Rural-urban differences in cancer care: results from the Lake Superior Rural Cancer Care Project.

Past studies have shown significant differences between rural and urban cancer patients in many measures of cancer care. There is little recent information about this disparity, which generally has shown disadvantages in rural populations. This study reports the rural and urban differences in cancer care using data from the Lake Superior Rural Cancer Care Project. The study used a prospective, population-based design that included all incident cases of breast, colorectal, lung, and prostate cancers diagnosed in northeastern Minnesota, northwestern Wisconsin, and the western portion of Michigan's Upper Peninsula from 1992 to 1997. The outcome measures were 9 endpoints that represented state-of-the-art cancer care during the study. Rural cancer patients as compared with their urban counterparts were disadvantaged in proportion staged, stage at diagnosis, initial management procedures, post-treatment surveillance testing, and participation in cancer clinical trials. These findings are similar to previously published studies. Further research is needed to determine more clearly the barriers in rural cancer care and to find more effective strategies.