Do Rural Breast and Colorectal Cancer Patients Present at More Advanced Disease Stages than Their Urban Counterparts?
Access to recommended cancer screening is more difficult for rural residents than their urban counterparts. Factors inhibiting screening include local availability, low socioeconomic status of rural residents, and minority status. As a result, rural patients may present at later stages than urban patients due to delays in detection. The goal for this study is to compare adjusted rates of early and late breast and colorectal cancer staging at diagnosis between patients residing in urban and three categories of rural counties (micropolitan adjacent to metropolitan, micropolitan non-adjacent to metropolitan and small and remote rural). Using Surveillance, Epidemiology and End Results Program (SEER) cancer registry data, we will identify and classify breast and colorectal cancer cases diagnosed in 2010-2014 as early or late stage diagnoses. We will run logistic regressions using patient and county level control variables, and general estimating equations to account for patients clustering within counties. We will calculate, compare and report the adjusted rates of urban and rural breast and colorectal cancer patients that present as late stage cancer cases overall and for different sociodemographic characteristics, cancer types, and regions of residence. We will also calculate adjusted rates for rural patients in different county types.