title: Place of residence and primary treatment of prostate cancer: examining trends in rural and nonrural areas in Wisconsin.
abstract: OBJECTIVE
  To determine whether rural residents were at a disadvantage compared with urban residents with regard to the receipt of curative therapy for prostate cancer.
  
  
  METHODS
  Using the Breast and Prostate Cancer Data Quality and Patterns of Care Study II, patients with prostate cancer who were diagnosed in 2004 were identified. Registrars reviewed the medical records of randomly selected patients with incident prostate cancer (n = 1906). The patients' residential address was geocoded and linked to the census tract from the 2000 U.S. Census. The place of residence was defined as rural or nonrural according to the census tract and rural-urban commuting area categorization. The distance from the residence to the nearest radiation oncology facility was calculated. The odds ratio and 95% confidence intervals associated with receipt of noncurative treatment was calculated from logistic regression models and adjusted for several potential confounders.
  
  
  RESULTS
  Of the incident patients, 39.1% lived in urban census tracts, 41.5% lived in mixed tracts, and 19.4% lived in rural tracts. Hormone-only or active surveillance was received by 15.4% of the patients. Relative to the urban patients, the odds ratio for noncurative treatment was 1.01 (95% confidence interval 0.59-1.74) for those living in mixed tracts and 0.96 (95% confidence interval 0.52-1.77) for those living in rural tracts. No association was found for noncurative treatment according to the Rural-Urban Commuting Area categorization. The linear trend was null between noncurative treatment and the distance to nearest radiation oncology facility (P = .92).
  
  
  CONCLUSIONS
  The choice of curative treatment did not significantly depend on the patient's place of residence, suggesting a lack of geographic disparity for the primary treatment of prostate cancer.
authors: University of Wisconsin Carbone Cancer Center, Madison, WI 53726, USA. jpcetnar@medicine.wisc.edu
authors: Jeremy P
authors: JP
authors: Cetnar
authors: John M
authors: JM
authors: Hampton
authors: Amy A
authors: AA
authors: Williamson
authors: Tracy
authors: T
authors: Downs
authors: Dian
authors: D
authors: Wang
authors: Jean B
authors: JB
authors: Owen
authors: Byron
authors: B
authors: Crouse
authors: Nathan
authors: N
authors: Jones
authors: J Frank
authors: JF
authors: Wilson
authors: Amy
authors: A
authors: Trentham-Dietz
mesh_terms: D000328:Adult; D000368:Aged; D003695:Delivery of Health Care / Q000639:trends*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011471:Prostatic Neoplasms / Q000628:therapy*; D012111:Residence Characteristics; D012423:Rural Health; D014504:Urban Health; D014922:Wisconsin; D055815:Young Adult