Rural residence is related to shorter survival in epithelial
The rural residence has been related to health disparities and greater mortality risk in cancer patients, including gynecologic cancer patients. Rural ovarian cancer patients have poorer survival than their urban counterparts even with access to specialized care.

Rural and urban patients with high-grade invasive ovarian cancer seeking treatment at two midwestern tertiary-care university hospitals were recruited pre-surgery and followed until death or censoring date. Rural/urban residence was categorized using the USDA Rural-Urban Continuum Codes.

- Despite specialized surgical care, rural cancer survivors showed a higher likelihood of death compared to their urban counterparts.

- A rurality by education interaction was observed, indicating significantly poorer survival in rural vs. urban patients among those with trade school/some college education; there was no rurality survival disparity for the other 2 levels of education.

Differences in ovarian cancer survival are impacted by rurality, which is moderated by educational attainment even in patients receiving initial care in tertiary settings. Clinicians should be aware of rurality and education as potential risk factors for adverse outcomes and develop approaches to address these possible risks.

Gynecologic Oncology