City vs. country: Cancer found at earlier stages in rural patients

Better screening for all is urged by researchers in a new study that looked at colorectal and lung cancer.

By Susan J. Landers, AMNews staff. Dec. 3, 2007.

Washington -- Who is more likely to seek an early diagnosis for colorectal or lung cancer: a resident of a large city or someone from the country? The authors of a new study were surprised by the answers they found.

Those who live in large cities, surrounded by physicians and hospitals, were less likely to come in for diagnosis and care at an earlier, and possibly curable, stage of disease than were those who lived far from any metropolitan center.

The findings, which appeared in the November Journal of the American College of Surgeons, run counter to the notion that rural cancer patients present at later stages of disease than do those who live in cities, said study authors.

The finding is part of a larger research push to uncover the demographic factors associated with patients delaying care until their cancer has progressed to an advanced stage, said study author Ian Paquette, MD, a surgical resident at Dartmouth-Hitchcock Medical Center in Lebanon, N.H.

There has been research on the impact of race, gender and finances on when people present with late stages of cancer, said Dr. Paquette. "We were trying to take that a step further and see if where patients live has any impact."

As a surgical resident in the rural state of New Hampshire and having been raised in neighboring Maine, Dr. Paquette also had a personal interest in the study's outcome. "A lot of the time we get the rural patient who hasn't seen a doctor in 20 years and comes in with a really late, metastatic cancer that we can't treat."