Cancer disparities in the context of rurality: risk factors and screening across various U.S. rural classification codes.
Cancer disparities in the context of rurality: risk factors and screening across various U.S. rural classification codes.
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DOI：
10.1007/s10552-022-01599-2
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发表时间：
2022-08
影响因子：
2.3
通讯作者：
Ford, Sabrina
中科院分区：
文献类型：
--
作者：
Hirko, Kelly A.;Xu, Huiwen;Rogers, Laura Q.;Martin, Michelle Y.;Roy, Siddhartha;Kelly, Kimberly M.;Christy, Shannon M.;Ashing, Kimlin Tam;Yi, Jean C.;Lewis-Thames, Marquita W.;Meade, Cathy D.;Lu, Qian;Gwede, Clement K.;Nemeth, Julianna;Ceballos, Rachel M.;Menon, Usha;Cueva, Katie;Yeary, Karen;Klesges, Lisa M.;Baskin, Monica L.;Alcaraz, Kassandra I.;Ford, Sabrina
先前的癌症研究受到定义乡村性不一致的限制。本研究的目的是描述癌症危险因素和癌症筛查行为的患病率在不同的县为基础的农村分类代码，包括反映连续的措施，告知我们的理解癌症的差距，根据农村的程度。采用生态学横断面设计，我们检验了行为危险因素监测系统和国民健康访谈调查中癌症危险因素和癌症筛查行为的差异（2008-2013年）农村县之间以及农村县和城市县之间的数据，2013年使用了四个县和县对应的城乡分类代码：美国管理和预算办公室，国家卫生统计中心，美国农业部经济研究服务的城乡连续体代码和城市影响代码。尽管在所有分类代码中农村到城市的梯度并不一致，但随着农村的增加，吸烟、肥胖、缺乏身体活动和酗酒的患病率增加（所有p趋势<0.03），而结直肠癌、宫颈癌和乳腺癌筛查减少（所有p趋势<0.001）。肥胖的危险因素和筛查行为在农村地区的患病率差异大于农村和城市县之间的差异（2.4% vs. 1.5%），体力活动（2.9%对2.5%）、酗酒（3.4%对0.4%）、宫颈癌筛查（6.8%对4.0%）和结直肠癌筛查（4.4%对3.8%）。在多个城乡分类代码中，农村癌症差异持续存在，农村地区的癌症风险因素和筛查明显存在显著差异。仅仅关注农村-城市二分法可能不足以涵盖农村居民中癌症风险和癌症相关死亡率更高的亚群。
Prior cancer research is limited by inconsistencies in defining rurality. The purpose of this study was to describe the prevalence of cancer risk factors and cancer screening behaviors across various county-based rural classification codes, including measures reflecting a continuum, to inform our understanding of cancer disparities according to the extent of rurality. Using an ecological cross-sectional design, we examined differences in cancer risk factors and cancer screening behaviors from the Behavioral Risk Factor Surveillance System and National Health Interview Survey (2008–2013) across rural counties and between rural and urban counties using four rural-urban classification codes for counties and county-equivalents in 2013: U.S. Office of Management and Budget, National Center for Health Statistics, USDA Economic Research Service’s rural-urban continuum codes, and Urban Influence Codes. Although a rural-to-urban gradient was not consistently evident across all classification codes, the prevalence of smoking, obesity, physical inactivity, and binge alcohol use increased (all ptrend<0.03), while colorectal, cervical and breast cancer screening decreased (all ptrend<0.001) with increasing rurality. Differences in the prevalence of risk factors and screening behaviors across rural areas were greater than differences between rural and urban counties for obesity (2.4% vs. 1.5%), physical activity (2.9% vs. 2.5%), binge alcohol use (3.4% vs. 0.4%), cervical cancer screening (6.8% vs. 4.0%), and colorectal cancer screening (4.4% vs. 3.8%). Rural cancer disparities persist across multiple rural-urban classification codes, with marked variation in cancer risk factors and screening evident within rural regions. Focusing only on a rural-urban dichotomy may not sufficiently capture subpopulations of rural residents at greater risk for cancer and cancer-related mortality.
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DOI：
10.1111/j.1748-0361.2012.00411.x
发表时间：
2012
期刊：
The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association
影响因子：
--
作者：
Befort CA;Nazir N;Perri MG
通讯作者：
Perri MG
DOI：
10.1158/1055-9965.epi-17-0092
发表时间：
2017-07
期刊：
Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology
影响因子：
--
作者：
Blake KD;Moss JL;Gaysynsky A;Srinivasan S;Croyle RT
通讯作者：
Croyle RT
影响因子：
17.1
作者：
Colditz GA;Wolin KY;Gehlert S
通讯作者：
Gehlert S
影响因子：
9.7
作者：
Bennett, Kevin J.;Borders, Tyrone F.;Ziller, Erika
通讯作者：
Ziller, Erika
影响因子：
5.1
作者：
Doogan, N. J.;Roberts, M. E.;Higgins, S. T.
通讯作者：
Higgins, S. T.