Prostate cancer in Scotland: Does geography matter? An analysis of incidence, disease characteristics and survival between urban and rural areas

Karina A. Laing, Stephen P. Bramwell, Alan McNeill, Brian D. Corr, Thomas B L Lam

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Objective: The objective of this article is to identify whether there is a difference in survival from prostate cancer in urban and rural areas of Scotland and to identify potential inequalities in incidence, disease characteristics and the treatment of prostate cancer between these areas. 

Subjects/patients and methods: A retrospective cohort study was undertaken. Retrospective analysis of data from Information Services Division and regional cancer databases from 2005 to 2010 was performed. A comparison of NHS Highland & Western Isles as the rural group with NHS Lothian as the urban group was made. Data were collected on patient and disease characteristics, first treatment and mortality. Non-parametric continuous data were analysed using the Mann-Whitney U test. Categorical data were assessed using a two-tailed Z test. The p value for statistical significance was set at <0.05. 

Results: The incidence of prostate cancer was higher in rural areas. Rural patients were older at diagnosis (p <0.0001), presented with higher risk disease (p <0.0001) and underwent less curative treatment (p <0.0001). There was potentially poorer survival in rural areas. 

Conclusions: Men living in rural areas of Scotland present with more aggressive prostate cancer and may have poorer survival. This could be due to high levels of PSA testing in urban areas, therefore further studies are needed to identify patterns of PSA testing in Scotland. These inequalities will be highlighted to the Scottish Government to inform the 'Detect Cancer Early' campaign for its second phase in 2015.

Original languageEnglish
Pages (from-to)176-184
Number of pages9
JournalJournal of Clinical Urology
Volume7
Issue number3
Early online date28 Nov 2013
DOIs
Publication statusPublished - May 2014

Keywords

  • disease characteristics
  • Prostate cancer
  • rural
  • Scotland
  • survival

ASJC Scopus subject areas

  • Surgery
  • Urology

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