Differences in prostate cancer (PCa) stage at primary diagnosis and PCa-specific mortality among rural versus urban populations in Kentucky.

Kentucky Cancer Registry (KCR) prostate cancer (PCa) cases between the years of 1994 and 2021 were analyzed to examine differences between rural and urban populations’ primary stage at diagnosis and PCa-specific mortality. After adjusting for covariates, rural populations did not experience significantly higher odds of stage 3 diagnosis when compared to urban populations (OR = 1.02, 95% CI = 0.95 – 1.06). Rural populations had 16% increased odds of stage 4 diagnosis when compared to urban populations (OR = 1.16, 95% CI = 1.10 – 1.23). Rural populations had a 17% increased rate of PCa-specific death when compared to urban populations after adjusting for covariates (HR = 1.17, 95% CI = 1.11 – 1.23). Further research into screening rates in each region, the effect of medically underserved area status, more granular definitions of rurality, and complex interactions such as the “Appalachian Gap” is needed to better understand these differences.