Rural and Minority Health Research Center, Arnold School of Public Health, University of South Carolina, 220 Stoneridge Suite 204, Columbia, SC, 29210, USA.
Department of Health Services Policy and Management, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA.
Support Care Cancer. 2019 Dec;27(12):4779-4786. doi: 10.1007/s00520-019-04742-z. Epub 2019 Apr 10.
Rural cancer survivors may disproportionately experience financial problems due to their cancer because of greater travel costs, higher uninsured/underinsured rates, and other factors compared to their urban counterparts. Our objective was to examine rural-urban differences in reported financial problems due to cancer using a nationally representative survey.
We used data from three iterations of the National Cancer Institute's Health Information and National Trends Survey (2012, 2014, and 2017) to identify participants who had a previous or current cancer diagnosis. Our outcome of interest was self-reported financial problems associated with cancer diagnosis and treatment. Rural-urban status was defined using 2003 Rural-Urban Continuum Codes. We calculated weighted percentages and Wald chi-square statistics to assess rural-urban differences in demographic and cancer characteristics. In multivariable logistic regression models, we examined the association between rural-urban status and other factors and financial problems, reporting the corresponding adjusted predicted probabilities.
Our sample included 1359 cancer survivors. Rural cancer survivors were more likely to be married, retired, and live in the Midwest or South. Over half (50.5%) of rural cancer survivors reported financial problems due to cancer compared to 38.8% of urban survivors (p = 0.02). This difference was attenuated in multivariable models, 49.3 and 38.7% in rural and urban survivors, respectively (p = 0.06).
A higher proportion of rural survivors reported financial problems associated with their cancer diagnosis and treatment compared to urban survivors. Future research should aim to elucidate these disparities and interventions should be tested to address the cancer-related financial problems experienced by rural survivors.
与城市癌症幸存者相比，农村癌症幸存者由于癌症而面临更多的旅行费用、更高的未保险/保险不足率和其他因素，因此可能会不成比例地经历经济问题。我们的目的是使用全国代表性调查来研究农村与城市癌症幸存者因癌症而报告的经济问题方面的差异。
我们使用国家癌症研究所健康信息和全国趋势调查（2012 年、2014 年和 2017 年）的三个迭代数据，确定了有先前或当前癌症诊断的参与者。我们感兴趣的结果是与癌症诊断和治疗相关的自我报告的经济问题。农村-城市地位使用 2003 年农村-城市连续体代码定义。我们计算了加权百分比和 Wald 卡方统计数据，以评估农村-城市人口统计学和癌症特征方面的差异。在多变量逻辑回归模型中，我们研究了农村-城市地位与其他因素和财务问题之间的关联，并报告了相应的调整后预测概率。
我们的样本包括 1359 名癌症幸存者。农村癌症幸存者更有可能已婚、退休，居住在中西部或南部。与城市幸存者（38.8%）相比，超过一半（50.5%）的农村癌症幸存者报告了因癌症而导致的经济问题（p=0.02）。在多变量模型中，这一差异减弱，农村和城市幸存者分别为 49.3%和 38.7%（p=0.06）。
与城市幸存者相比，农村幸存者报告的与癌症诊断和治疗相关的经济问题比例更高。未来的研究应该旨在阐明这些差异，并应测试干预措施来解决农村幸存者所经历的与癌症相关的经济问题。
