Prissel Christine M, Grossardt Brandon R, Finney Rutten Lila J, Patten Christi A, Austin Jessica D, St Sauver Jennifer L
Division of Epidemiology, Department of Quantitative Health, Mayo Clinic, Rochester, MN; Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN.
Division of Clinical Trials and Biostatistics, Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN.
Mayo Clin Proc. 2025 Jul;100(7):1172-1187. doi: 10.1016/j.mayocp.2024.11.026. Epub 2025 May 30.
To assess differences in cancer prevalence across the urban-rural continuum, which may help identify target areas for cancer treatment and prevention efforts.
We identified residents of a 27-county region of Minnesota and Wisconsin on January 1, 2020, using the Rochester Epidemiology Project. Rural-urban commuting area classifications were used to categorize addresses as urban core, large town, small town, or isolated rural. Diagnostic codes were extracted from the 4 years prior. Codes were grouped into cancer types by Clinical Classifications Software Refined categories. Logistic regression models were used to estimate the effect of rurality on cancer prevalence. Analyses were stratified by rurality, directly standardized by age and sex to the total 2020 US population using survey sampling weights and analytically adjusted by including indicator variables for non-White race, Hispanic ethnicity, and smoking status.
We found a higher prevalence of Hodgkin lymphoma among isolated rural residents compared with urban residents (odds ratio [OR], 1.77; 95% CI, 1.28 to 2.44). In addition, men in large towns had a higher prevalence of throat cancer compared with urban men (OR, 1.57 [1.03 to 2.39]). Rural women had a higher prevalence of colorectal (large town: OR, 1.32 [1.12 to 1.55]; small town: OR, 1.23 [1.00 to 1.53]), anal (isolated rural: OR, 2.22 [1.27 to 3.88]), and ovarian (large town: OR, 1.40 [1.09 to 1.78]) cancer compared with women residing in urban areas.
Our findings underscore the importance of moving beyond the simple urban-rural dichotomy to address cancer disparities.
评估城乡连续体中癌症患病率的差异，这可能有助于确定癌症治疗和预防工作的目标区域。
我们于2020年1月1日利用罗切斯特流行病学项目确定了明尼苏达州和威斯康星州27个县地区的居民。采用城乡通勤区分类将地址分为城市核心区、大城镇、小城镇或偏远农村。从之前4年中提取诊断代码。通过临床分类软件细化类别将代码分组为癌症类型。使用逻辑回归模型估计农村地区对癌症患病率的影响。分析按农村地区分层，使用调查抽样权重按年龄和性别直接标准化为2020年美国总人口，并通过纳入非白人种族、西班牙裔族裔和吸烟状况的指标变量进行分析调整。
我们发现，与城市居民相比，偏远农村居民中霍奇金淋巴瘤的患病率更高（优势比[OR]，1.77；95%置信区间，1.28至2.44）。此外，与城市男性相比，大城镇男性喉癌的患病率更高（OR，1.57[1.03至2.39]）。与城市地区的女性相比，农村女性患结直肠癌（大城镇：OR，1.32[1.12至1.55]；小城镇：OR，1.23[1.00至1.53]）、肛门癌（偏远农村：OR，2.22[1.27至3.88]）和卵巢癌（大城镇：OR，1.40[1.09至1.78]）的患病率更高。
我们的研究结果强调了超越简单的城乡二分法来解决癌症差异问题的重要性。
