Urban vs. rural patients. Differences in stage and overall survival among patients treated surgically for lung cancer
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Chair and Department of Thoracic Surgery, Medical University of Lublin, Poland
Department of Clinical Immunology, Medical University of Lublin, Poland
Department of Anaesthesiology and Intensive Care, Children’s University Hospital, Lublin, Poland
Ann Agric Environ Med. 2013;20(1):101–105
Introduction. Besides the undoubted influence of risk factors on morbidity and survival time, there are also other environmental factors, such as awareness of the prevalence of risk factors and the availability of modern diagnosis and treatment methods. Objective. To evaluate differences in lung cancer 5-year overall survival rates between urban and rural patients hospitalized in the Department of Thoracic Surgery of the Medical University in Lublin, Poland, and possible influence of several risk factors on these rates. Materials and methods. The analysis was based on 125 lung cancer patients who underwent surgical procedures in years 2006-2007 and who agreed to take part in the survey. The study aimed at recognition of the health situation and selected demographic traits of people who had been treated surgically for lung cancer. The differences were evaluated between rural and urban inhabitants in gender, age, lung function, smoking habits, exposure to risk factors at work, family history of cancer, staging of the disease, histological type of cancer, post-surgical treatment, and their possible influence on overall survival. Results. The results showed that the only noted differences between urban and rural population were in tobacco smoking and lung function. Survival rates were very similar and did not differ from the European average. Conclusions. The assumption that Polish rural patients are presenting with later cancer stages at the time of diagnosis, and have worse chances for survival, has become invalid in modern times.
Gross AJ. The Risk of Lung Cancer in Nonsmokers in The United States and Its Reported Association with Environmental Tobacco Smoke. J Clin Epidemiol. 1995; 48(5): 587-598.
Lewandowski T. Rak płuca.(Lung cancer) Nowa Med. 2003; 10(3): 110-116 (in Polish).
Park SK, Cho LY, Yang JJ, Park B, Chang SH, Lee KS, Kim H, Yoo KY, Lee CT. Lung cancer risk and cigarette smoking, lung tuberculosis according to histologic type and gender in a population based case– control study. Lung Cancer. 2010; 68(1): 20-26.
Radzikowska E, Głaz P, Roszkowski K. Lung cancer in women: age, smoking, histology, performance status, stage, initial treatment and survival. Population based study of 20561 cases. Ann Oncol. 2002; 13(7): 1087-1093.
Roszkowski-Śliż K. Rak płuca – aspekty epidemiologiczne i diagnostyczne.(Lung cancer-clinical and epidemiological aspects). Terapia 2005; 13(2/1): 43-48 (in Polish).
Ruano-Ravina A, Barros-Dios JM. Lung cancer and related risk factors: an update of literature. Public Health 2003; 117(3): 149-156.
Zatloukal P, Kubika A, Pauka N, Tomasek L, Petruzelka L. Adenocarcinoma of the lung among women: risk associated with smoking, prior lung disease, diet and menstrual and pregnancy history. Lung Cancer 2003; 41(3): 283-293.
Downing A, Formani D, Gilthorpe MS, Edwards KL Manda SOM. Joint disease mapping using six cancers in the Yorkshire region of England. http://www.ij-healthgeographic... (access: 2011.09.10).
Krzyżak M, Maślach D, Bielska-Lasota M, Juczewska M, Rabczenko D, Marcinkowski JT, Szpak A. Breast cancer survival gap between urban and rural female population in Podlaskie voivodship, Poland, in 2001- 2002. Population study. Ann Agric Environ Med. 2010; 17(2): 277-282.
Manoharan N, Tyagi BB, Raina V. Cancer Incidences in Rural Delhi – 2004-05. Asian Pacific J Cancer Prev. 2010; 11(1): 73-78.
Pozeta A, Westeela V, Berionc P, Danzona A, Debieuvree D, Bretonf JL, Monnierg A, Lahourcadeh J, Dalphina JC, Mercie M. Rurality and survival differences in lung cancer: A large population-based multivariate analysis. Lung Cancer 2008; 59(3): 291-300.
Shugarman, LR, Melony E. S. Sorbero, MES, Tian, H, Jain, AK, Ashwood, JS. An Exploration of Urban and Rural Differences in Lung Cancer Survival Among Medicare Beneficiaries. Am J Public Health. 2008; 98(7): 1280-1287.
Van der Heyden JHA, Schaap MM, Kunszt AE, Esnaola S, Borell C, Cox B, Leinsalu M, Stirbu I, Kaledienei R, Debooserej P, Mackenbach JP, Van Oyen H. Socioeconomic inequalities in lung cancer mortality in 16 European populations. Lung Cancer 2009; 65(3): 322-330.
Polish Main Statistical Office. TERYT- National Official Register of Territorial Division of the Country. access/definitionTree.jspa (access: 2011.09.01).
Goldstraw P, Crowley J, Chansky K, Giroux DJ, Groome PA, RamiPorta R, Postmus PE, Rusch V, Sobin L on behalf of the International Association for the Study of Lung Cancer International Staging Committee and Participating Institutions. The IASLC Lung Cancer Staging Project: Proposals for the Revision of the TNM Stage Groupings in the Forthcoming (Seventh) Edition of the TNM Classification of Malignant Tumours. J Thor Oncol. 2007; 2(8): 706-714.
The American Joint Committee on Cancer (AJCC) – official site: http:// (access: 2011.09.01).
Pearce J, Boyle P. Is the Urban excess in lung cancer in Scotland explained by patterns of smoking? Soc Sci Med. 2005; 3(60): 2833–2843.
Jakobsson R, Gustavsson P, Lundberg I. Increased risk of lung cancer among male professional drivers in urban but not rural areas of Sweden. Occup Environ Med. 1997; 54(3): 189-193.
Law MR, Morris JK. Why is mortality higher in poorer areas and in more northern areas of England and Wales? J Epidemiol Community Health. 1998; 52(6): 344-352.
McLafferty S, Wang F. Rural Reversal? Rural-Urban Disparities in Late-stage Cancer Risk in Illinois. Cancer 2009; 115(12): 2755-2764.
Nafstad P, Haheim L, Oftedal B, Gram F, Holme I, Hjermann I, Leren P. Lung cancer and air pollution: a 27 year follow up of 16 209 Norwegian men. Thorax. 2003; 58(21): 1071-1076.
Philips Jr BU, Gong G, Hargrave KA, Belasco E, Lyford CP. Correlation of the ratio of metastatic to nonmetastatic cancer cases with the degree of socioeconomic deprivation among Texas counties. (access: 2011.09.01).
Khan N, Afaq F, Mukhtar H. Lifestyle as risk factor for cancer: Evidence from human studies. Cancer Letters 2010; 293(2): 133-143.
Smailyte G and Kurtinaitis J. Cancer mortality differences among urban and rural residents in Lithuania.http//www.biomedcent.... com/1471-2458/8/36 (access: 2011.09.10).
Rachtan J, Sokołowski A, Niepsuj S, Memła B, Zwierno M. Familial lung cancer risk among women in Poland. Lung Cancer 2009; 65(2): 138–143.
Paquette I, Finlayson SRG. Rural Versus Urban Colorectal and Lung Cancer Patients: Differences in Stage AT Presentation. J Am Coll Surg. 2007; 205(5): 636-641.
O’Reilly G, O’ Reilly D, Rosato M and Connolly S. Urban and rural variations in morbidity and mortality in Northern Ireland. http//www. (access: 2011.09.10).