Influence of rural environment on diagnosis, treatment, and prognosis of colorectal cancer

STUDY OBJECTIVE--Several studies have shown that residential location (urban or rural) influences the incidence of colorectal cancer. The aim was to investigate the influence of rural environment on colorectal cancer history and survival in a well defined population. DESIGN--Patients with colorectal...

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Published in:Journal of epidemiology and community health (1979) 1992-08, Vol.46 (4), p.365-367
Main Authors: Launoy, G, Le Coutour, X, Gignoux, M, Pottier, D, Dugleux, G
Format: Article
Language:English
Subjects:
Age Factors
Anatomy
Biological and medical sciences
Cancer
Colorectal cancer
Colorectal Neoplasms - diagnosis
Colorectal Neoplasms - mortality
Colorectal Neoplasms - therapy
Delayed diagnosis
France
Gastroenterology. Liver. Pancreas. Abdomen
Humans
Life Sciences & Biomedicine
Loneliness
Medical sciences
Neoplasia
Place of residence
Prognosis
Public, Environmental & Occupational Health
Residence Characteristics
Rural Health
Rural populations
Science & Technology
Sex Factors
Stomach. Duodenum. Small intestine. Colon. Rectum. Anus
Symptoms
Tumors
Urban populations
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cited_by cdi_FETCH-LOGICAL-b532t-694f13bb435fb3f7da71cb6f09fff708068670a4608251c81abb9a3f17e689dd3
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container_title Journal of epidemiology and community health (1979)
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creator Launoy, G
Le Coutour, X
Gignoux, M
Pottier, D
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description STUDY OBJECTIVE--Several studies have shown that residential location (urban or rural) influences the incidence of colorectal cancer. The aim was to investigate the influence of rural environment on colorectal cancer history and survival in a well defined population. DESIGN--Patients with colorectal cancer diagnosed in the department of Calvados (France) were classified by place of residence (urban/rural) and information on clinical symptoms, tumour extension, treatment, and survival was collected. SETTING--The study was population based, in the department of Calvados in France. PATIENTS--During 1978-1984, 1445 colorectal cancers were collected by the Digestive Tract Cancer Registry of Calvados, 1047 with an urban place of residence (544 males and 503 females) and 284 with a rural place of residence (134 males and 150 females). MEASUREMENTS AND MAIN RESULTS--In both sexes, rural patients with colorectal cancers were treated less frequently in a specialised health care centre (40.0%) than patients from an urban population (53.4%). The difference was mainly but not entirely explained by distance from the specialised health care centre. In females in the rural population, cancers were diagnosed more frequently at the stage of severe clinical symptoms (22.1%) and metastases (18.8%) than they were in the urban population (15.5% and 12.3%). In addition among females a rural environment appeared to confer a worse prognosis (relative risk = 1.3). CONCLUSIONS--Our findings suggest an inequality between rural and urban populations, especially for women. The loneliness of rural women leads to a delay in diagnosis and worse survival. In health education campaigns on colorectal cancer, efforts must be made to provide medical information to rural women in order to reduce the delay in diagnosis and improve survival.
