NoRCa: a register-based data source for cancer research in northern Sweden

BACKGROUND: Rural populations often have poorer health outcomes than urban residents due to limited healthcare access, long travel distances, and diagnostic delays. Northern Sweden, covering 55% of the country but only 10% of its population, exemplifies these challenges. Yet research on cancer care and outcomes in the region remains scarce. To better understand structural factors underlying these inequities, we developed the Northern Region Cancer (NoRCa) database. The aim of this article is to describe the database, outline its coverage and linkage structure, and discuss how leveraging this resource has the potential to promote rural cancer research. METHODS: NoRCa includes all individuals diagnosed with cancer in the Northern Healthcare Region between 2007 and 2022. Using the Swedish personal identification number, each case was linked to national registers containing data on cancer type and stage, inpatient and specialist outpatient care, prescribed medications, cause of death, demographics, and socioeconomic factors. Geographic information includes residential location and distance to the nearest primary care centre and hospital at diagnosis. RESULTS: The database contains 88,796 incident cancer cases. By integrating clinical, socioeconomic, and geographic data, NoRCa offers a foundation for advancing rural cancer research and informing efforts toward more equitable cancer care. CONCLUSIONS: The NoRCa database is a unique register-based data source which has the potential to be used in numerous epidemiological studies, offering several possible research directions. Moreover, the insights generated through our research agenda can inform improvements in the healthcare system, supporting earlier detection efforts and promoting better health outcomes for the population.