Patterns of Cancer Surgery in Rural Versus Urban Cancer Patients (#92)
The poorer outcomes of cancer patients in rural areas has been well documented in Australia and other countries, but the reasons for the disparity remain unclear. In this study, we compared rural versus urban surgery rates in Queensland taking into account differences in demographic and clinical case mix.
Diagnostic and surgical data on patients diagnosed between 2001 and 2010 with breast cancer (n=24,850), colorectal cancer (n=25,852), and non-small cell lung cancer (NSCLC, n=12,730) were extracted from the Queensland Oncology Repository. The rate of surgery was compared across remoteness of residence categorised into metropolitan, regional, and rural areas. Logistic regression was used to model the rate of surgery across remoteness categories controlling for age, sex, and comorbidity.
The overall surgery rates were 90% for breast cancer, 91% for colorectal cancer, and 20% for NSCLC. In all cancer streams, rural patients had lower surgery rates compared to patients from metropolitan and regional areas. Adjusted odds ratios (OR) of cancer surgery in rural relative to metropolitan patients were 0.59 (95% confidence interval [CI]: 0.57-0.61) for breast cancer, 0.67 (CI: 0.65-0.70) for colorectal cancer, and 0.70 (CI: 0.67-0.73) for NSCLC.
The rate and types of cancer surgery vary between rural and urban patients. Further study is needed to determine the extent to which these differences reflect constraints in access to cancer services in rural areas.