Quality of Life of Head and NeckCancer Survivors in Urban and Rural IrelandAudrey Alforque Thomas1

Timmons A2, Molcho M1, Gallagher P3, O’Neill C1,Butow P4, Gooberman-Hill R5, O’Sullivan E6, Sharp L2

1National University of Ireland, Galway; 2National Cancer Registry Ireland; 3Dublin City University; 4University of Sydney, Australia; 5University of Bristol, UK; 6University College Cork

Funding from Interdisciplinary Capacity Enhancement FellowshipHealth Research Board

Irelandhead and neck cancer

Urban – Rural Comparisons

• Mostly incidence, treatment, clinical outcomes• United States, Australia, Canada, Scotland• Breast, colorectal, prostate cancers

health-related quality of lifeHow does health-related quality of life for head and neck cancer survivors differ in urban versus rural Ireland ?

SuN Study

• Support Needs of Survivors of Head & Neck Cancer Study• Data collection funded by HRB• Respondents identified from the Registry• 583 head and neck cancer survivors• Linked to Registry data

The SuN Study

Head & Neck Cancer

• Composite variable• Distance to treating hospital• Population density• Self-reported area

• Functional Assessment of Cancer Therapy (FACT)• Physical• Social/Family• Emotional• Functional• Head and Neck module

Measuring urban/rural and wellbeing

Analysis

FACT domain scores were skewed• Bootstrap linear regression• Bias-corrected and accelerated confidence intervals• Similar to OLS linear regression

Living in a rural area is associated with higher wellbeing

Physical Social Emotional Functional HN

Rural 1.27 0.89 0.99 1.41 1.55Female -0.22 1.64 -1.15 0.56 0.91Medical card -1.78 -0.79 -1.63 -2.44 -2.24Married/cohabiting 0.42 2.36 -0.18 1.76 1.10Third Level education 1.96 -1.51 0.61 0.69 2.62Age at survey 0.10 0.03 0.07 0.04 0.04Cancer returned/spread -3.77 0.44 -1.93 -2.22 -4.34Larynx -0.54 -0.24 -1.22 -1.65 -2.41Mouth -0.61 0.61 -0.85 -0.28 -3.36Pharynx -2.63 -1.17 -1.51 -2.65 -7.79

Coefficients in bold are significant at the 0.05 level

Living in a rural area is associated with higher wellbeing

• Drift Hypothesis• Breeder Hypothesis• Biophilia Hypothesis• Rural culture

Can only speculate about why there is a relationship

Urban and rural cancer survivors havedifferent life experiences.

ACKNOWLEDGEMENTS

Eamonn O’Leary, Statistical consultantNeil McCluskey, Geographic information consultant

Funding from Health Research Board