SAN DIEGO — Patients who live in rural and urban areas have experienced an unequal change in the incidence of gastrointestinal cancers, likely driven by differences in socioeconomic factors, according to research presented at Digestive Disease Week.
“Incidence of certain GI cancers has decreased over time,” Amir A. Khan, MD, of Southern Illinois University School of Medicine, said in his presentation. “However, limited research has been conducted on disparities in overall incidence rate and trends between urban and rural patients.”
Researchers conducted a population-based observational cohort study to determine if the incidence rate and trends of GI cancers were different among urban and rural populations. They used the Surveillance, Epidemiology and End Results (SEER) database to calculate age-adjusted incidence rates, rate ratios and annual percent change (APC) for alimentary canal cancers, hepatopancreatobiliary (HPB) cancers, and gasteroenteropancreatic neuroendocrine tumors (GEP-NETs) of the GI tract. Then, researchers compared incidence rates from 2010 to 2014 in rural and urban populations and analyzed trends from 2000 to 2014.
Khan and colleagues found that all alimentary tract cancers had a higher incidence in rural populations (37.2 per 100,000 people) compared with urban populations (33 per 100,000 people; P < .05). Total alimentary tract cancers have declined more rapidly in urban populations (APC = –2.5; 95% CI, –2.6 to –2.4) compared with rural populations (APC = –1.8; 95% CI, –2.2 to –1.5).
All HPB cancers had a lower incidence in rural populations (16.4 per 100,000 people) compared with urban populations (19.4 per 100,000; P < .05). However, the trend of HPB cancers has shown a greater increase in rural populations (APC = 3.1; 95% CI, 2.7–3.5) than in urban populations (APC = 2.5; 95% CI, 2.2–2.7).
Although there has been an increase of GEP-NETs in both rural (APC = 4.7; 95% CI, 3.6–5.8) and urban populations (APC = 4.1; 95% CI, 3.6–4.6), researchers found no difference in incidence among the two groups.
Khan said that rural and urban populations have experienced unequal rates and trends of GI cancers but highlighted a few ways to minimize the disparity among patients in rural areas.
“To improve prevention, efforts to mitigate risk factors and improvement in endoscopic screening could be implemented,” he said. “Virtual tumor boards, telemedicine and incentives for rural practice could be implemented to improve therapy and to address the growing burden of disease in rural populations.” – by Alex Young
Taylor S, et al. Abstract 183. Presented at: Digestive Disease Week; May 18-21, 2019; San Diego.
Disclosures: Khan reports no relevant financial disclosures. Please see the meeting disclosure index for all other authors’ relevant financial disclosures.