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Rural patients were found to have higher incidence rates of certain cancers, but the distribution also varied by sex and ethnicity.

Among patients with cancer in the US, there is significant variety in metrics related to whether or not the patients come from a rural or urban environment. This study, published in the Journal of the National Cancer Institute, analyzes the incidence rate of the top five cancers in California. The authors evaluate associations between rurality and incidence, as well as whether or not these associations further vary by sex, race, and ethnicity. 

Data Show Higher Rates for Some Cancers in Rural Areas; Lower Rates for Others

The study relied on data from the 2015–2019 California Cancer Registry to compare incidence rate ratios and trends for breast, prostate, lung, colorectal, and skin (melanoma) cancers. Census tract aggregation zones and seven levels of % rural population, from 0% to 50+%, were used. Zones with higher proportions of people living in rural areas were significantly associated with a lower incidence of female breast cancer and prostate cancer. However, the trends were not significant. Zones with a greater percentage of rural residents were also associated with a higher incidence of both lung cancer and melanoma. 

Cancer Incidence Was Also Found to Vary Along Racial, Ethnic, and Sex Lines

When areas with a 50+% rural population were compared with areas with a 0% rural population, the incidence rate ratio for lung cancer in Hispanic women was higher than in Hispanic males. Areas with 50+% rural population also showed a higher incidence rate ratio for melanoma in Hispanic females compared to non-Hispanic White females. 

The authors conclude by stating that rurality is associated with cancer incidence, and note the importance of looking at sex, race, and ethnicity together with rurality when analyzing a cancer site.

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Oh, D. L., Schumacher, K., Yang, J., Wang, K., Lin, K., Gomez, S. L., & Shariff-Marco, S. (2023). Disparities in cancer incidence by rurality in California. J Natl Cancer Inst. https://doi.org/10.1093/jnci/djac238