Patients Diagnosed with Colorectal Cancer in Rural Areas in Arizona Typically Present with Higher Stage Disease

Abstract

Background Despite the decreasing incidence of colorectal cancer (CRC) over the past three decades disparities remain in its incidence, stage at presentation, and efficiency of staging and treatment between different communities, particularly when comparing urban and rural areas. The aim of the study was to assess disparities that exist in CRC outcomes among urban, international border counties, and non-border counties in Arizona. Methods A retrospective analysis of CRC data from the Arizona Cancer Registry was performed. Data obtained included age, sex, ethnicity, tumor grade, and tumor stage. The data was then categorized into three sections: international border counties, urban counties, and rural counties. The outcome measure was stage of CRC at diagnosis. Results There were a total of 39, 958 reported incident cases of colorectal cancer from 1995-2010. Of the total incident cases, 53.1% were male and the average age at diagnosis was 69.5. 86.6% were white non-Hispanic, 8.37% Hispanic, 2.4% African American, 1.7% Native American and 1% Asian. There was a significant decrease in the incidence of CRC in all counties, 24.08% in border, 22.5% in urban, and 12.3% in rural. Rural counties showed a higher number of observed cases than expected cases of stage 4 CRC and more unknown diagnosis of grade, stage and lymph node assessment as determined by the adjusted residual. Conclusion Patients in rural counties are more likely to present with a higher stage of CRC and are less likely to have their cancer adequately staged. This is likely due to lack of better access to healthcare, lack of awareness and poor education and also inadequate specialists.

Colorectal Cancer in Egypt: Clinical, Life-Style, and Socio-Demographic Risk Factors

“…58 An urban residence was a significant risk factor for CRC (OR=1.95). 59 Individuals in rural areas are more likely to come with a higher stage of CRC. This could be a result of a lack of appropriate access to health care, a lack of awareness, poor education, and a paucity of specialists.…”

Comprehensive analysis of expression profiles of long non‑coding RNAs with associated ceRNA�network involved in gastric cancer progression

“…Two upregulated lncRNAs (HOTAIR and UCA1) and two downregulated lncRNAs (LOH12CR2 and PART1) were common between the microarray, CRN and circlncRNAnet results. Several studies have previously reported that HOTAIR is an oncogene that plays a crucial role in the progression of various types of cancer (20), including gastric cancer (21,22), lung cancer (23), colorectal cancer (24), liver cancer (25), gallbladder cancer (26), breast cancer (27), cervical cancer (28), ovarian cancer (29), and prostate cancer (30). The oncogene UCA1 is known to be involved in various types of cancer, such as gastric cancer (31), breast cancer (32), bladder cancer (33) and colorectal cancer (34).…”

Nonuniversity-Based Surgeons Coming Up Anything but Short in Solutions to the Future Surgeon Shortage

“…In addition, patient and hospital characteristics, which were controlled for in this analysis, are significant contributors to surgical outcomes. For example, even if surgical technical expertise is equivalent among surgeons performing colorectal cancer surgery, factors such as decreased access to subspecialists for multidisciplinary cancer care and more advanced disease at presentation as a result of delayed diagnosis may result in worsened colorectal cancer outcomes in small and/or rural hospitals (ie, those with a higher proportion of NUBR surgeons).…”