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

Area of Science:

• Oncology
• Public Health
• Health Services Research

Background:

• Colon cancer outcomes have improved in the US, but significant disparities persist, especially in rural areas.
• The independent impact of distance to treatment facilities on colon cancer mortality and outcomes remains unclear.
• This study investigates the relationship between facility distance, diagnosis stage, and mortality in colon cancer patients.

Purpose of the Study:

• To evaluate whether distance from a treating facility independently impacts colon cancer stage at diagnosis and mortality.
• To identify potential disparities in colon cancer care access related to geographic location.

Main Methods:

• Utilized the National Cancer Database (NCDB) for a cohort of adult colon cancer patients (2013-2017).
• Measured outcomes including colon cancer TNM stage, time to surgery, time to chemotherapy, and overall survival.
• Controlled for patient factors: race, education, insurance, comorbidities, and income.

Main Results:

• Increased distance to treating facilities significantly predicted more advanced clinical TNM stage at presentation (AORs 1.12-1.62, P < .001).
• Longer distances correlated with increased time to surgery (5.06-14.46 days, P < .001) and higher overall mortality (HR 1.11-1.28, P < .001).
• Median survival was significantly lower for patients living farther from treatment facilities (75.1 months vs. 82.4 months, P < .001).

Conclusions:

• Greater distance to treatment facilities is associated with higher colon cancer stage at diagnosis, delayed surgery, and increased mortality.
• Findings indicate significant disparities in cancer care access for rural populations.
• Targeted interventions are crucial for improving screening and timely treatment for rural colon cancer patients.