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Rurality and Other Determinants of Early Colorectal Cancer Diagnosis in Nebraska: A 6-Year Cancer Registry Study, 1998-2003
The Journal of Rural Health, 10/05/09

Sankaranarayanan J et al. – Of the 6,561 CRC patients identified, 45% were from metropolitan counties, 24% from micropolitan nonmetropolitan counties and 31% from rural nonmetropolitan counties, with 32%, 38%, and 33%, respectively, being diagnosed at an early stage. Multivariate analysis showed micropolitan nonmetropolitan residents were significantly more likely than rural nonmetropolitan residents to be diagnosed at an early stage. However, rural nonmetropolitan and metropolitan residents did not significantly differ in the likelihood of early diagnosis. Residents with Medicare rather than those with private insurance, married rather than unmarried residents, and residents with rectal cancer rather than those with colon cancer were more likely to be diagnosed at an early stage. This study concluded that early CRC diagnosis needs to be increased in rural (non–core) non–metropolitan residents, unmarried residents, and those with private insurance.

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