Risk Factors Contributing to Disparities in Medical Treatment and Lower Survival Rates among Patients with Non-Small Cell Lung Cancer Induced by Residential Areas.

OBJECTIVE

Because of a lack of medical resources for cancer treatment, particularly in rural areas, there are disparities in receiving medical treatment between urban and rural area. This study examined the association between residential area or areal deprivation index (ADI) and lack of surgical treatment or chemotherapy in patients with non-small cell lung cancer (NSCLC) in rural area, Japan.

METHODS

We analyzed the Aomori population-based cancer registry data from 926 cancer patients with NSCLC diagnosed between January and December 2014. Multivariable logistic regression and Cox proportional hazards models were used to examine association of patients' residential area/ADI with either surgery/chemotherapy or survival time, respectively. The residential area was divided into six medical areas based on the location of specialist hospitals. The medical areas were defined by Aomori Prefecture.

RESULTS

The residential area (medical area) was strongly associated with access to cancer treatment for patients with NSCLC and ultimately contributed to lower survival rates. There was no significant influence in the distance from home to hospital and areal deprivation.

CONCLUSION

We identified the risk factors related to a lack of medical treatment and shorter survival in rural area, Japan.