title: Negative impact of rurality on lung cancer survival in a population-based study.
abstract: 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.
authors.affiliation: University Hospital of Besançon and University of Franche Comte, Besançon, France.
authors.forename: Virginie
authors.initials: V
authors.lastname: Westeel
authors.forename: Alexandre
authors.initials: A
authors.lastname: Pitard
authors.forename: Mael
authors.initials: M
authors.lastname: Martin
authors.forename: Isabelle
authors.initials: I
authors.lastname: Thaon
authors.forename: Alain
authors.initials: A
authors.lastname: Depierre
authors.forename: Jean-Charles
authors.initials: JC
authors.lastname: Dalphin
authors.forename: Patrick
authors.initials: P
authors.lastname: Arveux
mesh_terms: 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