Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah, USA.
Department of Urology, Mayo Clinic, Phoenix, Arizona, USA.
Cancer Med. 2024 Mar;13(5):e7058. doi: 10.1002/cam4.7058.
Patients living in rural areas have worse cancer-specific outcomes. This study examines the effect of family-based social capital on genitourinary cancer survival. We hypothesized that rural patients with urban relatives have improved survival relative to rural patients without urban family.
We examined rural and urban based Utah individuals diagnosed with genitourinary cancers between 1968 and 2018. Familial networks were determined using the Utah Population Database. Patients and relatives were classified as rural or urban based on 2010 rural-urban commuting area codes. Overall survival was analyzed using Cox proportional hazards models.
We identified 24,746 patients with genitourinary cancer with a median follow-up of 8.72 years. Rural cancer patients without an urban relative had the worst outcomes with cancer-specific survival hazard ratios (HRs) at 5 and 10 years of 1.33 (95% CI 1.10-1.62) and 1.46 (95% CI 1.24-1.73), respectively relative to urban patients. Rural patients with urban first-degree relatives had improved survival with 5- and 10-year survival HRs of 1.21 (95% CI 1.06-1.40) and 1.16 (95% CI 1.03-1.31), respectively.
Our findings suggest rural patients who have been diagnosed with a genitourinary cancer have improved survival when having relatives in urban centers relative to rural patients without urban relatives. Further research is needed to better understand the mechanisms through which having an urban family member contributes to improved cancer outcomes for rural patients. Better characterization of this affect may help inform policies to reduce urban-rural cancer disparities.
农村地区的患者癌症特异性结局较差。本研究探讨了基于家庭的社会资本对泌尿生殖系统癌症生存的影响。我们假设，与没有城市亲属的农村患者相比，有城市亲属的农村患者的生存情况有所改善。
我们检查了 1968 年至 2018 年间在犹他州被诊断患有泌尿生殖系统癌症的农村和城市居民。使用犹他州人口数据库确定家族网络。根据 2010 年城乡通勤区代码，将患者和亲属分为农村或城市。使用 Cox 比例风险模型分析总生存情况。
我们确定了 24746 名患有泌尿生殖系统癌症的患者，中位随访时间为 8.72 年。没有城市亲属的农村癌症患者预后最差，5 年和 10 年癌症特异性生存风险比（HRs）分别为 1.33（95%CI 1.10-1.62）和 1.46（95%CI 1.24-1.73），而城市患者的 HRs 分别为 1.00 和 1.00。有城市一级亲属的农村患者的生存情况有所改善，5 年和 10 年的生存率 HRs 分别为 1.21（95%CI 1.06-1.40）和 1.16（95%CI 1.03-1.31）。
我们的研究结果表明，与没有城市亲属的农村患者相比，被诊断患有泌尿生殖系统癌症的农村患者在有城市中心的亲属时生存情况有所改善。需要进一步研究以更好地了解有城市家庭成员如何改善农村患者的癌症结局的机制。更好地描述这种影响可能有助于为减少城乡癌症差距的政策提供信息。
