Perioperative Outcomes of Rural-Dwelling Patients Undergoing Lung and Colon Cancer Operations in Rural Facilities

Area of Science:

• Oncology
• Rural Health
• Health Services Research

Background:

• Rural cancer patients face significant access barriers to care.
• This study assessed the safety and feasibility of local rural surgery for lung and colon cancer in Medicare-aged patients.

Purpose of the Study:

• To evaluate if rural Medicare patients can safely undergo lung and colon cancer surgery at local rural hospitals.
• To compare outcomes and travel burden for rural patients treated in rural versus urban facilities.

Main Methods:

• Utilized SEER-Medicare data for stage I-III colon and lung cancer patients residing in non-metropolitan statistical areas (rural).
• Compared outcomes (complications, mortality) and travel distances for rural patients undergoing surgery at rural vs. urban facilities.
• Employed multivariate logistic regression for risk-adjusted comparisons.

Main Results:

• No significant differences in demographics, cancer stage, or comorbidity risk between rural and urban treatment groups.
• Comparable mortality and complication rates were observed for lung and colon cancer surgery in rural vs. urban facilities.
• Rural patients treated locally experienced significantly shorter travel distances (16 vs. 49 miles for colon; 35 vs. 61 miles for lung).

Conclusions:

• Rural patients achieve comparable short-term surgical outcomes for lung and colon cancer when treated locally.
• Local treatment in rural facilities significantly decreases the travel burden compared to higher-volume urban centers.
• This supports the safety and efficacy of rural surgical centers for specific cancer types.