TY - JOUR
T1 - Investigating the role of county-level colorectal cancer screening rates on stage at diagnosis of colorectal cancer in rural Georgia
AU - Tsai, Meng Han
AU - Coughlin, Steven S.
N1 - Publisher Copyright:
© The Author(s), under exclusive licence to Springer Nature Switzerland AG 2024.
PY - 2024
Y1 - 2024
N2 - Background: To examine the impact of county-level colorectal cancer (CRC) screening rates on stage at diagnosis of CRC and identify factors associated with stage at diagnosis across different levels of screening rates in rural Georgia. Methods: We performed a retrospective analysis utilizing data from 2004 to 2010 Surveillance, Epidemiology, and End Results Program. The 2013 United States Department of Agriculture rural–urban continuum codes were used to identify rural Georgia counties. The 2004–2010 National Cancer Institute small area estimates for screening behaviors were applied to link county-level CRC screening rates. Descriptive statistics and multinominal logistic regressions were performed. Results: Among 4,839 CRC patients, most patients diagnosed with localized CRC lived in low screening areas; however, many diagnosed with regionalized and distant CRC lived in high screening areas (p-value = 0.009). In multivariable analysis, rural patients living in high screening areas were 1.2-fold more likely to be diagnosed at a regionalized and distant stage of CRC (both p-value < 0.05). When examining the factors associated with stage at presentation, Black patients who lived in low screening areas were 36% more likely to be diagnosed with distant diseases compared to White patients (95% CI, 1.08–1.71). Among those living in high screening areas, patients with right-sided CRC were 38% more likely to have regionalized disease (95% CI, 1.09–1.74). Conclusion: Patients living in high screening areas were more likely to have a later stage of CRC in rural Georgia. Impact: Allocating CRC screening/treatment resources and improving CRC risk awareness should be prioritized for rural patients in Georgia.
AB - Background: To examine the impact of county-level colorectal cancer (CRC) screening rates on stage at diagnosis of CRC and identify factors associated with stage at diagnosis across different levels of screening rates in rural Georgia. Methods: We performed a retrospective analysis utilizing data from 2004 to 2010 Surveillance, Epidemiology, and End Results Program. The 2013 United States Department of Agriculture rural–urban continuum codes were used to identify rural Georgia counties. The 2004–2010 National Cancer Institute small area estimates for screening behaviors were applied to link county-level CRC screening rates. Descriptive statistics and multinominal logistic regressions were performed. Results: Among 4,839 CRC patients, most patients diagnosed with localized CRC lived in low screening areas; however, many diagnosed with regionalized and distant CRC lived in high screening areas (p-value = 0.009). In multivariable analysis, rural patients living in high screening areas were 1.2-fold more likely to be diagnosed at a regionalized and distant stage of CRC (both p-value < 0.05). When examining the factors associated with stage at presentation, Black patients who lived in low screening areas were 36% more likely to be diagnosed with distant diseases compared to White patients (95% CI, 1.08–1.71). Among those living in high screening areas, patients with right-sided CRC were 38% more likely to have regionalized disease (95% CI, 1.09–1.74). Conclusion: Patients living in high screening areas were more likely to have a later stage of CRC in rural Georgia. Impact: Allocating CRC screening/treatment resources and improving CRC risk awareness should be prioritized for rural patients in Georgia.
KW - Cancer-related factors
KW - County-level colorectal cancer screening rates
KW - Demographics
KW - Rural Georgia
KW - Stage at diagnosis
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U2 - 10.1007/s10552-024-01874-4
DO - 10.1007/s10552-024-01874-4
M3 - Article
AN - SCOPUS:85189782548
SN - 0957-5243
JO - Cancer Causes and Control
JF - Cancer Causes and Control
ER -