Cancer survivors living in rural counties had higher rates of health-compromising behaviors than did their urban counterparts, a study has found.

Kathryn E. Weaver, PhD, assistant professor of social sciences and health policy at Wake Forest Baptist Medical Center in Winston-Salem, North Carolina, and colleagues noted in Cancer Causes & Control that rural cancer survivors have an increased risk of poor outcomes after cancer, including higher cancer mortality. Although rural-urban differences in health behaviors have been identified in the general population and may contribute to cancer health disparities, these factors had not been examined among US survivors.

Weaver’s team studied data from the population-based 2006–2010 National Health Interview Survey. Responses from 1,642 rural and 6,162 urban survivors of cancer showed that the rural patients had a significantly higher prevalence of the following:

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  • fair/poor health (36.7% among rural survivors vs 26.6% among urban survivors)
  • health-related unemployment (18.5% vs 10.6%)
  • smoking (25.3% vs 15.8%)
  • physical inactivity (50.7% vs 38.7%).

Alcohol consumption, however, was lower in the rural patient population than among the city-dwellers (46.3% vs 58.6%), and no significant differences were seen in overweight/obesity (rural 65.4%; urban 62.6%).

After adjustment for behaviors, rural survivors remained more likely than urban survivors to report fair/poor health and health-related unemployment.

The investigators concluded that rural survivors may need tailored, accessible health promotion interventions to address health-compromising behaviors and improve outcomes after cancer.