Rural-metropolitan disparities in ovarian cancer survival: a statewide population-based study

Jihye Park, Brenna E. Blackburn, Kerry Rowe, John Snyder, Yuan Wan, Vikrant Deshmukh, Michael Newman, Alison Fraser, Ken Smith, Kim Herget, Lindsay Burt, Theresa Werner, David K. Gaffney, Ana Maria Lopez, Kathi Mooney, Mia Hashibe

Research output: Contribution to journalArticlepeer-review

11 Scopus citations


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.

Original languageEnglish (US)
Pages (from-to)377-384
Number of pages8
JournalAnnals of epidemiology
Issue number6
StatePublished - Jun 2018


  • Ovarian cancer
  • Rural
  • Survivorship

ASJC Scopus subject areas

  • Epidemiology


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