Skip to main content
PMC home page
British Journal of Cancer logoLink to British Journal of Cancer
. 2001 Apr;84(7):910–914. doi: 10.1054/bjoc.2000.1708

Rural and urban differences in stage at diagnosis of colorectal and lung cancers

N C Campbell 1, A M Elliott 1, L Sharp 2, L D Ritchie 1, J Cassidy 2, J Little 2
PMCID: PMC2363829  PMID: 11286470

Abstract

There is evidence that patients living in outlying areas have poorer survival from cancer. This study set out to investigate whether they have more advanced disease at diagnosis. Case notes of 1323 patients in north and northeast Scotland who were diagnosed with lung or colorectal cancer in 1995 or 1996 were reviewed. Of patients with lung cancer, 42% (69/164) living 58 km or more from a cancer centre had disseminated disease at diagnosis compared to 33% (71/215) living within 5 km. For colorectal cancer the respective figures were 24% (38/161) and 16% (31/193). For both cancers combined, the adjusted odds ratio for disseminated disease at diagnosis in furthest group compared to the closest group was 1.59 (P = 0.037). Of 198 patients with non-small-cell lung cancer in the closest group, 56 (28%) had limited disease (stage I or II) at diagnosis compared to 23 of 165 (14%) of the furthest group (P = 0.002). The respective figures for Dukes A and B colorectal cancer were 101 of 196 (52%) and 67 of 172 (39%) (P = 0.025). These findings suggest that patients who live remote from cities and the associated cancer centres have poorer chances of survival from lung or colorectal cancer because of more advanced disease at diagnosis. This needs to be taken into account when planning investigation and treatment services. © 2001 Cancer Research Campaign http://www.bjcancer.com

Keywords: colorectal cancer, lung cancer, epidemiology, rural, urban, staging

Full Text

The Full Text of this article is available as a PDF (54.1 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Bain N. S., Campbell N. C. Treating patients with colorectal cancer in rural and urban areas: a qualitative study of the patients' perspective. Fam Pract. 2000 Dec;17(6):475–479. doi: 10.1093/fampra/17.6.475. [DOI] [PubMed] [Google Scholar]
  2. Campbell N. C., Elliott A. M., Sharp L., Ritchie L. D., Cassidy J., Little J. Rural factors and survival from cancer: analysis of Scottish cancer registrations. Br J Cancer. 2000 Jun;82(11):1863–1866. doi: 10.1054/bjoc.1999.1079. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Campbell N. C., Ritchie L. D., Cassidy J., Little J. Systematic review of cancer treatment programmes in remote and rural areas. Br J Cancer. 1999 Jun;80(8):1275–1280. doi: 10.1038/sj.bjc.6690498. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Cox J. Poverty in rural areas. BMJ. 1998 Mar 7;316(7133):722–722. doi: 10.1136/bmj.316.7133.722. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Ionescu M. V., Carey F., Tait I. S., Steele R. J. Socioeconomic status and stage at presentation of colorectal cancer. Lancet. 1998 Oct 31;352(9138):1439–1439. doi: 10.1016/s0140-6736(98)00052-x. [DOI] [PubMed] [Google Scholar]
  6. Launoy G., Le Coutour X., Gignoux M., Pottier D., Dugleux G. Influence of rural environment on diagnosis, treatment, and prognosis of colorectal cancer. J Epidemiol Community Health. 1992 Aug;46(4):365–367. doi: 10.1136/jech.46.4.365. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Liff J. M., Chow W. H., Greenberg R. S. Rural-urban differences in stage at diagnosis. Possible relationship to cancer screening. Cancer. 1991 Mar 1;67(5):1454–1459. doi: 10.1002/1097-0142(19910301)67:5<1454::aid-cncr2820670533>3.0.co;2-k. [DOI] [PubMed] [Google Scholar]
  8. Merrill R. M., Henson D. E., Barnes M. Conditional survival among patients with carcinoma of the lung. Chest. 1999 Sep;116(3):697–703. doi: 10.1378/chest.116.3.697. [DOI] [PubMed] [Google Scholar]
  9. Parry J. M., Collins S., Mathers J., Scott N. A., Woodman C. B. Influence of volume of work on the outcome of treatment for patients with colorectal cancer. Br J Surg. 1999 Apr;86(4):475–481. doi: 10.1046/j.1365-2168.1999.01064.x. [DOI] [PubMed] [Google Scholar]
  10. Reading R., Jarvis S., Openshaw S. Measurement of social inequalities in health and use of health services among children in Northumberland. Arch Dis Child. 1993 May;68(5):626–631. doi: 10.1136/adc.68.5.626. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Selby P., Gillis C., Haward R. Benefits from specialised cancer care. Lancet. 1996 Aug 3;348(9023):313–318. doi: 10.1016/s0140-6736(96)02482-8. [DOI] [PubMed] [Google Scholar]
  12. Weinert C., Boik R. J. MSU Rurality Index: development and evaluation. Montana State University. Res Nurs Health. 1995 Oct;18(5):453–464. doi: 10.1002/nur.4770180510. [DOI] [PubMed] [Google Scholar]

Articles from British Journal of Cancer are provided here courtesy of Cancer Research UK

RESOURCES