Geographic remoteness and risk of advanced colorectal cancer at diagnosis in Queensland: a multilevel study
2011

Geographic Remoteness and Colorectal Cancer Risk in Queensland

Sample size: 18561 publication Evidence: moderate

Author Information

Author(s): Baade P D, Dasgupta P, Aitken J, Turrell G

Primary Institution: Viertel Centre for Research in Cancer Control, Cancer Council Queensland

Hypothesis

Does geographic remoteness and area disadvantage affect the risk of advanced colorectal cancer at diagnosis?

Conclusion

Patients living in more remote areas are more likely to be diagnosed with advanced colorectal cancer, particularly colon cancer.

Supporting Evidence

  • Colorectal cancer patients in inner and outer regional areas were more likely to be diagnosed with advanced cancer than those in major cities.
  • The remoteness effect was significant for colon cancer but not for rectal cancer.
  • The study used a large, unselected, state-wide population-based registry.

Takeaway

People who live far away from cities are more likely to find out they have advanced colon cancer when they go to the doctor.

Methodology

Multilevel models were used to assess area- and individual-level contributions to the risk of advanced colorectal cancer.

Potential Biases

The odds ratios may reflect an overestimation of the relative risk due to the high prevalence of advanced CRC.

Limitations

The study was limited to individual-level SES data on occupation, and did not include education or income information.

Participant Demographics

57.1% of patients were male, 67.2% had colon cancer, and the mean age at diagnosis was 65 years.

Statistical Information

P-Value

0.045

Confidence Interval

1.01–1.19 for inner regional, 1.01–1.22 for outer regional

Statistical Significance

p=0.045

Digital Object Identifier (DOI)

10.1038/bjc.2011.356

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