title: Rural residency and prostate cancer specific mortality: results from the Victorian Radical Prostatectomy Register.
abstract: OBJECTIVE
  To present long-term survival data from the Victorian Radical Prostatectomy Register (VRPR), 1995-2000, and analyse the effect of rural residence on survival.
  
  
  METHODS
  Men who underwent open radical prostatectomy (RP) in Victoria from 1995 to 2000 were recorded in a population register co-ordinated by the Victorian Cancer Registry and Cancer Council Victoria. Baseline clinical, pathological and demographic information such as location were recorded and linked to mortality and recurrence data. Men who had neoadjuvant therapy or missing data for socioeconomic status (SES), tumour grade and stage were excluded leaving 1984 patients in the analyses (92.1% of total register).
  
  
  RESULTS
  Follow-up concluded in 2009 with 238 deaths observed, of which 77 were prostate cancer (PCa) specific. Cox and competing risk regressions were used for analysis. Living in a rural area was associated with higher odds of PCa specific mortality after RP (trend p<0.001) and a higher hazard of PCa death, the discrepancy rising up to four-fold (SHR=4.09, p=0.004) with increasing remoteness of residence. This effect is apparent after adjustment for SES, age, private or public hospital treatment, PSA level and tumour-specific factors.
  
  
  CONCLUSIONS
  Rural men in Victoria have a shorter time to PCa death following definitive treatment, even after adjustment for SES and adverse tumour characteristics.
  
  
  CONCLUSIONS
  Rural men are faring worse than their urban counterparts following the same cancer treatment.
authors: Austin Hospital, Victoria; Cancer Epidemiology Centre, Cancer Council Victoria.
authors: Nathan
authors: N
authors: Papa
authors: Nathan
authors: N
authors: Lawrentschuk
authors: David
authors: D
authors: Muller
authors: Robert
authors: R
authors: MacInnis
authors: Anthony
authors: A
authors: Ta
authors: Gianluca
authors: G
authors: Severi
authors: Jeremy
authors: J
authors: Millar
authors: Rodney
authors: R
authors: Syme
authors: Graham
authors: G
authors: Giles
authors: Damien
authors: D
authors: Bolton
mesh_terms: D000368:Aged; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009364:Neoplasm Recurrence, Local / Q000473:pathology; D016016:Proportional Hazards Models; D011446:Prospective Studies; D017430:Prostate-Specific Antigen; D011468:Prostatectomy / Q000706:statistics & numerical data*; D011471:Prostatic Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D012042:Registries; D012111:Residence Characteristics; D012306:Risk; D012424:Rural Population; D012923:Social Class; D015996:Survival Rate
chemical_list: D017430:Prostate-Specific Antigen
keywords: population study; prostate cancer; rural health