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Cancer. 2009 Jun 15;115(12):2755-64. doi: 10.1002/cncr.24306.

Rural reversal? Rural-urban disparities in late-stage cancer risk in Illinois.

Author information

1
Department of Geography, University of Illinois at Urbana-Champaign, Urbana, Illinois 61801, USA. smclaff@illinois.edu

Abstract

BACKGROUND:

Differences in late-stage cancer risk between urban and rural residents are a key component of cancer disparities. Using data from the Illinois State Cancer Registry from 1998 through 2002, the authors investigated the rural-urban gradient in late-stage cancer risk for 4 major types of cancer: breast, colorectal, lung, and prostate.

METHODS:

Multilevel modeling was used to evaluate the role of population composition and area-based contextual factors in accounting for rural-urban variation. Instead of a simple binary rural-urban classification, a finer grained classification was used that differentiated the densely populated City of Chicago from its suburbs and from smaller metropolitan areas, large towns, and rural settings.

RESULTS:

For all 4 cancers, the risk was highest in the most highly urbanized area and decreased as rurality increases, following a J-shaped progression that included a small upturn in risk in the most isolated rural areas. For some cancers, these geographic disparities were associated with differences in population age and race; for others, the disparities remained after controlling for differences in population composition, zip code socioeconomic characteristics, and spatial access to healthcare.

CONCLUSIONS:

The observed pattern of urban disadvantage emphasized the need for more extensive urban-based cancer screening and education programs.

PMID:
19434667
PMCID:
PMC2774239
DOI:
10.1002/cncr.24306
[Indexed for MEDLINE]
Free PMC Article

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