Urological malignancy incidence rates over time by county rurality.

Abstract

750 Background: Approximately 20% of the U.S. population resides in non-metropolitan (rural) areas. We aimed to evaluate urological cancer incidence among populations residing in metropolitan (metro) and rural counties, categorized by adjacency to a metro area. Methods: Using data from CDC’s National Program of Cancer Registries and NCI’s Surveillance, Epidemiology, and End Results Program, we compared incidence rates of prostate (PCa), kidney (KCa), and bladder (BCa) cancers diagnosed during 2007–2011 and 2012–2016 among adults age ≥ 20 years residing in metro and rural counties, as designated by rural-urban continuum codes. Rural counties were divided into those adjacent to a metro area (Rural-A) and those not adjacent to a metro area (Rural-NA). For the time period studied, these data cover approximately 97% of the US population. Rates were age-adjusted to the 2000 U.S. standard population. Results: We identified 1,980,168 PCa, 541,225 KCa, and 688,562 BCa cases newly diagnosed during 2007–2016. Patients from rural-A counties comprised 11% of all cases, rural-NA counties 6%, and metro counties 83%. Table shows the age-adjusted incidence per 100,000 with 95% confidence intervals. Overall, PCa and BCa incidence decreased over time; KCa incidence increased. PCa exhibited higher incidence rates in metro areas; KCa and BCa had higher incidence rates in rural counties (Table). Conclusions: Rural counties have higher BCa and KCa incidence relative to metro counties, but lower PCa incidence. Changes in PCa screening practices may have contributed to decreases in PCa incidence. Further investigation is needed to understand how rurality influences KCa and BCa epidemiology. Disclaimer: The findings and conclusion of this report are those of the authors and do not represent the official position of the CDC.[Table: see text]