Regional disparities in cancer mortality across the rural-urban axis: a case study from north-eastern Greece

Rural Remote Health. 2015 Jul-Sep;15(3):3013. Epub 2015 Aug 7.

Abstract

Introduction: The aim of this study was to identify differences in cancer mortality in north-eastern Greece, to describe potential drivers operating at the population level and to propose practical interventions and mitigation strategies.

Methods: Cancer mortality data were collected from local registries using the WHO 10th edition of International Classification of Disease (ICD-10). The direct standardization method was used to address demographic differences in the two regions, with the Standard European Population as reference. Rate ratios (RR) were employed for comparisons and 95% confidence intervals (95%CI) were calculated according to the Poisson approximation method.

Results: An increased risk of digestive system cancers (excluding liver neoplasms) was observed in rural versus urban areas (RR=1.25, 95%CI=1.02-1.54). Stomach cancer, in particular, was more prevalent in the older cohorts (>65 years), suggesting a historical epidemiological perspective. A more pronounced discrepancy was observed for prostate cancer mortality (RR=1.86, 95%CI=1.10-3.14), indicating a strong positive correlation with rurality.

Conclusions: Cancer mortality disparities have been observed between rural and urban regions of north-eastern Greece. Health promotion and education, including improved access to medical facilities and early cancer screening, can help mitigate the burden and extend survival rates. Decreasing cancer staging at the time of diagnosis and reversing social and economic inequalities is key for combating these types of malignancy.

Keywords: Cancer; Determinants of Health; Diabetes; Environmental Health; Epidemiology; Europe; Health Scientist; Informatics; Primary Health Care; Public Health; Researcher.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Cohort Studies
  • Communication Disorders
  • Disasters
  • Early Detection of Cancer
  • Female
  • Greece / epidemiology
  • Health Status Disparities*
  • Humans
  • Male
  • Middle Aged
  • Neoplasms / epidemiology
  • Neoplasms / mortality*
  • Neoplasms / prevention & control
  • Organizational Case Studies
  • Poisson Distribution
  • Population Density
  • Preventive Health Services
  • Program Development
  • Reference Standards
  • Risk Factors
  • Rural Population / statistics & numerical data*
  • Socioeconomic Factors
  • Urban Population / statistics & numerical data*