Marina Deuker, Lara Franziska Stolzenbach, Claudia Collà Ruvolo, Luigi Nocera, Zhe Tian, Frederik Roos, Andreas Becker, Luis Kluth, Derya Tilki, Shahrokh F. Shariat, Fred Saad, Felix Chun, Pierre I. Karakiewicz
- Objective: Relative to urban populations, rural patients may have more limited access to care, which may undermine timely bladder cancer (BCa) diagnosis and even survival.
Methods: We tested the effect of residency status (rural areas [RA < 2500 inhabitants] vs. urban clusters [UC ≥ 2500 inhabitants] vs. urbanized areas [UA, ≥50,000 inhabitants]) on BCa stage at presentation, as well as on cancer-specific mortality (CSM) and other cause mortality (OCM), according to the US Census Bureau definition. Multivariate competing risks regression (CRR) models were fitted after matching of RA or UC with UA in stage-stratified analyses.
Results: Of 222,330 patients, 3496 (1.6%) resided in RA, 25,462 (11.5%) in UC and 193,372 (87%) in UA. Age, tumor stage, radical cystectomy rates or chemotherapy use were comparable between RA, UC and UA (all p > 0.05). At 10 years, RA was associated with highest OCM followed by UC and UA (30.9% vs. 27.7% vs. 25.6%, p < 0.01). Similarly, CSM was also marginally higher in RA or UC vs. UA (20.0% vs. 20.1% vs. 18.8%, p = 0.01). In stage-stratified, fully matched CRR analyses, increased OCM and CSM only applied to stage T1 BCa patients.
Conclusion: We did not observe meaningful differences in access to treatment or stage distribution, according to residency status. However, RA and to a lesser extent UC residency status, were associated with higher OCM and marginally higher CSM in T1N0M0 patients. This observation should be further validated or refuted in additional epidemiological investigations.
MetadatenAuthor: | Marina DeukerORCiDGND, Lara Franziska StolzenbachORCiDGND, Claudia Collà RuvoloORCiD, Luigi NoceraORCiD, Zhe Tian, Frederik RoosGND, Andreas BeckerGND, Luis KluthORCiDGND, Derya TilkiORCiDGND, Shahrokh F. ShariatORCiDGND, Fred SaadORCiDGND, Felix ChunORCiDGND, Pierre I. Karakiewicz |
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URN: | urn:nbn:de:hebis:30:3-813305 |
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DOI: | https://doi.org/10.1007/s10552-020-01366-1 |
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ISSN: | 1573-7225 |
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Pubmed Id: | https://pubmed.ncbi.nlm.nih.gov/33230694 |
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Parent Title (English): | Cancer causes & control |
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Publisher: | Springer Nature Switzerland |
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Place of publication: | Cham |
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Document Type: | Article |
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Language: | English |
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Date of Publication (online): | 2020/11/23 |
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Date of first Publication: | 2020/11/23 |
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Publishing Institution: | Universitätsbibliothek Johann Christian Senckenberg |
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Release Date: | 2024/01/31 |
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Tag: | Bladder cancer; Geographical disparities; Social differences; Stage at presentation; Treatment rates |
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Volume: | 32 |
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Issue: | 2 |
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Page Number: | 7 |
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First Page: | 139 |
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Last Page: | 145 |
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Note: | Open Access funding enabled and organized by Projekt DEAL. |
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Note: | Data availability: SEER data are publicly available. Access to the SEER database is provided for researchers by the National Health Institute.
Code availability: Custom code upon request. |
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HeBIS-PPN: | 517871815 |
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Institutes: | Medizin |
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Dewey Decimal Classification: | 6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit |
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Sammlungen: | Universitätspublikationen |
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Licence (German): | Creative Commons - CC BY - Namensnennung 4.0 International |
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