Cancer Disparities Research Articles

Assessing Socioeconomic Disparities and Health Outcomes among Cancer Patients in a Nigerian Teaching Hospital

Background: Cancer affects all population groups in the Nigeria, but due to social, environmental, and economic disadvantages, certain groups bear a different burden of cancer. Disparities in health among populations account for preventable morbidity and mortality. Research in this area is focused on identifying health disparities and outcomes contributing to overall wellbeing. Different groups may experience cancer disparities and these groups can be defined by age, gender, education, ethnicity, income, race, origin, and other characteristics. Health disparities can affect cancer outcomes, from diagnosis to treatment. This study evaluates the health disparities and outcomes of cancer patients in a Nigerian Teaching Hospital. Methods: This is a descriptive cross-sectional study using a structured questionnaire among patients visiting the oncology unit in the hospital. The questionnaire was interviewer- administered. Descriptive statistics was used to present respondents’ sociodemographic characteristics. Pearson correlation test was used to determine relationship between the determinant of cancer disparity (social demographics) and the outcomes (from patient perspective). Results: A total of 150 patients participated in the study. More female respondents (70%) than male respondents (45%), mostly within the age range of 62 and above (56.7%) participated in this study. The disparities examined include: age, gender, marital status, educational level, occupatina, montly income, religion and health insurance. There was a correlation between the different disparities and health outcomes. All disparities except gender were statistically significant (P = 0.05 & 0.01). Age, marital status, occupation status, religion and health insurance associated postively, while educational level and monthly income associated negatively. Gender had no associaton at all. Overall, patients (50%) were a little satisfied with the overall health outcomes.

Global Disparities of Cancer and Its Projected Burden in 2050.

Cancer prevention and care efforts have been challenged by the COVID-19 pandemic and armed conflicts, resulting in a decline in the global Human Development Index (HDI), particularly in low- and middle-income countries. These challenges and subsequent shifts in health care priorities underscore the need to continuously monitor cancer outcome disparities and statistics globally to ensure delivery of equitable and optimal cancer prevention and care in uncertain times. To measure the global burden of 36 cancers in 2022 by sex, age, and geographic location and to project future trends by 2050. This cross-sectional study used population-based data from 2022 in 185 countries and territories were obtained from the Global Cancer Observatory database. Data extraction and analysis were carried out in April 2024. Counts, rates, prevalence, mortality to incidence ratios (MIRs), and demography-based projections were used to characterize current and future cancer burden. This population-based study included 36 cancer types from 185 countries and territories. By 2050, 35.3 million cancer cases worldwide are expected, a 76.6% increase from the 2022 estimate of 20 million. Similarly, 18.5 million cancer deaths are projected by 2050, an 89.7% increase from the 2022 estimate of 9.7 million. Cancer cases and deaths are projected to nearly triple in low-HDI countries by 2050, compared to a moderate increase in very high-HDI countries (142.1% vs 41.7% for cancer cases and 146.1% vs 56.8% for cancer deaths). Males had a higher incidence and greater number of deaths in 2022 than females, with this disparity projected to widen by up to 16.0% in 2050. In 2022, the MIR for all cancers was 46.6%, with higher MIRs observed for pancreatic cancer (89.4%), among males (51.7%), among those aged 75 years or older (64.3%), in low-HDI countries (69.9%), and in the African region (67.2%). In this cross-sectional study based on data from 2022, cancer disparities were evident across HDI, geographic regions, age, and sex, with further widening projected by 2050. These findings suggest that strengthening access to and quality of health care, including universal health insurance coverage, is key to providing evidence-based cancer prevention, diagnostics, and care.

Evaluating machine learning model bias and racial disparities in non-small cell lung cancer using SEER registry data.

