Rural women who have ovarian cancer are more likely to find out about it when it's already at stage IV than women who live in metropolitan areas, according to a study just published in The Journal of Rural Health.
That matters, because early detection makes survival more likely. From 2000 to 2015, the five-year survival rate of stage IV ovarian cancer was only 29 percent. The American Cancer Society estimates that 23,000 women were diagnosed with ovarian cancer in 2019, and about 14,000 died or will die from it. That includes 280 new cases in Kentucky, and 190 deaths.
Researchers at the University of Iowa and the Centers for Disease Control and Prevention studied about 1,000 women in Iowa, Kansas and Missouri who had been diagnosed with ovarian cancer in 2011-12. At the time they were diagnosed, 111 had stage IV and 889 had stages I-III. Stage IV patients were more likely to be older, rural, and have other health problems.
It is tempting to attribute that difference to poverty, or to difficulty in accessing care, but the study controlled for those factors. Rural women were more likely to be diagnosed with late-stage ovarian cancer regardless of the socioeconomic status of their census tract or the distance to their primary-care provider.
This disparity also isn't likely related to lifestyle factors such as smoking, obesity, or lack of physical activity; though such factors are more prevalent in rural areas, they aren't prominent risk factors for ovarian cancer. And though such lifestyle factors could create a higher incidence of cancer, they aren't likely to create geographic-survival or diagnostic disparities, researchers said.
Rural cancer patients generally have poorer outcomes than non-rural patients, including a lower survival rate. That's true of rural ovarian-cancer patients too, probably because of less access to specialty care and treatment after diagnosis.
The researchers suggest that if rural women had better access to gynecological specialists in urban areas, it could make a difference, since those doctors are highly trained and may be able to recognize the symptoms of ovarian cancer sooner than other health-care providers.
That matters, because early detection makes survival more likely. From 2000 to 2015, the five-year survival rate of stage IV ovarian cancer was only 29 percent. The American Cancer Society estimates that 23,000 women were diagnosed with ovarian cancer in 2019, and about 14,000 died or will die from it. That includes 280 new cases in Kentucky, and 190 deaths.
Researchers at the University of Iowa and the Centers for Disease Control and Prevention studied about 1,000 women in Iowa, Kansas and Missouri who had been diagnosed with ovarian cancer in 2011-12. At the time they were diagnosed, 111 had stage IV and 889 had stages I-III. Stage IV patients were more likely to be older, rural, and have other health problems.
It is tempting to attribute that difference to poverty, or to difficulty in accessing care, but the study controlled for those factors. Rural women were more likely to be diagnosed with late-stage ovarian cancer regardless of the socioeconomic status of their census tract or the distance to their primary-care provider.
This disparity also isn't likely related to lifestyle factors such as smoking, obesity, or lack of physical activity; though such factors are more prevalent in rural areas, they aren't prominent risk factors for ovarian cancer. And though such lifestyle factors could create a higher incidence of cancer, they aren't likely to create geographic-survival or diagnostic disparities, researchers said.
Rural cancer patients generally have poorer outcomes than non-rural patients, including a lower survival rate. That's true of rural ovarian-cancer patients too, probably because of less access to specialty care and treatment after diagnosis.
The researchers suggest that if rural women had better access to gynecological specialists in urban areas, it could make a difference, since those doctors are highly trained and may be able to recognize the symptoms of ovarian cancer sooner than other health-care providers.
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