doi_str_mv 10.1136/jech.46.4.365
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The aim was to investigate the influence of rural environment on colorectal cancer history and survival in a well defined population. DESIGN--Patients with colorectal cancer diagnosed in the department of Calvados (France) were classified by place of residence (urban/rural) and information on clinical symptoms, tumour extension, treatment, and survival was collected. SETTING--The study was population based, in the department of Calvados in France. PATIENTS--During 1978-1984, 1445 colorectal cancers were collected by the Digestive Tract Cancer Registry of Calvados, 1047 with an urban place of residence (544 males and 503 females) and 284 with a rural place of residence (134 males and 150 females). MEASUREMENTS AND MAIN RESULTS--In both sexes, rural patients with colorectal cancers were treated less frequently in a specialised health care centre (40.0%) than patients from an urban population (53.4%). The difference was mainly but not entirely explained by distance from the specialised health care centre. In females in the rural population, cancers were diagnosed more frequently at the stage of severe clinical symptoms (22.1%) and metastases (18.8%) than they were in the urban population (15.5% and 12.3%). In addition among females a rural environment appeared to confer a worse prognosis (relative risk = 1.3). CONCLUSIONS--Our findings suggest an inequality between rural and urban populations, especially for women. The loneliness of rural women leads to a delay in diagnosis and worse survival. 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The aim was to investigate the influence of rural environment on colorectal cancer history and survival in a well defined population. DESIGN--Patients with colorectal cancer diagnosed in the department of Calvados (France) were classified by place of residence (urban/rural) and information on clinical symptoms, tumour extension, treatment, and survival was collected. SETTING--The study was population based, in the department of Calvados in France. PATIENTS--During 1978-1984, 1445 colorectal cancers were collected by the Digestive Tract Cancer Registry of Calvados, 1047 with an urban place of residence (544 males and 503 females) and 284 with a rural place of residence (134 males and 150 females). MEASUREMENTS AND MAIN RESULTS--In both sexes, rural patients with colorectal cancers were treated less frequently in a specialised health care centre (40.0%) than patients from an urban population (53.4%). 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The aim was to investigate the influence of rural environment on colorectal cancer history and survival in a well defined population. DESIGN--Patients with colorectal cancer diagnosed in the department of Calvados (France) were classified by place of residence (urban/rural) and information on clinical symptoms, tumour extension, treatment, and survival was collected. SETTING--The study was population based, in the department of Calvados in France. PATIENTS--During 1978-1984, 1445 colorectal cancers were collected by the Digestive Tract Cancer Registry of Calvados, 1047 with an urban place of residence (544 males and 503 females) and 284 with a rural place of residence (134 males and 150 females). MEASUREMENTS AND MAIN RESULTS--In both sexes, rural patients with colorectal cancers were treated less frequently in a specialised health care centre (40.0%) than patients from an urban population (53.4%). The difference was mainly but not entirely explained by distance from the specialised health care centre. In females in the rural population, cancers were diagnosed more frequently at the stage of severe clinical symptoms (22.1%) and metastases (18.8%) than they were in the urban population (15.5% and 12.3%). In addition among females a rural environment appeared to confer a worse prognosis (relative risk = 1.3). CONCLUSIONS--Our findings suggest an inequality between rural and urban populations, especially for women. The loneliness of rural women leads to a delay in diagnosis and worse survival. In health education campaigns on colorectal cancer, efforts must be made to provide medical information to rural women in order to reduce the delay in diagnosis and improve survival.</abstract><cop>LONDON</cop><pub>BMJ Publishing Group Ltd</pub><pmid>1431708</pmid><doi>10.1136/jech.46.4.365</doi><tpages>3</tpages><oa>free_for_read</oa></addata></record>
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source Web of Science - Science Citation Index Expanded - 1992<img src="https://exlibris-pub.s3.amazonaws.com/fromwos-v2.jpg" />; JSTOR Archival Journals and Primary Sources Collection; BMJ_英国医学会期刊; PubMed Central
subjects Age Factors
Anatomy
Biological and medical sciences
Cancer
Colorectal cancer
Colorectal Neoplasms - diagnosis
Colorectal Neoplasms - mortality
Colorectal Neoplasms - therapy
Delayed diagnosis
France
Gastroenterology. Liver. Pancreas. Abdomen
Humans
Life Sciences & Biomedicine
Loneliness
Medical sciences
Neoplasia
Place of residence
Prognosis
Public, Environmental & Occupational Health
Residence Characteristics
Rural Health
Rural populations
Science & Technology
Sex Factors
Stomach. Duodenum. Small intestine. Colon. Rectum. Anus
Symptoms
Tumors
Urban populations
title Influence of rural environment on diagnosis, treatment, and prognosis of colorectal cancer
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