Despite decades of pursuing health equity, racial and ethnic disparities persist in healthcare in America. For cancer specifically, one of the leading observed disparities is worse mortality among non-Hispanic Black patients compared to non-Hispanic White patients across the cancer care continuum. These real-world disparities are reflected in the data used to inform the decisions made to alleviate such inequities. Failing to account for inherently biased data underlying these observations could intensify racial cancer disparities and lead to misguided efforts that fail to appropriately address the real causes of health inequity. Estimate the racial/ethnic bias of machine learning models in predicting two-year survival and surgery treatment recommendation for non-small cell lung cancer (NSCLC) patients. A Cox survival model, and a LOGIT model as well as three other machine learning models for predicting surgery recommendation were trained using SEER data from NSCLC patients diagnosed from 2000-2018. Models were trained with a 70/30 train/test split (both including and excluding race/ethnicity) and evaluated using performance and fairness metrics. The effects of oversampling the training data were also evaluated. The survival models show disparate impact towards non-Hispanic Black patients regardless of whether race/ethnicity is used as a predictor. The models including race/ethnicity amplified the disparities observed in the data. The exclusion of race/ethnicity as a predictor in the survival and surgery recommendation models improved fairness metrics without degrading model performance. Stratified oversampling strategies reduced disparate impact while reducing the accuracy of the model. NSCLC disparities are complex and multifaceted. Yet, even when accounting for age and stage at diagnosis, non-Hispanic Black patients with NSCLC are less often recommended to have surgery than non-Hispanic White patients. Machine learning models amplified the racial/ethnic disparities across the cancer care continuum (which are reflected in the data used to make model decisions). Excluding race/ethnicity lowered the bias of the models but did not affect disparate impact. Developing analytical strategies to improve fairness would in turn improve the utility of machine learning approaches analyzing population-based cancer data.

The Context of Poverty and Cancer: Denying Human Potential.

Poverty is a carcinogen and a leading cause of cancer disparities and overall mortality in the United States. Poverty is often viewed as an individual failure for "being poor," but in fact, poverty is structurally driven, intergenerational, and place-based that socially deprives and denies human potential. Disparities in timely cancer prevention, diagnosis, treatment, survivorship, and survival disproportionally impact people living in poverty and especially in persistent poverty areas, an extreme form of place-based poverty that affects communities over multiple generations. There has been some progress made to address place-based conditions that exacerbate poverty, such as the NCI's initiative on persistent poverty. However, gross inequality and cancer disparities continue to exist and persist. The time is now to accelerate the development of research-informed strategies and solutions with communities along with multisectoral collaborations with education, housing, occupation/workforce, foster care, criminal justice, transportation, and data collection systems. This commentary discusses the structural, place-based, and generational context of poverty, illustrates how entrenched inequities shape poor cancer outcomes, and describes opportunities for future research.

Seeing health disparities in cervical cancer: Mapping behavioral and socioeconomic drivers of geographic dispersion of disease burden with the Geo-Analyzer tool

Seeing health disparities in cervical cancer: Mapping behavioral and socioeconomic drivers of geographic dispersion of disease burden with the Geo-Analyzer tool

Racial disparities in malignant cervical cancer from 2000 to 2020

Racial disparities in malignant cervical cancer from 2000 to 2020

Seeing health disparities in cervical cancer: Mapping behavioral and socioeconomic drivers of geographic dispersion of disease burden with the Geo-Analyzer tool

Seeing health disparities in cervical cancer: Mapping behavioral and socioeconomic drivers of geographic dispersion of disease burden with the Geo-Analyzer tool

Research funding disparity in uterine cancer: An analysis of funding and race in relation to the burden of disease

Research funding disparity in uterine cancer: An analysis of funding and race in relation to the burden of disease

Cervical cancer disparities in Puerto Rico: Does BMI associate with cervical dysplasia regardless of HPV genotypes?

Cervical cancer disparities in Puerto Rico: Does BMI associate with cervical dysplasia regardless of HPV genotypes?

Geospatial Hot Spots and Cold Spots in US Cancer Disparities and Associated Risk Factors, 2004-2008 to 2014-2018.

Despite declining cancer death rates in the US, cancer remains the second deadliest disease and disparities persist. Although research has focused on identifying risk factors for cancer deaths and associated disparities, few studies have examined how these relationships vary over time and space. The primary objective of this study was to identify cancer mortality hot spots and cold spots - areas where cancer death rates decreased less than or more than neighboring areas over time. A secondary objective was to identify risk factors of cancer mortality hot spots and cold spots. We analyzed county-level cancer death rates from 2004 through 2008 and 2014 through 2018, exploring disparities in changes over time for socioeconomic and demographic variables. We used hot spot analysis to identify areas with larger decreases (cold spots) and smaller decreases (hot spots) in cancer death rates and random forest machine learning analysis to assess the relative importance of risk factors associated with hot spots and cold spots. We mapped spatial clustering areas. Geospatial analysis showed hot spots predominantly in the Plains states and Midwest and cold spots in the Southeast, Northeast, 2 Mountain West states (Utah and Idaho), and a portion of Texas. Factors with the strongest influence on hot spots and cold spots were unemployment, preventable hospital stays, mammography screening, and high school education. Geospatial disparities in changes in cancer death rates point out the critical role of access to care, socioeconomic position, and health behaviors in persistent cancer mortality disparities. Study results provide insights for interventions and policies that focus on addressing health care access and social determinants of health.

