{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,29]],"date-time":"2025-10-29T03:56:03Z","timestamp":1761710163244,"version":"3.44.0"},"reference-count":44,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,7,10]],"date-time":"2025-07-10T00:00:00Z","timestamp":1752105600000},"content-version":"vor","delay-in-days":39,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Journal of Rural Health"],"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Importance<\/jats:title><jats:p>There is a need to understand how the increasing rate of HPV\u2010positive oropharyngeal cancers may affect underresourced populations.<\/jats:p><\/jats:sec><jats:sec><jats:title>Purpose<\/jats:title><jats:p>To investigate possible disparities in survival and cause\u2010specific mortality between rural and urban populations with HPV\u2010associated oropharyngeal cancer.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Our retrospective cohort study utilized the Surveillance, Epidemiology, and End Results (SEER) Pharyngeal Cancer with HPV Status Database from 2006 to 2018. \u00a0 Cox proportional hazard models and Kaplan\u2013Meier curves were employed to evaluate the differences in overall survival and cause\u2010specific mortality.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>SEER data used in this study originate from a set of regional cancer registries located across the country.<\/jats:p><\/jats:sec><jats:sec><jats:title>Participants<\/jats:title><jats:p>Patients diagnosed with HPV\u2010associated oropharyngeal cancer from 2006 through 2018 in the SEER HPV status database.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main Outcome(s) and Measure(s)<\/jats:title><jats:p>The difference in overall survival and cause\u2010specific mortality between rural and urban populations with HPV\u2010associated oropharyngeal cancer.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 13,294 patients were included in our study, most of whom lived in urban counties (88.5%, <jats:italic>n<\/jats:italic>\u00a0=\u00a011,766), had a mean age of 60.6\u00a0years (SD\u00a0=\u00a09.6), and had a primary tumor site located in the tonsil (47.6%, <jats:italic>n<\/jats:italic>\u00a0=\u00a06328). Rural communities had a higher likelihood of all\u2010cause mortality (hazard ratio [HR] 1.14, 95% confidence interval [CI], 1.02\u20131.29) compared to their urban counterparts. Additionally, rural residents had a higher probability of cause\u2010specific mortality (HR 1.15, 95% CI, 1.01\u20131.32) compared to their urban counterparts.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Patients with HPV\u2010associated oropharyngeal cancer who reside in rural areas were more likely to die when compared to their urban counterparts. More research is needed to determine the best way to mitigate this disparity.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jrh.70048","type":"journal-article","created":{"date-parts":[[2025,7,10]],"date-time":"2025-07-10T11:23:40Z","timestamp":1752146620000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Disparities in rural and urban outcomes in populations with human papillomavirus\u2013associated oropharyngeal cancers"],"prefix":"10.1111","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9915-9382","authenticated-orcid":false,"given":"Kale G.","family":"Mills","sequence":"first","affiliation":[{"name":"Department of Otolaryngology The University of Kansas Medical Center Kansas City Kansas USA"},{"name":"The University of Kasnas School of Medicine\u2010Wichita  Wichita Kansas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8731-4464","authenticated-orcid":false,"given":"Nathan","family":"Farrokhian","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology The University of Kansas Medical Center Kansas City Kansas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4550-2162","authenticated-orcid":false,"given":"Elizabeth","family":"Ablah","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology The University of Kansas Medical Center Kansas City Kansas USA"},{"name":"The University of Kasnas School of Medicine\u2010Wichita  Wichita Kansas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9379-3406","authenticated-orcid":false,"given":"Kevin J.","family":"Sykes","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology The University of Kansas Medical Center Kansas City Kansas USA"},{"name":"Health and Wellness Center Baylor Scott &amp; White Health Dallas Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,7,10]]},"reference":[{"key":"e_1_2_7_2_1","unstructured":"HPV and oropharyngeal cancer.Centers for Disease Control and Prevention. 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