2008 Woodie Awards
Rural/urban divide in cancer
Zhi Xiong - The Daily Iowan
Issue date: 12/4/07 Section: Metro
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People living in rural areas - even those who are poorer and older - are likely to seek treatment in early stages of some cancers compared with urbanites, according to recent research.
"We were surprised," said Ian Paquette, the lead researcher and a physician at the Dartmouth-Hitchcock Medical Center in New Hampshire. "In our experience, and we're in a rural area, there was anecdotal evidence of the contrary."
But the findings, besides being counterintuitive, may not apply to Iowans, local experts said.
The new publication, which appeared in The Journal of the American College of Surgeons, analyzed approximately 300,000 colorectal- and lung-cancer cases from the National Cancer Institute between 2000 and 2003. More than 140,000 people were diagnosed with colorectal cancer in 2003, compared with more than 190,000 with lung cancer, according to statistics from the Centers for Disease Control and Prevention.
Patients in urban areas are similar demographically to those who seek treatment at stage IV, where cancer has spread to other parts of the body: black and divorced. Patients in rural areas are generally poorer than their city counterparts, according to the study.
Definitions of rural and urban were based on the population of each county - a significant limitation of the study, said Charles Lynch, a UI epidemiologist.
Just how rural is considered rural?
"Rural in Iowa is not the same as rural in the Appalachian mountains," he said. "If you compared west, southwest, or northeast Iowa, would their definition of urban and rural still hold up?"
Furthermore, data from the National Cancer Institute's Surveillance Epidemiology and End Results database cover approximately 20 percent of the population.
"I would be cautious of extending a larger study to an individual state," Lynch said.
Studies conducted in Iowa have not shown the same trend, said Nancy Thompson, an associate professor of community and behavioral health. She and a group of UI scientists compiled statistics about colorectal-cancer screening, examining data from the State Health Registry of Iowa between 1999 and 2002.
"We were surprised," said Ian Paquette, the lead researcher and a physician at the Dartmouth-Hitchcock Medical Center in New Hampshire. "In our experience, and we're in a rural area, there was anecdotal evidence of the contrary."
But the findings, besides being counterintuitive, may not apply to Iowans, local experts said.
The new publication, which appeared in The Journal of the American College of Surgeons, analyzed approximately 300,000 colorectal- and lung-cancer cases from the National Cancer Institute between 2000 and 2003. More than 140,000 people were diagnosed with colorectal cancer in 2003, compared with more than 190,000 with lung cancer, according to statistics from the Centers for Disease Control and Prevention.
Patients in urban areas are similar demographically to those who seek treatment at stage IV, where cancer has spread to other parts of the body: black and divorced. Patients in rural areas are generally poorer than their city counterparts, according to the study.
Definitions of rural and urban were based on the population of each county - a significant limitation of the study, said Charles Lynch, a UI epidemiologist.
Just how rural is considered rural?
"Rural in Iowa is not the same as rural in the Appalachian mountains," he said. "If you compared west, southwest, or northeast Iowa, would their definition of urban and rural still hold up?"
Furthermore, data from the National Cancer Institute's Surveillance Epidemiology and End Results database cover approximately 20 percent of the population.
"I would be cautious of extending a larger study to an individual state," Lynch said.
Studies conducted in Iowa have not shown the same trend, said Nancy Thompson, an associate professor of community and behavioral health. She and a group of UI scientists compiled statistics about colorectal-cancer screening, examining data from the State Health Registry of Iowa between 1999 and 2002.
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