{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T01:57:38Z","timestamp":1780624658545,"version":"3.54.1"},"reference-count":19,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,3,3]],"date-time":"2025-03-03T00:00:00Z","timestamp":1740960000000},"content-version":"vor","delay-in-days":61,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Journal of Rural Health"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Prostate cancer is a common malignancy among men, with disparities based on the geographic location.\u00a0This study aims to evaluate long\u2010term trends in prostate cancer outcomes among rural and urban populations within a universal health care system, providing insights into the persistent disparities in cancer\u2010specific mortality despite supposed equal access to medical coverage.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective cohort study was conducted using data from the Alberta Cancer Registry (January 1, 1999 to December 31, 2022) and the Alberta Prostate Cancer Research Initiative (APCaRI) (July 1, 2014 to June 7, 2024). There were 45,602,119 person\u2010years from the Alberta Cancer Registry and 8932 men from APCaRI. The exposure was the place of residence, categorized as urban or rural, based on postal codes at the time of diagnosis and death. The primary outcome was prostate cancer\u2010specific mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Findings<\/jats:title>\n                    <jats:p>\n                      Rural men were diagnosed at an older age (66.7\u00a0vs. 68.9,\n                      <jats:italic>p<\/jats:italic>\n                      &lt;0.001) and had higher age\u2010adjusted prostate cancer\u2010specific mortality compared to urban men (52.0\u00a0vs. 37.6 deaths per 100,000,\n                      <jats:italic>p<\/jats:italic>\n                      &lt;0.001). Though both groups showed improvements over time, rural areas consistently had higher age\u2010adjusted mortality rates. Despite a 38% relative increase in prostate cancer specific mortality, rural patients had minimal, though statistically significant differences in PSA (9% vs. 11% &gt;20,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.008), stage (40%\u00a0vs. 46% T2\u2013T4, p&lt;0.001) and Gleason Grade Group (11% vs. 14% \u22654,\n                      <jats:italic>p<\/jats:italic>\n                      &lt;0.001) at diagnosis.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The study reveals that rural men experienced significantly worse prostate cancer outcomes compared to urban men. These findings highlight the need for targeted health care interventions to improve access to care in rural areas.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jrh.70008","type":"journal-article","created":{"date-parts":[[2025,3,12]],"date-time":"2025-03-12T00:37:34Z","timestamp":1741739854000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["The rural disadvantage \u2013 prostate cancer outcomes of rural and urban patients over 25 years"],"prefix":"10.1111","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8032-8393","authenticated-orcid":false,"given":"Patrick","family":"Albers","sequence":"first","affiliation":[{"name":"Department of Surgery Division of Urology University of Alberta  Edmonton Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guocheng","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Surgery Division of Urology University of Alberta  Edmonton Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Safaa","family":"Bashir","sequence":"additional","affiliation":[{"name":"Department of Medicine University of Alberta  Edmonton Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikhile","family":"Mookerji","sequence":"additional","affiliation":[{"name":"Department of Surgery Division of Urology University of Alberta  Edmonton Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacob","family":"Bennett","sequence":"additional","affiliation":[{"name":"Department of Surgery Division of Urology University of Alberta  Edmonton Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stacey","family":"Broomfield","sequence":"additional","affiliation":[{"name":"Department of Surgery Division of Urology University of Alberta  Edmonton Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana\u00efs Medina","family":"Mart\u00edn","sequence":"additional","affiliation":[{"name":"Alberta Prostate Cancer Research Initiative (APCaRI)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sunita","family":"Ghosh","sequence":"additional","affiliation":[{"name":"Department of Oncology University of Alberta"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam","family":"Kinnaird","sequence":"additional","affiliation":[{"name":"Department of Surgery Division of Urology University of Alberta  Edmonton Canada"},{"name":"Alberta Prostate Cancer Research Initiative (APCaRI)"},{"name":"Department of Oncology University of Alberta"},{"name":"Alberta Centre for Urologic Research and Excellence (ACURE)"},{"name":"Cancer Research Institute of Northern Alberta (CRINA)  Edmonton Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,3,3]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2017.7248"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/S10552\u2010010\u20109722\u20103"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1200\/OP.23.00626\/SUPPL_FILE\/DS.OP.23.00626.PDF"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.3389\/FONC.2019.00238"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1080\/22423982.2017.1324231"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.5694\/J.1326\u20105377.2011.TB02977.X"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/S00345\u2010020\u201003483\u20107"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1001\/JAMANETWORKOPEN.2024.18475"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.34812"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/JRH.12137"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen\u20102020\u2010037222"},{"key":"e_1_2_8_13_1","unstructured":"The 2024 Report on Cancer Statistics in Alberta | Tableau Public. Accessed July 21 2024.https:\/\/public.tableau.com\/app\/profile\/cancercontrol.ab\/viz\/The2024ReportonCancerStatisticsinAlberta\/Highlights"},{"key":"e_1_2_8_14_1","unstructured":"Dictionary Census of Population 2021 \u2013 Rural area (RA). February 9 2022. Accessed August 5 2024.https:\/\/www12.statcan.gc.ca\/census\u2010recensement\/2021\/ref\/dict\/az\/Definition\u2010eng.cfm?ID=geo042"},{"key":"e_1_2_8_15_1","unstructured":"Edn.presented at the EAU Annual Congress Paris. EAU Guidelines.2024. 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