Same People, Different Results: Categorizing Cancer Registry Cases across the Rural-Urban Continuum

Abstract Background: Many rural-urban indexes are utilized in United States cancer research. This variation introduces inconsistencies between studies with a rural-urban component. Recommendations to date on which index to utilize have prioritized index geographical unit over feasibility of index inclusion in analysis. We evaluated rural-urban indexes and recommend one index for use to increase comparability across studies. Methods: We assessed nine U.S. rural-urban indexes regarding their respective rural and urban code ranges; geographical unit, land area, and population distributions; percent agreement; suitability as continuous variables in analysis; and feasibility of integration into national, state, and local cancer research. We referenced 1,569 Wisconsin Pancreatic Cancer Registry patients to demonstrate how rural-urban index choice impacts patient categorization. Results: Six indexes categorized rural and urban areas. Indexes agreed on binary rural-urban designation for 88.8% of the U.S. population. As ternary variables, they agreed for 83.4%. For cancer registry patients, this decreased to 73.4% and 60.4% agreement, respectively. Rural-Urban Continuum Codes (RUCC) performed the best with ability to differentiate metropolitan, micropolitan, and rural counties, are available for retrospective and prospective studies, and can be coded continuously for analysis. Conclusions: Whether a patient was categorized as urban or rural changed depending on which index was used when applied to a cancer registry data set. We conclude that RUCC is an appropriate and feasible rural-urban index to include in cancer research, as it is standardly available in national cancer registries in its 9-code format and can be matched to patient’s county of residence for local research and it had the least amount of fluctuation of the indices analyzed. Utilizing RUCC as a continuous variable across studies with a rural-urban component will increase reproducibility and comparability of results and eliminate the choice of rural-urban index as a potential source of discrepancy between studies. Trial registration: Not applicable.

Medienart:	Preprint

Erscheinungsjahr:	2022
Erschienen:	2022

Enthalten in:	ResearchSquare.com - (2022) vom: 03. März Zur Gesamtaufnahme - year:2022

Sprache:	Englisch

Beteiligte Personen:	Schiefelbein, Andrea M. [VerfasserIn] Taylor, Amy K. [VerfasserIn] Krebsbach, John K. [VerfasserIn] Zhang, Jienian [VerfasserIn] Haimson, Chloe E. [VerfasserIn] Varley, Patrick R. [VerfasserIn] Skala, Melissa C. [VerfasserIn] Eason, John M. [VerfasserIn] LoConte, Noelle K. [VerfasserIn]

Links:	Volltext [kostenfrei]

doi:	10.21203/rs.3.rs-1200114/v1

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PPN (Katalog-ID):	XRA034919244