Jean A. McDougall|Matthew P. Banegas|Charles L. Wiggins|Vi K. Chiu|Ashwani Rajput|Anita Y. Kinney
Rural Disparities in Treatment-Related Financial Hardship and Adherence to Surveillance Colonoscopy in Diverse Colorectal Cancer Survivors
New Mexico Cancer Center|University of New Mexico|Kaiser Permanente Center for Health Research|New Mexico Cancer Center|University of New Mexico|New Mexico Cancer Center|University of New Mexico|New Mexico Cancer Center|University of New Mexico|New Mexico Cancer Center|University of New Mexico
abstract background cancer survivors increasingly report financial hardship consequence high cost cancer care yet financial experience rural cancer survivors remains largely unstudied purpose study investigate potential rural disparities likelihood financial hardship nonadherence surveillance colonoscopy methods individuals diagnosed localized regional colorectal cancer 2004 2012 ascertained populationbased new mexico tumor registry participants completed mailed questionnaire telephone survey colorectal cancer survivorship experience including treatmentrelated financial hardship receipt surveillance colonoscopy multivariable logistic regression used estimate adjusted odds ratios ors 95 confidence intervals cis results compared urban colorectal cancer survivors n 168 rural colorectal cancer survivors n 109 slightly older likely married 65 vs 59 annual income amplt30000 37 vs 27 less likely employed 35 vs 41 college degree 28 vs 38 high level health literacy 39 vs 51 rural survivors twice likely urban survivors report treatmentrelated financial hardship 186 95 ci 106328 nonadherence surveillance colonoscopy guidelines 228 95 ci 107485 addition financial hardship independently associated nonadherence surveillance colonoscopy 217 95 ci 101485 conclusions substantial rural disparities likelihood financial hardship nonadherence surveillance colonoscopy exist impact treatmentrelated financial hardship among rural colorectal cancer survivors may negatively affect adherence guidelinerecommended followup care cancer epidemiol biomarkers prev 2711 127582 2018 aacr