancer 4,5 ; however, the data are weak and mixed. 6,7 Previous studies have shown that head and neck cancer patients have an increased risk of death when hospitalized at small-bed, rural, or non-teaching hospitals. 8 Moreover, rural patients with early laryngeal cancer were less likely to receive laryngeal preservation techniques as primary therapy, likely secondary to inadequate access to radiation oncology care.…”

Section: Introductionmentioning

confidence: 99%

“…Urban patients with lung, breast, and prostate cancer have a marked mortality advantage compared to their rural counterparts in epidemiologic studies 2,3 . As in these other cancers, there is some evidence that rurality may be associated with poorer survival in oral cavity cancer 4,5 ; however, the data are weak and mixed 6,7 . Previous studies have shown that head and neck cancer patients have an increased risk of death when hospitalized at small‐bed, rural, or non‐teaching hospitals 8 .…”

Section: Introductionmentioning

confidence: 99%

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Rural–Urban Disparities in Otolaryngology: The State of Illinois

Urban

Wojcik²,

Eggerstedt

et al. 2020

The Laryngoscope

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Objectives/Hypothesis To highlight rural–urban disparities in otolaryngology, and to quantify the disparities in access to otolaryngology specialist care across Illinois. Several studies across disciplines have shown increased prevalence and severity of disease in rural communities, relative to their urban counterparts. There is very little published quantifying a disparity in rural access to otolaryngologists. Study Design Population study. Methods Counties in Illinois were classified based on urbanization level on a scale from I (most urban) to VI (least urban) using the 2013 National Center for Health Statistics (NCHS) Urban–Rural Classification scheme. The six urbanization levels include four metropolitan (I–IV) and two nonmetropolitan levels (V and VI). The name and practice location of all registered otolaryngologists in Illinois were collected using the American Academy of Otolaryngology website (http://entnet.org). Population data were recorded from the most recent US Census (2010). Results Two hundred seventy‐eight academy‐registered otolaryngologists were identified in Illinois. One hundred fifty‐one of these providers were located in a single county categorized as a level I by the NCHS scheme. There are over 18,000 square miles and 600,000 persons living in NCHS level VI counties in Illinois with zero registered otolaryngologists. Overall, metropolitan counties (I–IV) averaged 1.32 otolaryngologists per 100,000 population, whereas nonmetropolitan counties (V and VI) averaged 0.46 otolaryngologists per 100,000 (P < .01). Conclusions There is a paucity of academy‐certified otolaryngologists with primary practice locations in rural counties of Illinois. There is a significant rural population and massive land area with limited spatial access to otolaryngologic specialist care. Level of Evidence NA Laryngoscope, 131:E70–E75, 2021

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Rural–Urban Disparities in Otolaryngology: The State of Illinois

Urban

Wojcik²,

Eggerstedt

et al. 2020

The Laryngoscope

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“…17 Other studies have reported increased incidence, adverse outcomes in urban dwellers, 18 or no rural-urban disparities. 19 Age at diagnosis is an important prognostic factor in all types of cancers, and HNC is no exception. Some studies report better prognosis in young patients, [20][21][22] while others report differently.…”

Section: Introductionmentioning

confidence: 99%

Geographical and Racial Disparities in Head and Neck Cancer Diagnosis in South-Eastern United States: Using Real-World Electronic Medical Records Data

Mukherjee

Idigo

et al. 2020

Health Equity

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Background: Rurality, race, and age at diagnosis are important predictors in head and neck cancer (HNC) prognosis. However, literature on the associations of rurality and race with age at HNC diagnosis is limited. Data on geographical, racial, and gender disparities in young HNC patients (diagnosed £ 45 years) are also scarce. Materials and Methods: This retrospective study assesses rural-urban, racial, and gender disparities in age at HNC diagnosis, using electronic medical records (Cerner) data of 4258 HNC patients (1538 residing in rural counties and 2720 in urban counties) from National Cancer Institute-designated cancer center in Alabama. Rurality was defined based on 2010 U.S. Census Bureau's rural-urban classification. Logistic regression was used to assess the association of young HNC diagnosis with demographical, behavioral, and clinical variables. ArcGIS 10.2 was used to map geospatial distribution of age and population-adjusted HNC case across rural and urban counties. Results: Patients from rural counties were less likely to be diagnosed at younger age (£ 45 years) compared with urban counties (odds ratio [OR] [95% confidence interval (CI)]: 0.74 [0.58-0.93]). Most patients present at stage III/IV (64.9% in rural and 60.2% in urban). Compared with white patients, black patients were 70% more likely to get diagnosed at a young age (95% CI: 1.23-2.35). Young patients were more likely to be females and blacks compared with older patients (p < 0.0001). Among oral cavity cancer patients, rural patients were 51% less likely to get diagnosed at young age compared with urban patients (95% CI: 0.27-0.89). Conclusions: Head and neck cancer screening is not routinely conducted so most show up at later stage of cancer. There is also evidence of disparities in age at HNC diagnosis based on rurality, race, and gender; targeted screening can help in reducing these disparities.

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Demographics and access to head and neck cancer care in rural areas compared to urban areas in Germany

Vahl,

Nagel,

Grages

et al. 2023

Cancer Medicine

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BackgroundDemographic development in rural and urban areas differs substantially. Demographics and access to specialized head and neck cancer centers may affect head and neck cancer patients' (HNCP) outcomes. Here, we compare epidemiological indicators and outcomes of HNCP in rural and urban Germany.Patients and MethodsIn a retrospective analysis of data from the Center for Cancer Registry Data (ZfKD) between 2002 and 2017, 212,920 HNCP were included. Incidence, demographics, travel distance to specialized centers, and ground values were compared between rural and urban areas with a focus on their association with patient outcomes.ResultsThe mean age of HNCP was significantly higher in urban areas (mean difference = 1.4 years; p < 0.0001), but increased at a comparable rate (p = 0.26) in rural and urban areas during the observation period. Gender imbalance was higher in rural areas (mean ratio of men/women: 4.1 vs. 3.1; p < 0.0001), but showed a comparable trend toward equilibration in both, rural and urban districts (p = 0.46). The portion of HNCP of the entire HNCP population living in urban areas increased from 55.9% in the year 2002 to 76.4% in the year 2017. There was no significant difference or change in the ratio of advanced to low UICC stage during the observation period (p = 0.26). However, travel distances to medical centers were higher in rural areas, especially (p < 0.0001) in East Germany. Median survival of HNCP in rural areas was significantly lower than in urban areas (42 months [SEM = 0.7; CI: 40.5–43.5] vs. 54 months [SEM = 1.2; CI: 51.7–56.3]; p < 0.0001) in East Germany, whereas in West Germany no significant difference was observed (59 months [SEM = 0.8; CI: 57.4–60.6] vs. 60 months [SEM = 0.5; CI: 59.0–61.0]; p = 0.15).ConclusionsPlace of residence contributes to survival outcome of HNCP. Access to specialized care and socioeconomic factors could be improved in East Germany.

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Urban and rural differences in outcomes of head and neck cancer

Abstract: 2c. Laryngoscope, 128:852-858, 2018.

Cited by 22 publications

References 49 publications

Rural–Urban Disparities in Otolaryngology: The State of Illinois

Rural–Urban Disparities in Otolaryngology: The State of Illinois

Geographical and Racial Disparities in Head and Neck Cancer Diagnosis in South-Eastern United States: Using Real-World Electronic Medical Records Data

Demographics and access to head and neck cancer care in rural areas compared to urban areas in Germany

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