@article{1f6c0c3c5fb44ec8acbdadb677961e5f,
title = "Rural-metropolitan disparities in ovarian cancer survival: a statewide population-based study",
abstract = "Purpose: To investigate rural-metropolitan disparities in ovarian cancer survival, we assessed ovarian cancer mortality and differences in prognostic factors by rural-metropolitan residence. Methods: The Utah Population Database was used to identify ovarian cancer cases diagnosed between 1997 and 2012. Residential location information at the time of cancer diagnosis was used to stratify rural-metropolitan residence. All-cause death and ovarian cancer death risks were estimated using Cox proportional hazard regression models. Results: Among 1661 patients diagnosed with ovarian cancer, 11.8% were living in rural counties of Utah. Although ovarian cancer patients residing in rural counties had different characteristics compared with metropolitan residents, we did not observe an association between rural residence and risk of all-cause nor ovarian cancer–specific death after adjusting for confounders. However, among rural residents, ovarian cancer mortality risk was very high in older age at diagnosis and for mucinous carcinoma, and low in overweight at baseline. Conclusions: Rural residence was not significantly associated with the risk of ovarian cancer death. Nevertheless, patients residing in rural-metropolitan areas had different factors affecting the risk of all-cause mortality and cancer-specific death. Further research is needed to quantify how mortality risk can differ by residential location accounting for degree of health care access and lifestyle-related factors.",
keywords = "Ovarian cancer, Rural, Survivorship",
author = "Jihye Park and Blackburn, {Brenna E.} and Kerry Rowe and John Snyder and Yuan Wan and Vikrant Deshmukh and Michael Newman and Alison Fraser and Ken Smith and Kim Herget and Lindsay Burt and Theresa Werner and Gaffney, {David K.} and Lopez, {Ana Maria} and Kathi Mooney and Mia Hashibe",
note = "Funding Information: This work was supported by grants from the National Institutes of Health (R21 CA185811, R03 CA159357, M.Hashibe, PI), the Huntsman Cancer Institute, Cancer Control and Population Sciences Program (HCI Cancer Center Support Grant P30CA042014), and an National Center for Research Resources grant (R01 RR021746, G. Mineau, PI) with additional support from the Utah State Department of Health and the University of Utah. The authors thank the Pedigree and Population Resource of the Huntsman Cancer Institute, University of Utah (funded in part by the Huntsman Cancer Foundation) for its role in the ongoing collection, maintenance, and support of the Utah Population Database (UPDB). We also acknowledge partial support for the UPDB through grant P30 CA2014 from the National Cancer Institute, University of Utah and from the University of Utah's Program in Personalized Health and Center for Clinical and Translational Science. The authors thank the University of Utah Center for Clinical and Translational Science (funded by NIH Clinical and Translational Science Awards), the Pedigree and Population Resource, University of Utah Information Technology Services and Biomedical Informatics Core for establishing the Master Subject Index between the UPDB, the University of Utah Health Sciences Center and Intermountain Health Care. Publisher Copyright: {\textcopyright} 2018 Elsevier Inc.",
year = "2018",
month = jun,
doi = "10.1016/j.annepidem.2018.03.019",
language = "English (US)",
volume = "28",
pages = "377--384",
journal = "Annals of epidemiology",
issn = "1047-2797",
publisher = "Elsevier Inc.",
number = "6",
}