Determining the association of rurality and cardiovascular disease among prostate cancer survivors
Copyright © 2023 Elsevier Inc. All rights reserved..
PURPOSE: Rural disparities in prostate cancer survivorship and cardiovascular disease remain. Prostate cancer treatment also contributes to worse cardiovascular disease outcomes. Our objective was to determine whether rural-urban differences in cardiovascular outcomes contribute to disparities in prostate cancer survivorship.
MATERIALS AND METHODS: Data were collected from the Utah Population Database. Rural and urban prostate cancer survivors were matched by diagnosis year and age. Cox proportional hazards models were used to estimate hazard ratios for cardiovascular disease (levels 1-3) based on rural-urban classification, while controlling for demographic and socioeconomic characteristics. We identified 3,379 rural and 16,253 urban prostate cancer survivors with a median follow-up of 9.3 years.
RESULTS: Results revealed that rural survivors had a lower risk of hypertension (HR 0.90), diseases of arteries (HR 0.92), and veins (HR 0.92) but a higher risk of congestive heart failure (HR 1.17). Interactions between level 2 cardiovascular diseases and rural/urban status, showed that diseases of the heart had a distinct between-group relationship for all-cause (P = 0.005) and cancer-specific mortality (P = 0.008).
CONCLUSIONS: This study revealed complex relationships between rural-urban status, cardiovascular disease, and prostate cancer. Rural survivors were less likely to be diagnosed with screen-detected cardiovascular disease but more likely to have heart failure. Further, the relationship between cardiovascular disease and survival was different between rural and urban survivors. It may be that our findings underscore differences in healthcare access where rural patients are less likely to be screened for preventable cardiovascular disease and have worse outcomes when they have a major cardiovascular event.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:41 |
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| Enthalten in: |
Urologic oncology - 41(2023), 10 vom: 15. Okt., Seite 429.e15-429.e23 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Nielsen, Shaelee [VerfasserIn] |
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| Links: |
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| Anmerkungen: |
Date Completed 06.11.2023 Date Revised 18.02.2024 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.urolonc.2023.06.008 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| 100 | 1 | |a Nielsen, Shaelee |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Determining the association of rurality and cardiovascular disease among prostate cancer survivors |
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| 500 | |a Date Completed 06.11.2023 | ||
| 500 | |a Date Revised 18.02.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2023 Elsevier Inc. All rights reserved. | ||
| 520 | |a PURPOSE: Rural disparities in prostate cancer survivorship and cardiovascular disease remain. Prostate cancer treatment also contributes to worse cardiovascular disease outcomes. Our objective was to determine whether rural-urban differences in cardiovascular outcomes contribute to disparities in prostate cancer survivorship | ||
| 520 | |a MATERIALS AND METHODS: Data were collected from the Utah Population Database. Rural and urban prostate cancer survivors were matched by diagnosis year and age. Cox proportional hazards models were used to estimate hazard ratios for cardiovascular disease (levels 1-3) based on rural-urban classification, while controlling for demographic and socioeconomic characteristics. We identified 3,379 rural and 16,253 urban prostate cancer survivors with a median follow-up of 9.3 years | ||
| 520 | |a RESULTS: Results revealed that rural survivors had a lower risk of hypertension (HR 0.90), diseases of arteries (HR 0.92), and veins (HR 0.92) but a higher risk of congestive heart failure (HR 1.17). Interactions between level 2 cardiovascular diseases and rural/urban status, showed that diseases of the heart had a distinct between-group relationship for all-cause (P = 0.005) and cancer-specific mortality (P = 0.008) | ||
| 520 | |a CONCLUSIONS: This study revealed complex relationships between rural-urban status, cardiovascular disease, and prostate cancer. Rural survivors were less likely to be diagnosed with screen-detected cardiovascular disease but more likely to have heart failure. Further, the relationship between cardiovascular disease and survival was different between rural and urban survivors. It may be that our findings underscore differences in healthcare access where rural patients are less likely to be screened for preventable cardiovascular disease and have worse outcomes when they have a major cardiovascular event | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, N.I.H., Extramural | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 4 | |a Research Support, U.S. Gov't, P.H.S. | |
| 650 | 4 | |a Accessibility of health services | |
| 650 | 4 | |a Cardiovascular disease | |
| 650 | 4 | |a Prostate cancer | |
| 650 | 4 | |a Rural population | |
| 650 | 4 | |a Socioeconomic status | |
| 700 | 1 | |a O'Neil, Brock |e verfasserin |4 aut | |
| 700 | 1 | |a Chang, Chun-Pin |e verfasserin |4 aut | |
| 700 | 1 | |a Mark, Bayarmaa |e verfasserin |4 aut | |
| 700 | 1 | |a Snyder, John |e verfasserin |4 aut | |
| 700 | 1 | |a Deshmukh, Vikrant |e verfasserin |4 aut | |
| 700 | 1 | |a Newman, Michael |e verfasserin |4 aut | |
| 700 | 1 | |a Date, Ankita |e verfasserin |4 aut | |
| 700 | 1 | |a Galvao, Carlos |e verfasserin |4 aut | |
| 700 | 1 | |a Henry, N Lynn |e verfasserin |4 aut | |
| 700 | 1 | |a Lloyd, Shane |e verfasserin |4 aut | |
| 700 | 1 | |a Hashibe, Mia |e verfasserin |4 aut | |
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