ArticleCancer medicine2026
Geography as an Independent Determinant and Immuno-Inflammatory Correlates of Long-Term Oral Cancer Survival: A Population-Based Cohort Study From India.
Article in Cancer medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundIndia contributes approximately one-third of global oral cancer cases, with pronounced disparities in outcomes across geographic and socio-economic strata. While rural-urban survival differences have been documented, limited evidence exists regarding whether geographic residence independently predicts long-term survival.
methodsWe conducted a retrospective population-based cohort study using data from the Wardha Population-Based Cancer Registry, Maharashtra, for oral cancer cases (ICD-10 C00-C06) diagnosed between 2010 and 2022, with follow-up through December 2024. Overall survival was analysed using Kaplan-Meier methods and Cox proportional hazards regression. A mechanistic extension incorporated systemic immune-inflammatory biomarkers derived from pretreatment laboratory values, including neutrophil-to-lymphocyte ratio, systemic immune-inflammation index, systemic inflammation response index, C-reactive protein/albumin ratio and CRP-albumin-lymphocyte index.
resultsAmong 12,847 registered cancers, 1683 (13.1%) were oral cancers; 66.2% were rural residents. Five-year survival was 42.1% for rural versus 56.3% for urban residents. Rural residence remained independently associated with mortality after adjustment for age, sex, education and clinical extent (HR 1.34, 95% CI 1.21-1.48). Rural patients demonstrated elevated inflammatory biomarkers and lower CRP-albumin-lymphocyte index. Sequential model adjustment demonstrated attenuation of the rural hazard ratio from 1.41 to 1.22.
conclusionGeographic residence independently predicts long-term oral cancer survival in this population-based cohort. Systemic immune-inflammatory biomarkers are associated with survival and partially account for rural-urban disparities.
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