Disparities in cancer stage shifts associated with the COVID-19 pandemic in California, 2020-2021.

The COVID-19 pandemic and associated shutdowns disrupted healthcare access and resulted in decreased cancer screenings. Cancer diagnosis delays have concerning downstream effects on late-stage cancer, especially for marginalized populations. The study population included 349,458 adults in the California Cancer Registry diagnosed with cancer between January 2019-December 2021, during which California experienced two stay-at-home orders. We examined the percentage of late-stage (III-IV) cancer diagnoses across five periods: Pre-Pandemic (January 2019-February 2020), Shutdown #1 (March-June 2020), Post-Shutdown #1 (July-November 2020), Post-Shutdown #2 (December 2020-March 2021), and Post-Vaccine Rollout (April-December 2021). To examine the association between time-period and late-stage diagnoses, we conducted a multivariable log binomial regression model adjusted for sociodemographic and neighborhood factors. The percentage of late-stage cancer diagnoses increased during Shutdown #1 (+5.2%) and returned to baseline Post-Vaccine Rollout. Groups with notably higher increases in the percentage of late-stage cancer (vs. overall population) during Shutdown #1 include: Pacific Islander (+13.7%), Thai (+11.2%), Chinese (+8.1%), Native Hawaiian (+7.4%), Filipino (+6.6%), and uninsured (+7.4%). Uninsured (vs. private insurance) (PR: 1.41), low neighborhood SES (nSES) (vs. high) (PR: 1.19), and racial and ethnic minoritized groups (vs. NH White) (PR's: 1.04-1.19) had higher likelihood for late-stage cancer diagnosis. The pandemic exacerbated late-stage cancer disparities for racial and ethnic minoritized groups, underinsured, and low nSES communities in California (2020-2021). Interventions to improve cancer screening must be focused on racial and ethnic minoritized, underinsured, and low nSES communities, as they are likely to be more vulnerable to healthcare disruptions like the pandemic.

Healthcare Access Domains and Treatment as Mediators of Ovarian Cancer Racial Disparities in Survival: A Structural Equation Modeling Analysis in SEER-Medicare.

Racial differences in healthcare access (HCA) may contribute to disparities in ovarian cancer (OC) survival. We used structural equation models (SEM) to examine associations between race and HCA domains (affordability, availability, accessibility) in relation to overall and OC-specific mortality. Non-Hispanic (NH)-Black and non-Black (Hispanic, NH-White) women diagnosed with OC in 2008-2015 were identified from SEER-Medicare. Cox proportional hazards regression was used to conduct mediation analysis for associations between race and HCA domains with overall and OC-specific mortality. SEM models adjusting for demographic and clinical covariates were used to estimate hazard ratios (HR) and 95% confidence intervals (CI). A total of 4,629 eligible OC patients were identified, including 255 (5.5%) patients who were NH-Black. In SEM adjusting for demographic, clinical, and HCA latent variables, there was a total effect of NH-Black race on overall (HR: 1.11, 95% CI: 1.03,1.19) and OC-specific mortality (HR: 1.16, 95% CI: 1.08, 1.24), which was primarily driven by a direct effect. There was a modest indirect association between NH-Black race and mortality through decreased treatment receipt, though not through HCA. There is a need for studies investigating additional social and biological mechanisms that contribute to worse cancer survival among NH-Black patients.

Unveiling Cervical Cancer Inequities Among Georgia Immigrant Latinas: A Robust Qualitative Examination of the Facilitators and Barriers to Prevention, with Emphasis on the Impact of Community-Based Organizations.

