Midwest Urban-Rural Differences in Cancer Prevalence.

OBJECTIVE

To assess differences in cancer prevalence across the urban-rural continuum, which may help identify target areas for cancer treatment and prevention efforts.

METHODS

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.

RESULTS

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.

CONCLUSION

Our findings underscore the importance of moving beyond the simple urban-rural dichotomy to address cancer disparities.