title: The effects of geography on survival in patients with oral cavity squamous cell carcinoma.
abstract: OBJECTIVE
  To assess the survival outcomes of oral cavity squamous cell carcinoma (OCSCC) by differing geographical location.
  
  
  METHODS
  Demographic, pathologic, treatment, and survival data was obtained from OCSCC patients from 1998-2010 in Alberta, Canada. 554 patients were included from 660 OCSCC patients. Overall, disease-specific, and disease-free survivals were estimated with Kaplan-Meier and Cox regression analyses. Patients were grouped by geographic locations.
  
  
  RESULTS
  Patients from urban locations had improved overall, disease-specific, and disease-free survival compared to rural locations (p<0.05). Two and five year estimates of overall survival were significantly higher in the urban cohort at 84% and 78%, versus rural with 48% and 44%, respectively (p<0.05). Disease-specific and disease-free survival rates were also superior in the urban group (p<0.05). Diagnosis to treatment time for all 3 geographical groups was not found to be statistically significant (p>0.05).
  
  
  CONCLUSIONS
  This study shows that patients with OCSCC living in urban settings have improved survival compared to rural groups.
authors: Division of Otolaryngology-Head and Neck Surgery, University of Alberta, Edmonton, Alberta, Canada.
authors: Han
authors: H
authors: Zhang
authors: Division of Otolaryngology-Head and Neck Surgery, University of Alberta, Edmonton, Alberta, Canada; Department of Otolaryngology, University of Florida, Gainesville, FL, USA.
authors: Peter T
authors: PT
authors: Dziegielewski
authors: Department of Family Medicine, Université de Sherbrooke, Sherbrooke, Quebec, Canada.
authors: T T
authors: TT
authors: Jean Nguyen
authors: Division of Otolaryngology-Head and Neck Surgery, University of Alberta, Edmonton, Alberta, Canada.
authors: Caroline C
authors: CC
authors: Jeffery
authors: Division of Otolaryngology-Head and Neck Surgery, University of Alberta, Edmonton, Alberta, Canada.
authors: Daniel A
authors: DA
authors: O'Connell
authors: Division of Otolaryngology-Head and Neck Surgery, University of Alberta, Edmonton, Alberta, Canada.
authors: Jeffrey R
authors: JR
authors: Harris
authors: Division of Otolaryngology-Head and Neck Surgery, University of Alberta, Edmonton, Alberta, Canada. Electronic address: hadi.seikaly@albertahealthservices.ca.
authors: Hadi
authors: H
authors: Seikaly
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002170:Canada / Q000453:epidemiology; D002294:Carcinoma, Squamous Cell / Q000401:mortality*; D005260:Female; D062306:Geography, Medical; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000401:mortality*; D012044:Regression Analysis; D012111:Residence Characteristics; D012307:Risk Factors; D012423:Rural Health; D014504:Urban Health; D055815:Young Adult
keywords: Head and neck cancer; Oral cavity cancer; Survival outcomes