This qualitative study delves into the facilitators and barriers surrounding cervical cancer prevention among Latina women in Georgia, with a specific focus on the impact of community-based organizations (CBOs). Employing semi-structured interviews with healthcare providers and representatives from CBOs, faith-based organizations, and other key stakeholders, the study uncovers key themes and subthemes shaping cervical cancer disparities. Themes such as challenges in cross-cultural healthcare access, difficulties due to lack of US citizenship, and limited mobility emerge as significant barriers, while community and family support stand out as crucial facilitators to cancer prevention. Additionally, the study examines community intervention methods from CBOs to target cervical cancer disparity, highlighting the importance of public awareness campaigns, building trust within the Latina community, and providing medical support tailored to immigrant populations. Through this comprehensive examination, the study not only offers invaluable insights into the intricate web of issues surrounding cervical cancer prevention but also endeavors to serve as a catalyst for targeted interventions and evidence-based policies aimed at ameliorating cervical cancer disparities among immigrant Latinas in Georgia and beyond.

An Intersectional Approach to Cervical Cancer Screening Disparities by Race/Ethnicity and Immigrant Status.

Background: Disparities in cervical cancer (CC) screening exist within racial/ethnic minority and immigrant groups. However, few studies have explored the joint influence of race/ethnicity and immigrant status on screening, and the disparities that have been identified by existing studies remain incompletely explained. This study aims to identify the joint influence of race/ethnicity and immigrant status on CC screening and elucidate the barriers contributing to identified disparities. Methods: A cross-sectional analysis of 25,660 U.S. women from the 2005, 2010, and 2015 National Health Interview Surveys was done. The CC screening up-to-date status of cases was analyzed by race/ethnicity and immigrant status using logistic regression models. Conceptualized mediators were added to models to identify their contribution to identified disparities. Results: All immigrants had lower screening odds than U.S.-born non-Hispanic White women with foreign-born non-Hispanic Asians having the lowest odds (adjusted odds ratio [aOR]: 0.36, 95% confidence interval [CI]: 0.26-0.49) followed by foreign-born non-Hispanic White (aOR: 0.52, 95% CI: 0.36-0.76), Hispanic/Latinx (aOR: 0.58, 95% CI: 0.47-0.73), and non-Hispanic Black women (aOR: 0.62, 95% CI: 0.38-0.99). Adjusting for only socioeconomic status or access to care attenuated the aOR: for foreign-born Hispanic/Latinx and non-Hispanic Black women only. Adjusting simultaneously for language and acculturation attenuated the aOR: for all immigrants. Conclusions: Disparities in CC screening were only found in the immigrant populations of various racial/ethnic groups. Targeting insurance and health care access may address disparities in immigrant Hispanic/Latinx and non-Hispanic Black women. Focusing on culturally and linguistically competent care and education may be more crucial for immigrant non-Hispanic Asian and White women.

Racial disparities in prostate cancer in the UK and the USA: similarities, differences and steps forwards.

In the USA, Black men are approximatelytwice as likely to be diagnosed with and to die of prostate cancer than white men. In the UK, despite Black men having vastly different ancestral contexts and health-care systems from Black men in the USA, the lifetime risk of being diagnosed with prostate cancer is two-to-three times higher among Black British men than among white British men and Black British men are twice as likely to die of prostate cancer as white British men. Examination of racial disparities in prostate cancer in the USA and UK highlights systemic, socio-economic and sociocultural factors that might contribute to these differences. Variation by ancestry could affect incidence and tumour genomics. Disparities in incidence might alsobe affected by screening guidelines and access to and uptake of screening. Disparities in treatment access, continuity of care and outcomes could contribute to survival differences. In both localized and metastatic settings, equal access could diminish the observed disparities in both the USA and the UK. An understanding of behavioural medicine, especially an appreciation of cultural beliefs about illness and treatment, could inform and improve the ways in which health systems can engage withand deliver care to patients in minoritized groups affected by prostate cancer. Methods of promotingequity include targeting systemic barriers including systemic racism,proportional recruitment of patients into clinical trials, diversifying the health-care workforce and facilitating care informed by cultural humility.Actively engaging patients and communities in research and intervention might enable the translation of research into increasingly equitable care for patients with prostate cancer in the UK, the USAand globally.

Travel burden and bypassing closest site for surgical cancer treatment for urban and rural oncology patients.

