TY - JOUR
T1 - Cancer disparities in the context of rurality
T2 - risk factors and screening across various U.S. rural classification codes
AU - Hirko, Kelly A.
AU - Xu, Huiwen
AU - Rogers, Laura Q.
AU - Martin, Michelle Y.
AU - Roy, Siddhartha
AU - Kelly, Kimberly M.
AU - Christy, Shannon M.
AU - Ashing, Kimlin Tam
AU - Yi, Jean C.
AU - Lewis-Thames, Marquita W.
AU - Meade, Cathy D.
AU - Lu, Qian
AU - Gwede, Clement K.
AU - Nemeth, Julianna
AU - Ceballos, Rachel M.
AU - Menon, Usha
AU - Cueva, Katie
AU - Yeary, Karen
AU - Klesges, Lisa M.
AU - Baskin, Monica L.
AU - Alcaraz, Kassandra I.
AU - Ford, Sabrina
N1 - Publisher Copyright:
© 2022, The Author(s), under exclusive licence to Springer Nature Switzerland AG.
PY - 2022/8
Y1 - 2022/8
N2 - Purpose: Prior cancer research is limited by inconsistencies in defining rurality. The purpose of this study was to describe the prevalence of cancer risk factors and cancer screening behaviors across various county-based rural classification codes, including measures reflecting a continuum, to inform our understanding of cancer disparities according to the extent of rurality. Methods: Using an ecological cross-sectional design, we examined differences in cancer risk factors and cancer screening behaviors from the Behavioral Risk Factor Surveillance System and National Health Interview Survey (2008–2013) across rural counties and between rural and urban counties using four rural–urban classification codes for counties and county-equivalents in 2013: U.S. Office of Management and Budget, National Center for Health Statistics, USDA Economic Research Service’s rural–urban continuum codes, and Urban Influence Codes. Results: Although a rural-to-urban gradient was not consistently evident across all classification codes, the prevalence of smoking, obesity, physical inactivity, and binge alcohol use increased (all ptrend < 0.03), while colorectal, cervical and breast cancer screening decreased (all ptrend < 0.001) with increasing rurality. Differences in the prevalence of risk factors and screening behaviors across rural areas were greater than differences between rural and urban counties for obesity (2.4% vs. 1.5%), physical activity (2.9% vs. 2.5%), binge alcohol use (3.4% vs. 0.4%), cervical cancer screening (6.8% vs. 4.0%), and colorectal cancer screening (4.4% vs. 3.8%). Conclusions: Rural cancer disparities persist across multiple rural–urban classification codes, with marked variation in cancer risk factors and screening evident within rural regions. Focusing only on a rural–urban dichotomy may not sufficiently capture subpopulations of rural residents at greater risk for cancer and cancer-related mortality.
AB - Purpose: Prior cancer research is limited by inconsistencies in defining rurality. The purpose of this study was to describe the prevalence of cancer risk factors and cancer screening behaviors across various county-based rural classification codes, including measures reflecting a continuum, to inform our understanding of cancer disparities according to the extent of rurality. Methods: Using an ecological cross-sectional design, we examined differences in cancer risk factors and cancer screening behaviors from the Behavioral Risk Factor Surveillance System and National Health Interview Survey (2008–2013) across rural counties and between rural and urban counties using four rural–urban classification codes for counties and county-equivalents in 2013: U.S. Office of Management and Budget, National Center for Health Statistics, USDA Economic Research Service’s rural–urban continuum codes, and Urban Influence Codes. Results: Although a rural-to-urban gradient was not consistently evident across all classification codes, the prevalence of smoking, obesity, physical inactivity, and binge alcohol use increased (all ptrend < 0.03), while colorectal, cervical and breast cancer screening decreased (all ptrend < 0.001) with increasing rurality. Differences in the prevalence of risk factors and screening behaviors across rural areas were greater than differences between rural and urban counties for obesity (2.4% vs. 1.5%), physical activity (2.9% vs. 2.5%), binge alcohol use (3.4% vs. 0.4%), cervical cancer screening (6.8% vs. 4.0%), and colorectal cancer screening (4.4% vs. 3.8%). Conclusions: Rural cancer disparities persist across multiple rural–urban classification codes, with marked variation in cancer risk factors and screening evident within rural regions. Focusing only on a rural–urban dichotomy may not sufficiently capture subpopulations of rural residents at greater risk for cancer and cancer-related mortality.
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U2 - 10.1007/s10552-022-01599-2
DO - 10.1007/s10552-022-01599-2
M3 - Article
C2 - 35773504
AN - SCOPUS:85133166576
SN - 0957-5243
VL - 33
SP - 1095
EP - 1105
JO - Cancer Causes and Control
JF - Cancer Causes and Control
IS - 8
ER -