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J Rural Health. 2019 May 17. doi: 10.1111/jrh.12374. [Epub ahead of print]

Impact of Rurality on National Trends in Thyroid Cancer Incidence and Long-Term Survival.

Author information

1
Department of Surgery, Indiana University School of Medicine, Indianapolis, Indiana.
2
Department of Population Science and Policy, Southern Illinois University School of Medicine, Springfield, Illinois.
3
Rural and Minority Health Research Center, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina.
4
Department of Surgery, University of Chicago Pritzker School of Medicine, Chicago, Illinois.
5
Department of Surgery, Southern Illinois University School of Medicine, Springfield, Illinois.

Abstract

PURPOSE:

Thyroid cancer incidence is rising, possibly secondary to increased imaging and surveillance. Based on rural access to care disparities, we hypothesized that incidence would be greater in urban compared to rural counties with no significant difference in long-term survival.

METHODS:

An observational study was performed on thyroid cancer patients using Surveillance Epidemiology and End Results data (2000-2012). Age-adjusted incidence rates, incidence rate ratios, and survival rates were calculated across rural-urban designations.

FINDINGS:

Incidence rates were 11.2, 9.8, and 10.1 per 100,000 for urban, rural-adjacent, and rural-nonadjacent counties, respectively. Statistically significantly lower incidence was noted in rural-adjacent and rural-nonadjacent compared to urban areas. Five-year and 10-year survival was significantly lower in rural-nonadjacent counties compared to urban counties.

CONCLUSIONS:

Higher incidence and increased long-term survival for thyroid cancer were noted in urban areas compared to rural areas. It is uncertain if rural-urban differences in long-term survival reflect health care disparities, differences in therapy, or other origins.

KEYWORDS:

cancer incidence; cancer mortality; overdiagnosis; rural disparities; thyroid cancer

PMID:
31099945
DOI:
10.1111/jrh.12374

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