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Further Distance From Treating Facility is Associated With Advanced Colon Cancer at Presentation and Increased Mortality. | LitMetric

AI Article Synopsis

  • Colon cancer outcomes have improved in the U.S. over the past thirty years, but disparities remain, particularly in rural areas, where distance to treatment facilities may impact diagnosis and mortality rates.
  • An analysis of data from the National Cancer Database showed that over 356,000 adult colon cancer patients experienced more advanced disease stages and longer wait times for surgery as their distance from treatment centers increased.
  • The study concluded that living further from treatment facilities is associated with higher mortality rates and highlights the need for targeted interventions to improve cancer care access in rural populations.

Article Abstract

Background: Colon cancer outcomes in the United States have improved over the last thirty years. However, there remain significant outcome disparities, especially in rural regions. It is unclear if distance to the treating facility has an independent effect on colon cancer mortality and outcomes. We sought to evaluate whether distance from a treating facility impacts stage at diagnosis and mortality.

Methods: The National Cancer Database (NCDB) was utilized to identify a cohort of adult patients with colon cancer between the years 2013 and 2017 in all regions of the United States. Outcomes measured included colon cancer TNM stage, time to surgery, time to chemotherapy, and overall survival.

Results: A total of n = 356,189 patients met inclusion criteria. When controlling for race, education status, insurance status, comorbidities, and income, distance from the treating facility was a significant predictor of stage at presentation with more advanced clinical TNM stage as distance increased (AORs 1.12-1.62, < .001 for all groups). Longer distance significantly increased the time to surgery (between 5.06 and 14.46 days, < .001) and overall mortality (HR 1.11-1.28, < .001). Median survival was 82.4 months for the closest group, versus 75.1 months for the farthest group ( < .001).

Conclusions: Increased distance from the treating facility resulted in a significantly higher stage at presentation, increased time to surgery, and increased mortality. These results suggest that there are significant disparities in access to cancer care for patients who live in rural areas. Targeted interventions by treating facilities are needed to improve screening and timely treatment for rural colon cancer patients.

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Source
http://dx.doi.org/10.1177/00031348241241613DOI Listing

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