We examined the relationship between travel burden for surgical cancer care and rurality, geographic bypass of the nearest surgical facility, cancer type, and mortality outcomes. Using Medicare claims and enrollment data (2016-2018) from beneficiaries with cancer of the colon, rectum, lung, or pancreas, we measured travel times to: the nearest surgical facility and facility used. For those who bypassed the nearest, we examined travel time and rurality in relation to surgical rates. Using multivariable regression modeling, we estimated associations of bypass with 90-day postoperative- and one-year mortality; rurality was examined as an effect modifier. Among 211,025 beneficiaries with cancer, 25.5% resided in non-metropolitan areas. About 66% of metropolitan/micropolitan, and 78% of small town/rural patients bypassed their closest facility. Increasing rurality was significantly associated with increased likelihood of bypass (Referent=metropolitan, OR; 95%CI: micropolitan 1.10; 1.04-1.16, small town/rural 2.08; 1.96-2.20. Bypassing the nearest facility was associated with decreased likelihood of both 90-day postoperative mortality (OR=0.79; 95%CI 0.74-0.85) and 1-year mortality (OR=0.81; 95%CI 0.77-0.86). The greatest decrement in 1-year mortality was for pancreatic cancer across all rural-urban categories (OR; 95%CI: metropolitan 0.63; 0.53-0.76; micropolitan 0.53; 0.29-0.97); small town/rural 0.46; 0.25-0.86). Most Medicare beneficiaries with lung, colon, rectal, or pancreatic cancer bypassed the closest facility providing surgical cancer care, especially rural patients. Bypassing was associated with a lower likelihood of 90-day postoperative, and 1-year mortality. Understanding determinants of bypassing, particularly among rural patients, may reveal potential mechanisms to improve cancer outcomes and reduce rural cancer disparities.

Disparities in Testicular Cancer: A Review of the Literature.

Background: Testicular cancer is the most common malignancy diagnosed in adolescents and young adults, and evidence has emerged regarding disparities that affect different groups of patients. Methods: In this article, we conducted a thorough review of this area and summarized the existing literature. Results: Some of the pertinent findings from our review include poorer outcomes for various groups including the native Māori population of New Zealand, those who live in the United States-Mexico border region, those who live in Eastern Europe, those who are uninsured and those with poorer socioeconomic status, amongst others. In the United States specifically, there is significant evidence showing that racial/ethnic minorities, compared to white patients, tend to fare worse with later presentation at higher stages and worse survival rates. Hispanic patients in particular appear to have the potential for more aggressive tumor biology than other groups and are projected to have the highest incidence rates in the US by 2026. Conclusions: Overall, disparities exist in many aspects of testicular cancer and are striking in some instances, and further research is needed in this arena and in potential solutions.

9260 Insulin Receptor Signaling and Racial Disparities in Triple Negative Breast Cancer

Abstract Disclosure: A.J. Engel: None. K. Samuel: None. I.R. Bass: None. S. Lin: None. I. Antoniou: None. R. Yagnik: None. D. LeRoith: None. N.A. Bickell: None. E.J. Gallagher: Consulting Fee; Self; Novartis Pharmaceuticals. Introduction: Obesity and type 2 diabetes are associated with poor breast cancer (BC) prognosis. These disorders, along with hyperinsulinemia are more common in Black than in White women. Black women also have higher rates of triple negative breast cancer (TNBC), and greater breast cancer mortality than White women. We hypothesized that Black women with TNBC have worse outcomes in part due to tumor promoting effects of hyperinsulinemia via the insulin receptor (IR) signaling pathway. Methods: From our IRB-approved, multi-institutional, cross-sectional, NIH-funded, study of women with newly diagnosed BC, we identified women with TNBC. We performed immunohistochemistry (IHC) analysis of formalin-fixed-paraffin-embedded tumor samples from 45 self-identified Black women and 48 self-identified White women. We quantified the BC expression of IR (n=92), IGF1R (n=92), pERK (n=91), FOXO3a (n=90) for intensity (none=0, weak=1, moderate=2, intense=3). In subsequent analysis, 0 and 1 intensity IHC staining were considered negative, and 2 and 3 were considered positive. Quantification was performed with reviewers blinded to clinical information. Clinical information (age, race, body mass index [BMI], waist circumference, fasting insulin, BC Nottingham Prognostic Index [NPI]) was evaluated after IHC scoring. Statistical proportions were compared using Fishers Exact test, and continuous variables were evaluated using parametric or non-parametric tests, as appropriate. Results: Positive IR staining was seen in 64% of samples (n=59), 74% (n=68) for IGF1R, 68% (n=62) for FOXO3a and 43.3% (n=39) for pERK. Positive IR staining was more prevalent in Black women than White women (P=0.003) but was not significantly associated with age or NPI. IGF1R, FOXO3a, pERK positive staining were not associated with race or NPI. Positive IR staining was also associated with higher BMI, waist circumference, and fasting insulin (P<0.05 for all). Positive IGF1R, FOXO3a, pERK staining were not associated with any of these factors. Conclusions: We found that 64% of TNBCs had positive expression of IR, and IR expression was more prevalent in tumors from Black women and associated with higher insulin levels, suggesting that tumors from Black women may be more sensitive to the tumor promoting effects of systemic hyperinsulinemia. Presentation: 6/2/2024

