Negative impact of rurality on lung cancer survival in a population-based study.
BACKGROUND
Several studies have suggested that rurality is a risk factor for worse prognosis in cancer.


METHODS
The study population included the 2268 lung cancer cases collected between 1981 and 1996 in the Doubs Cancer Registry (France).


RESULTS
The numbers of patients were 849 (31.8%) in rural areas and 89 (3.3%) in very rural areas. The relative 5-year survival was 15.2% in rural areas and 13.4% in urban areas (p = 0.5), and 2.7% in very rural areas and 14.4% in extended urban areas (p = 0.02). Multivariate analyses of observed and relative survival showed that patients living in very rural areas (p < 0.0001), 65 years of age and older and having small cell carcinoma had a significantly shorter survival.


CONCLUSIONS
This study showed that the multidimensional definition of rurality identified a population with unfavorable prognoses.
Westeel
Virginie
V
University Hospital of Besançon and University of Franche Comte, Besançon, France.
Pitard
Alexandre
A
Martin
Mael
M
Thaon
Isabelle
I
Depierre
Alain
A
Dalphin
Jean-Charles
JC
Arveux
Patrick
P
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D008175:Lung Neoplasms / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D012424:Rural Population; D015996:Survival Rate / Q000639:trends