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Trend and Predictors of Unstaged Cancer in Nebraska

Nebraska Cancer Registry

Stage at diagnosis is a key factor in the prognosis and treatment of cancer. However, for reasons that are not well understood, a small but significant proportion of patients are not staged. To examine trends and identify factors contributing to unstaged cancer cases among the four most common cancers (prostate, female breast, lung, and colorectal), Nebraska Cancer Registry data from 1996 to 2005 were analyzed.

The proportion of unstaged cancer was highest for lung cancer cases (14%) and lowest for breast cancer cases (4%). The rate of unstaged cancer was significantly lower during a more recent period (2001–2005) than an earlier period (1996–2000). Older patients, and those with a lower socioeconomic status, were significantly more likely to be unstaged for all four cancers.

The effects of rurality on the results are mixed. For lung and colorectal cancer, rural patients were more likely than urban patients to be unstaged. However, for prostate cancer, patients in smaller urban communities and rural communities were less likely than urban patients to be unstaged.

The findings of this study may indicate the need for increased access to care for socioeconomically disadvantaged patients to receive a complete cancer assessment.

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