Abstract A126: Rural-urban disparities in prostate cancer in Nebraska

BACKGROUND: Rural-urban disparities in US life expectancy have widened since the 1970s, with cancer as one of the leading causes. Available data on rural-urban disparities in patients with prostate cancer is limited, especially in understudied geographic locations. In this study, we investigated additional measures of potential prostate cancer disparity in rural and urban Nebraskan residents. METHODS: The integrated Cancer Repository for Cancer Research (iCaRe2) is a multi-institutional resource created and maintained by the Fred & Pamela Buffett Cancer Center to collect and manage standardized, multi-dimensional, longitudinal data and biospecimens on adult cancer patients, high-risk individuals, and healthy controls. It is uniquely enriched with comprehensive data on individuals residing in rural areas of the central US. Patients diagnosed with prostate cancer from 1991-2023 living in Nebraska were identified in iCaRe2 and categorized as rural and urban by rural-urban commuting area (RUCA) codes. RUCA codes 1-3 were categorized as urban, and RUCA codes 4-10 were categorized as rural. We investigated general demographic characteristics, age of prostate cancer diagnosis, age of death, Gleason scores, and American Joint Committee on Cancer (AJCC) stages, and overall survival (OS). RESULTS: The iCaRe2 patient registry contained data on 765 men with prostate cancer living in Nebraska: 81.2% were urban residents and 18.8% were rural residents. Rural residents were diagnosed with prostate cancer at 65.6 ± 8.21 years while urban residents were diagnosed with prostate cancer at 68.7 ± 9.08 years, resulting in a mean difference of 3.1 years (P < 0.001). Rural residents with prostate cancer died at a mean age of 72.9 ± 9.75 years while urban residents with prostate cancer died at a mean age of 77.1 ± 8.85 years, resulting in a mean difference of 4.2 years (P < 0.001). Analyses of Gleason scores, AJCC stages, and OS did not demonstrate statistically significant differences between rural and urban patients. CONCLUSIONS: Rural patients in Nebraska appear to be diagnosed and die with prostate cancer at younger ages compared to urban patients, which is both statistically and clinically meaningful. In our analysis, there was no statistical difference in OS between rural and urban men after they were diagnosed with prostate cancer, which is congruent with currently published literature. Our findings support exploring clinical features of cancer disease course, such as age of diagnosis and age of death, as well as performing state- and region-specific analyses as novel approaches to better define and delineate cancer disparity. Citation Format: Cassie Liu, Kaeli K. Samson, Oleg Shats, Raymond Bergan. Rural-urban disparities in prostate cancer in Nebraska [abstract]. In: Proceedings of the 18th AACR Conference on the Science of Cancer Health Disparities; 2025 Sep 18-21; Baltimore, MD. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2025;34(9 Suppl):Abstract nr A126.