{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T12:36:08Z","timestamp":1753878968315,"version":"3.41.2"},"reference-count":34,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2025,5,8]],"date-time":"2025-05-08T00:00:00Z","timestamp":1746662400000},"content-version":"vor","delay-in-days":68,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Journal of Rural Health"],"published-print":{"date-parts":[[2025,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Rural prostate cancer patients face challenges such as greater distance for cancer treatment and care fragmentation. There have been very few studies investigating adverse health outcomes among prostate cancer survivors residing in rural areas. A comprehensive evaluation of adverse health outcomes among rural prostate cancer patients is needed to understand potential health disparities and provide scientific evidence for interventions. The aims of this study were to investigate prevalent and incident adverse health outcomes among older rural prostate cancer survivors compared to urban prostate cancer survivors in the United States.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The SEER\u2010Medicare linked database was used to identify first primary prostate cancer survivors. Fine\u2010Gray subdistribution hazard models were utilized to estimate hazard ratios (HR) and 95% confidence intervals (CI), comparing rural prostate cancer patients to urban prostate cancer patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 37,126 rural prostate cancer survivors and 109,176 urban prostate cancer survivors were identified. We observed that rural prostate cancer survivors had a higher prevalence of rheumatoid arthritis\/osteoarthritis (22.1% vs 20.9%; <jats:italic>P<\/jats:italic>\u2010value &lt;.001) and chronic obstructive pulmonary disease (COPD)\/bronchiectasis (14.2% vs 10.5%; <jats:italic>P<\/jats:italic>\u2010value &lt;.001). A higher incident risk of acute myocardial infarction, COPD\/bronchiectasis, hip pelvic fracture, and rheumatoid arthritis\/osteoarthritis among rural prostate cancer was observed compared to their urban counterparts &gt;5 years after cancer diagnosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This study provides important results on the prevalence and incident adverse health outcomes among older rural prostate cancer survivors. Further investigation into how other factors influence these disparities is warranted.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jrh.70029","type":"journal-article","created":{"date-parts":[[2025,5,9]],"date-time":"2025-05-09T03:24:58Z","timestamp":1746761098000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Risks of adverse health outcomes among older rural prostate cancer survivors in the SEER\u2010Medicare data"],"prefix":"10.1111","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0878-997X","authenticated-orcid":false,"given":"Chun\u2010Pin","family":"Chang (Esther)","sequence":"first","affiliation":[{"name":"Huntsman Cancer Institute Salt Lake City Utah USA"},{"name":"Division of Public Health, Department of Family and Preventive Medicine University of Utah School of Medicine Salt Lake City Utah USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daren","family":"Huang","sequence":"additional","affiliation":[{"name":"Huntsman Cancer Institute Salt Lake City Utah USA"},{"name":"Division of Public Health, Department of Family and Preventive Medicine University of Utah School of Medicine Salt Lake City Utah USA"},{"name":"Department of Epidemiology UCLA Fielding School of Public Health Los Angeles California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shane","family":"Lloyd","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology University of Utah Salt Lake City Utah USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"N. 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