Corresponding author:Ahmed Gamal Elsayed, Joan C. Edwards School of Medicine, Edwards Comprehensive Cancer Center, Marshall University, Huntington, West Virginia. 1400 Hal Greer Boulevard, Huntington, WV 25701, USA
Received: July 20, 2017; Published: August 02, 2017
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Objective: Disparities in cancer diagnosis, treatment and survival among different subgroups classified based on race, socioeconomic status and age have been previously noted. There is however a paucity of data addressing cancer disparities in rural populations. The purpose of this study is to examine multiple myeloma disease characteristics and survival in a rural population in comparison to their urban counterparts.
Methods: This is a retrospective analysis of 81 multiple myeloma patients who presented to a New Mexico local hospital and cancer center from 2003 to 2013. Patients were classified to either rural or urban based on the Rural-Urban Commuting Area codes (RUCA) version 2.0, Categorization D.
Results: Rural patients had longer duration of initial presenting symptom prior to diagnosis, suggesting that urban patients were more likely to seek medical attention earlier than their rural counterparts (p = 0.0037). Numerically, rural patients were more likely to be diagnosed at a more advanced disease stage (p = 0.063), while urban patients were more likely to be diagnosed at an asymptomatic stage. Patients in the rural group had a median survival of 39 months, while urban patients had a median survival of 69 months (p < 0.001). Log-rank test for equality of survivor function suggested a survival benefit in favor of the urban group.
Conclusion: Rural patients with multiple myeloma had shorter survival compared to their urban counterparts. The worse outcome of the rural patients is likely a result of diverse challenges that impact health care in rural populations. It is recommended to encourage efforts aiming to enhance health care services in rural areas, in order to minimize the disparities between rural and urban populations.