The Cancer Equity Compass: Interactive maps showing the association between social determinants of health and cancer disparities.

149 Background: Cancer incidence and mortality in Black, Hispanic and Native American populations is over twice that in the White population for some prevalent cancers. A new, publicly available mapping tool, the Cancer Equity Compass (CEC), was developed to inform data-driven initiatives to improve equity by identifying community factors associated with cancer disparities. The tool is comprised of interactive maps that visually reveal correlations between two variables. Development of the tool began with assembling a group of nine advisors with expertise in cancer prevention, treatment and health equity. These experts inform the strategy, data sources, variables of interest, and stakeholder value propositions for the CEC. Methods: The data source for the CEC is a national, multi-level database developed using individual, health system, and community data, aggregated by county. For the three most common cancers in the U.S., breast, prostate and lung, screening and prevalence rates were collected from 2021 Medicare 5% research identifiable files and mortality rates from 2020 SEER Medicare rates. These metrics were each mapped with a variety of social determinants of health (SDOH) variables. Population rates for minorities, education, poverty, income and unemployment, and an air quality measure were from the Area Health Resources File. Environmental risks were derived from the Environmental Justice Index and included environmental burden (ranked 0-17 for pollution, toxic sites, built environment, transportation infrastructure and water pollution), air pollution (ranked 0-4), and social vulnerability (ranked 0-14 across socioeconomic variables). Results: Each map includes one cancer metric and one SDOH variable. Each variable is stratified to show the top quartile, middle 50%, and bottom quartile. The choropleth heat maps, created on Tableau, display 9 colors representing each combination of the three levels (>75%, 25-75%, <25%) for both mapped variables. The CEC currently has 140 maps presenting visualizations of county SDOH associations with cancer disparities. Conclusions: The expert advisors on the project have outlined four avenues for the CEC to aid efforts to improve cancer equity: 1) Enhance diversity in clinical trial recruitment and data registries through targeted site recruitment; 2) Identify high opportunity targets for improving equity and informing solutions; 3) Identify common correlates of disparities within and across U.S. counties to direct priorities for national policy and programs for large-scale impact; and 4) Measure change to support improvement efforts and report impact of equity initiatives. The CEC will be expanded with additional measures including healthcare access. The goal is use by stakeholders and changemakers who can apply the reported data to fuel advocacy efforts and enact positive change.

Inter‐prefectural and urban–rural regional disparities in rectal cancer and rectal resections: A Japanese nationwide population‐based cohort study from 2014 to 2019

AbstractAimThis observational study aimed to elucidate the regional disparities in rectal cancer (RC) and rectal resections (RRs) across Japan.MethodsThe annual incidence of RC, and number of all RRs and board‐certified surgeons by the Japan Society for Endoscopic Surgery were examined by prefecture in Japan from 2014 to 2019. The surgical approaches were broken down by open and laparoscopic. Disparities in 47 prefectures and urban–rural disparities were evaluated using the Gini coefficient and unpaired t‐test.ResultsThe annual national average incidence of RC was 50 127 and the number of all RRs was 39 903. Gini coefficients for RC, and laparoscopic and all RRs were <0.2, indicating low inequality. There was no significant difference between urban and rural prefectures in the number of RRs, despite a significantly higher incidence of RC in rural prefectures and a significantly higher number of board‐certified surgeons in urban prefectures (p < 0.05).ConclusionRC and laparoscopic and all RRs exhibited minimal inter‐prefectural disparities. The urban–rural analysis revealed significant differences in the incidence/number of RC and board‐certified surgeons between urban and rural prefectures, despite minor differences in RRs regardless of approach. This pattern suggests a potential migration of surgical services from rural to urban areas. This preliminary study is expected to contribute to a basic epidemiological database for RC and RRs.