Making the Case for Investment in Rural Cancer Control: An Analysis of Rural Cancer Incidence, Mortality, and Funding Trends.
Making the Case for Investment in Rural Cancer Control: An Analysis of Rural Cancer Incidence, Mortality, and Funding Trends.
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DOI：
10.1158/1055-9965.epi-17-0092
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发表时间：
2017-07
期刊：
影响因子：
--
通讯作者：
Croyle RT
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文献类型：
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作者：
Blake KD;Moss JL;Gaysynsky A;Srinivasan S;Croyle RT
据估计，居住在农村县的人口在4620万到5900万之间，占美国人口的14%到19%。与城市地区相比，农村社区面临劣势，包括贫困程度更高、受教育程度较低以及无法获得医疗服务。我们的目标是证明癌症的城乡差异，并检查NCI资助的专注于农村人口的癌症控制拨款。对2009-2013年期间农村-城市连续体各级县以及大都市与非大都市县、所有癌症合并和几种单独癌症类型的五年癌症发病率和死亡率进行了估计。我们还检查了2011-2016年间由NCI资助的农村癌症控制赠款的数量和重点。癌症发病率在大城市县为447/100,000，在非大城市县为460/100,000(p<；0.001)。癌症死亡率在大城市县为166/100,000，在非大城市县为182/100,000(p<；0.001)。在农村地区，宫颈癌、结直肠癌、肾癌、肺癌、黑色素瘤和口咽癌的发病率和死亡率较高。2011-2016年间，有48项以农村为重点的R-机制和3-P机制赠款(占1655项的3%)。需要进一步的投资来理清个体水平的SES和地区水平的因素的影响，以了解观察到的农村对癌症的影响。
Estimates of those living in rural counties vary from 46.2–59 million, or 14–19% of the U.S. population. Rural communities face disadvantages compared to urban areas, including higher poverty, lower educational attainment, and lack of access to health services. We aimed to demonstrate rural-urban disparities in cancer and to examine NCI-funded cancer control grants focused on rural populations. Estimates of five-year cancer incidence and mortality from 2009–2013 were generated for counties at each level of the rural-urban continuum and for metropolitan versus non-metropolitan counties, for all cancers combined and several individual cancer types. We also examined the number and foci of rural cancer control grants funded by NCI from 2011–2016. Cancer incidence was 447 cases per 100,000 in metropolitan counties and 460 per 100,000 in non-metropolitan counties (p<0.001). Cancer mortality rates were 166 per 100,000 in metropolitan counties and 182 per 100,000 in non-metropolitan counties (p<0.001). Higher incidence and mortality in rural areas were observed for cervical, colorectal, kidney, lung, melanoma, and oropharyngeal cancers. There were 48 R- and 3 P-mechanism rural-focused grants funded from 2011–2016 (3% of 1655). Further investment is needed to disentangle the effects of individual-level SES and area-level factors to understand observed effects of rurality on cancer.