Rural/urban residence and childhood and adolescent cancer survival in the United States

Background To the authors’ knowledge, no previous study has examined the relationship between rural/urban residence and childhood or adolescent cancer survival in the United States. Using the Surveillance, Epidemiology, and End Results 18 registries database, the authors examined childhood and adole...

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Bibliographic Details
Published in:Cancer 2019-01, Vol.125 (2), p.261-268
Main Authors: Delavar, Arash, Feng, Qianxi, Johnson, Kimberly J.
Format: Article
Language:English
Subjects:
adolescent
Adolescents
Cancer
Childhood
Children
Confidence intervals
Diagnosis
Epidemiology
Hazards
Health risks
metropolitan
Metropolitan areas
Minority & ethnic groups
neoplasms
Oncology
pediatrics
Public health
Rural areas
rural population
Statistical analysis
Surveillance
Survival
survival analysis
urban
Urban areas
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Summary:Background To the authors’ knowledge, no previous study has examined the relationship between rural/urban residence and childhood or adolescent cancer survival in the United States. Using the Surveillance, Epidemiology, and End Results 18 registries database, the authors examined childhood and adolescent cancer survival by rural/urban residence as defined by Rural‐Urban Continuum Codes (RUCCs). Methods The authors obtained data from Surveillance, Epidemiology, and End Results 18 registries for individuals diagnosed at ages birth to 19 years with a first primary malignant cancer from 2000 through 2010. Rural/urban residence at the time of diagnosis was defined using both metropolitan/nonmetropolitan county classifications and individual RUCC categories. Cox proportional hazards regression was used to compute adjusted hazard ratios (HRs) and 95% confidence intervals (95% CIs) for the association between rural/urban residence and cancer survival. The authors also examined effect modification by age group, sex, race/ethnicity, and cancer type. Results Among 41,879 cancer cases, approximately 54.7% were non‐Hispanic white, 54.3% were male, and 90.4% lived in a metropolitan county. Individuals living in nonmetropolitan counties versus metropolitan counties had a similar risk of cancer death (HR,  1.03; 95% CI, 0.94‐1.13) as did those living in nonmetropolitan rural counties with
ISSN:0008-543X
1097-0142
DOI:10.1002/cncr.31704