Abstract

The incidence of all cancers in China is generally higher in urban areas; however, the mortality risk for affected patients is considerably higher in rural areas. We present a subanalysis investigating the differences in patient and disease characteristics, treatment patterns, and outcomes between rural and urban patients who were diagnosed with breast cancer at West China Hospital between 2005–2009. Baseline patient and disease characteristics were recorded, and patients were followed up for a minimum of 3 years, or until death. For this subanalysis, patients were stratified by their residential status (rural or urban). Of the 2252 patients in the cohort, 76.3% were from urban areas and 22.1% were from rural areas. Significant differences were observed in the prevalence of luminal A and human epidermal growth factor receptor 2-positive breast cancers among rural and urban patients. Estrogen receptor (ER)-positive patients were less likely to receive anti-ER therapy if they were from rural areas compared with urban areas; the use of aromatase inhibitors was also significantly lower for rural patients than urban patients. Univariate, multivariate, and Kaplan–Meier analyses all demonstrated that overall survival and progression-free survival were significantly lower for rural patients than urban patients.

Highlights

  • China is the most populous country in the world [1]

  • overall survival (OS) and progression-free survival (PFS) were significantly better in patients from urban areas than in patients from rural areas

  • This relative OS and PFS benefit for urban patients over rural patients was observed in univariate, multivariate, and Kaplan-Meier analyses

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Summary

Introduction

China is the most populous country in the world [1]. In common with other emerging economies, China has experienced an increase in the reported incidence and prevalence of breast cancer [2]. China has a heterogeneous population from a diverse range of socioeconomic and geographical backgrounds. One manifestation of this diversity is the difference in health status between populations from rural residential settings and those from urban residential settings [4]. The incidence of all cancers in China is generally higher in urban areas but the mortality risk is considerably higher in rural areas [7]. This may reflect higher exposure to risk factors in urban environments, and limited access to medical care and lower health education in rural areas

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