Negative impact of rurality on lung cancer survival in a population-based study

Introduction: Several studies have suggested that rurality is a risk factor for worse prognosis in cancer. Methods: The study population included the 2268 lung cancer cases collected between 1981 and 1996 in the Doubs Cancer Registry (France). Results: The numbers of patients were 849 (31.8%) in rural areas and 89 (3.3%) in very rural areas. The relative 5-year survival was 15.2% in rural areas and 13.4% in urban areas (p = 0.5), and 2.7% in very rural areas and 14.4% in extended urban areas (p = 0.02). Multivariate analyses of observed and relative survival showed that patients living in very rural areas (p < 0.0001), 65 years of age and older and having small cell carcinoma had a significantly shorter survival. Conclusions: This study showed that the multidimensional definition of rurality identified a population with unfavorable prognoses.