Abstract
Background: Geographical disparity in colorectal cancer (CRC) survival rates may be partly due to aging populations and disadvantage in more remote locations; factors that also impact the incidence and outcomes of other chronic health conditions. The current study investigates whether geographic disparity exists amongst previously diagnosed health conditions in CRC patients above and beyond age and area-level disadvantage and whether this disparity is linked to geographic disparity in CRC survival.Methods: Data regarding previously diagnosed health conditions were collected via computer-assisted telephone interviews with a cross-sectional sample of n = 1,966 Australian CRC patients between 2003 and 2004. Ten-year survival outcomes were acquired in December 2014 from cancer registry data. Multivariate logistic regressions were applied to test associations between previously diagnosed health conditions and survival rates in rural, regional, and metropolitan areas.Results: Results suggest that only few geographical disparities exist in previously diagnosed health conditions for CRC patients and these were largely explained by socio-economic status and age. Living in an inner regional area was associated with cardio-vascular conditions, one or more respiratory diseases, and multiple respiratory diagnoses. Higher occurrences of these conditions did not explain lower CRC-specific 10 years survival rates in inner regional Australia.Conclusion: It is unlikely that health disparities in terms of previously diagnosed conditions account for poorer CRC survival in regional and remote areas. Interventions to improve the health of regional CRC patients may need to target issues unique to socio-economic disadvantage and older age.
Highlights
There is growing concern over health disparities between rural, regional, and metropolitan communities in Australia and internationally [1,2,3,4]
Preliminary analyses of variance showed that remoteness of living was negatively associated with socio-economic status (SES) and the patients living in regional areas were significantly older than those in metropolitan or rural areas
SES was weakly, but significantly negatively associated with a previous diagnosis of heart attack (r = −0.07, p < 0.01), angina pectoris (r = −0.08, p < 0.01), high blood pressure (r = −0.06, p < 0.01), one or more other serious illness (r = −0.05, p
Summary
There is growing concern over health disparities between rural, regional, and metropolitan communities in Australia and internationally [1,2,3,4]. Geographical health disparities are thought to be due, to limited physical access to health care, and to differences in demography, attitudes, lifestyle factors, and cultural practices in regional and rural settings [5, 6, 15]. Pre-existing comorbid health conditions often lead to later CRC detection, make patients less suitable candidates for curative surgery, and increase the chance of mortality by approximately 20% [16,17,18]. Given these risks, it is plausible that geographical disparity in CRC outcomes may be somewhat accounted for by a tendency for regional and remote patients to report multiple health problems. The current study investigates whether geographic disparity exists amongst previously diagnosed health conditions in CRC patients above and beyond age and area-level disadvantage and whether this disparity is linked to geographic disparity in CRC survival
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
