A study of more than 1,000 women in Missouri, Kansas and Iowa diagnosed with ovarian cancer showed those with the more lethal stage IV tended to come from rural areas.
The study published in the Journal of Rural Health shows rural women are two and half times as likely as their urban counterparts to be diagnosed when the disease is at its most severe stage.
Researchers are not sure why that’s the case.
“It’s not proximity to primary care physicians, because that variable didn’t have an impact on the numbers," said the lead author of the study, Kristen Weeks, a Ph.D. and MD candidate at the University of Iowa.
Weeks said it may be the lack of specialists in rural areas, specifically gynecologists.
“So a female doctor that takes care of female issues may not be as available to rural patients, and those types of providers may be more able to recognize the symptoms early on," Weeks said.
The other possibility Weeks and her co-authors are considering is that the data shows that rural women are also more likely to have other medical conditions. It’s called the theory of competing demand.
“That kind of suggests that if women are sicker and have more medical conditions, they might miss, and their doctors might miss symptoms of cancer because they are associating them with the other conditions that they are known to have,” Weeks said.
But Weeks said that raises other questions, including why rural women are more likely to have other medical ailments. She plans to continue her research to answer those questions as well as learn more about any differences in treatment of ovarian cancer patients between rural and urban areas.
According to the American Cancer Society, ovarian cancer diagnosed at stage I has a five-year survival rate of over 90%, while a stage IV diagnosis survival rate is 29%.
“It’s literally an issue of life and death,” Weeks said.
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