Demographic Differences in Lung, Prostate, Breast, and Colorectal Cancer Survival

Researchers, led by Marquita W. Lewis-Thames, PhD, MPH, MS, conducted a cross-sectional study of the Surveillance, Epidemiology, and End Results (SEER) database in order to describe the “rural-urban trends” in five-year lung, prostate, breast, and colorectal cancer-specific survival. After their analyses, researchers concluded that, “even after accounting for sociodemographic and tumor characteristics, these findings suggest that non-Hispanic Black patients with cancer are particularly vulnerable to cancer burden, and resources are urgently needed to reverse decades-old survival trends.”

According to the article in JAMA Network Open, the study’s authors analyzed patients from the SEER database who were diagnosed no later than 2011. Participants’ rural or urban status was based on the 2013 Rural-Urban Continuum Codes. Cox, linear regression, and joinpoint regression models were used to calculate the cancer-specific survival rates for rural and urban individuals.

Findings on Rural-Urban Cancer Survival in the SEER Database

Overall, the analysis included 3,659,417 patients with cancer (1,918,609 [52.4%] male; 237,815 [6.5%] Hispanic patients; 396,790 [10.8%] Black patients; and 2,825,037 [77.2%] White patients). Among the subjects, 888,338 patients had lung cancer (24.3%), 750,704 patients had colorectal cancer (20.5%), 987,826 patients with breast cancer (27.0%), and 1,023,549 patients with prostate cancer (28.0%). Overall, 430,353 patients were rural.

Investigators found that, in general, “rural patients were likely to be non-Hispanic White individuals, have more cases of distant tumors, and be older,” and, furthermore, “rural and non-Hispanic Black patients for all cancer types often had shorter survival.” Specifically, five-year lung cancer survival was “shorter for non-Hispanic Black rural patients in 1975 at 48%, while increasing to 57% for both non-Hispanic Black urban and rural patients in 2011, but still the shortest among all cancer types.”

Ultimately, “although the probability of survival increased during the observed time, rarely did the differences between urban and rural patients narrow,” according to the results, and the investigators reinforced the need for measures to address the “36-year” discrepancy in urban and rural cancer survival probability.

Find More Related Research, Expert Interviews, and Cancer News