Rural Patients' Cancers Diagnosed Earlier

Rural patients are often assumed to be the top truants in American medicine, not seeking medical attention until a condition is more advanced and less treatable. However, a new study by Dartmouth researchers suggests that urban, not rural, patients are most likely to slip through the cracks—at least when it comes to colorectal and lung cancer.

Looking at national data on those two types of cancer, the study found that urban patients tend to be diagnosed at a later stage than their rural counterparts—even when the study controlled for other factors associated with late-stage presentation, such as age, race, gender, marital status, income level, and level of education.

The paper, "Rural Versus Urban Colorectal and Lung Cancer Patients: Differences in Stage at Presentation," was published in the November 2007 Journal of the American College of Surgeons. The authors are Ian Paquette, a general surgery resident at the Dartmouth-Hitchcock Medical Center (DHMC), and Sam Finlayson, a DHMC surgeon and vice chair for academic affairs for the Department of Surgery of the Dartmouth Medical School.

The team's findings fly in the face of the anecdotal evidence, including the sorts of tales traded in the corridors of DHMC, which serves a rural slice of New Hampshire and Vermont. "Where we practice, most doctors can tell stories about patients who have presented at a very late stage of a disease, and we find it hard to imagine that they could have ignored their symptoms for so long," says Paquette.

Knowing which types of patients are more likely to present with more advanced cancers helps doctors better implement screening efforts, allowing them to diagnose patients at earlier stages and improve their prognoses, said Paquette. The study focused on colorectal and lung cancer because these are types that surgeons see frequently in their day-to-day practice.

The team looked at more than 125,000 people with colorectal cancer and more than 160,000 people with lung cancer, drawing on 2000-03 data.

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U.K. Study Finds No Health Effects of Cell Phone Use

Mobile phones have not been found to be associated with any biological or adverse health effects, according to the UK's largest investigation into the possible health risks from mobile telephone technology.

The Mobile Telecommunications and Health Research (MTHR) Program published its conclusions on September 12 as part of its 2007 Report.

The six-year research programme, chaired by Lawrie Challis, emeritus professor of physics at the University of Nottingham, has found no association between short term mobile phone use and brain cancer. Studies on volunteers also showed no evidence that brain function was affected by mobile phone signals or the signals used by the emergency services (TETRA).

The MTHR program management committee believes there is no need to support further work in this area.

The research programme also included the largest and most robust studies of electrical hypersensitivity undertaken anywhere in the world. These studies have found no evidence that the unpleasant symptoms experienced by sufferers are the result of exposure to signals from mobile phones or base stations.

The situation for longer-term exposure is less clear as studies have so far only included a limited number of participants who have used their phones for ten years or more. The committee recommends more research be conducted in this area.

The MTHR program also investigated whether mobile phones might affect cells and tissue beyond simply heating them. The results so far show no evidence for this and the committee believes there is no need to support further work in this area.

Challis says: “This is a very substantial report from a large research programme. The work reported today has all been published in respected peer-reviewed scientific or medical journals.

“The results are so far reassuring but there is still a need for more research, especially to check that no effects emerge from longer-term phone use from adults and from use by children.”

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