Negative Impact of Rurality on Lung Cancer Survival in a Population-based Study

IntroductionSeveral studies have suggested that rurality is a risk factor for worse prognosis in cancer.MethodsThe study population included the 2268 lung cancer cases collected between 1981 and 1996 in the Doubs Cancer Registry (France).ResultsThe numbers of patients were 849 (31.8%) in rural areas and 89 (3.3%) in very rural areas. The relative 5-year survival was 15.2% in rural areas and 13.4% in urban areas (p = 0.5), and 2.7% in very rural areas and 14.4% in extended urban areas (p = 0.02). Multivariate analyses of observed and relative survival showed that patients living in very rural areas (p < 0.0001), 65 years of age and older and having small cell carcinoma had a significantly shorter survival.ConclusionsThis study showed that the multidimensional definition of rurality identified a population with unfavorable prognoses.