Acknowledgments: The authors acknowledge the assistance of the Community Sciences and Health Outcomes Core of the Penn State Hershey Cancer Institute in this research.
Does Rurality Influence Treatment Decisions in Early Stage Laryngeal Cancer?
Article first published online: 21 MAR 2014
© 2014 National Rural Health Association
The Journal of Rural Health
Volume 30, Issue 4, pages 406–411, Autumn 2014
How to Cite
Mackley, H. B., Teslova, T., Camacho, F., Short, P. F. and Anderson, R. T. (2014), Does Rurality Influence Treatment Decisions in Early Stage Laryngeal Cancer?. The Journal of Rural Health, 30: 406–411. doi: 10.1111/jrh.12069
- Issue published online: 2 OCT 2014
- Article first published online: 21 MAR 2014
- early stage;
- laryngeal cancer;
- organ preservation;
The mortality rate of laryngeal cancer has been trending downward with the use of more effective surgical, radiation, and systemic therapies. Although the best treatment for this disease is not entirely clear, there is a growing consensus on the value of primary radiotherapy as an organ preservation strategy. This study examines urban-rural differences in the use of radiotherapy as the primary treatment for early stage laryngeal cancer in Pennsylvania.
The sample was drawn from the Pennsylvania tumor registry, which lists 2,437 laryngeal cancer patients diagnosed from 2001 to 2005. We selected 1,705 adults with early stage squamous cell carcinoma of the larynx for our analysis. Demographic data and tumor characteristics were included as control variables in multivariate analyses. Rurality was assigned by ZIP code of patient residence.
Controlling for demographic and clinical factors, rural patients were less likely than urban patients to receive radiotherapy as the primary treatment modality for early stage larynx cancer (OR 0.740, 95% CI 0.577-0.949, P = .0087). No other associations between rural status and treatment choice were statistically significant.
Relatively fewer rural patients with larynx cancer are treated primarily with radiation therapy. Further investigations to describe this interaction more thoroughly, and to see if this observation is found in larger population data sets, are warranted.