Rural-urban differences in stage at diagnosis. Possible relationship to cancer screening.
Stage at diagnosis was examined for various malignancies identifiable through screening to determine whether rural-urban differences exist in Georgia. Data were obtained from a population-based cancer registry which registers all incident cancers among residents of metropolitan Atlanta and ten neighboring rural counties. Black and white patients with a first primary invasive malignancy newly diagnosed between 1978 and 1985 were included in this study. Residents of the rural area were twice as likely to have unstaged cancers (18.3%) as were urban residents (9.6%). Among patients with known stage at diagnosis, rural patients tended to have more advanced disease than urban patients. The relative excess of nonlocalized malignancies in rural Georgia was 21% for whites and 37% for blacks. The rural excess of nonlocalized prostate cancer among blacks was especially pronounced. Differences in access to or utilization of early detection methods may contribute to the rural-urban differential in the extent of disease at diagnosis.
Liff
J M
JM
Division of Epidemiology, Emory University School of Public Health, Atlanta, Georgia 30329.
Chow
W H
WH
Greenberg
R S
RS
D001741:Black or African American; D000368:Aged; D005845:Georgia / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D009367:Neoplasm Staging; D009369:Neoplasms / Q000453:epidemiology / Q000473:pathology* / Q000517:prevention & control; D015203:Reproducibility of Results; D012423:Rural Health / Q000706:statistics & numerical data*; D014504:Urban Health / Q000706:statistics & numerical data*; D044465:White People