ArticleDiseases of the colon and rectum2015
Does patient rurality predict quality colon cancer care?: A population-based study.
Article in Diseases of the colon and rectum, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 54 papers, 1 of them a synthesis that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
54 citing papers in PubMed, 1 synthesis or guideline pooled it, 94 citations in OpenAlex.
- Rural-Urban Disparities in Colorectal Cancer Screening, Diagnosis, Treatment, and Survivorship Care: A Systematic Review and Meta-Analysis.The oncologist · 2024Pooled it
- Lymph Node Yield and Disease-Free Survival After Neoadjuvant Chemoimmunotherapy for Esophageal Squamous Cell Carcinoma: A Multicenter, Retrospective Cohort Study.Annals of surgical oncology · 2026Observational
- Veteran Satisfaction With Lung Cancer Screening Care: A Cross-Sectional Evaluation.Medical care · 2026Article
- Allocation of Postacute Care Services Differs Among Rural and Urban Patients after Colon Cancer Resection.Journal of the American College of Surgeons · 2026Article
- Feasibility and Outcomes of Endoscopic Submucosal Dissection for Colorectal Premalignant and Early-Stage Malignant Lesions at a Community Hospital Serving Rural Population.Gastro hep advances · 2026Article
- Temporal Trends in Vulvar Cancer Cases and Associated Factors of Adverse Clinical Features: A 6-year Retrospective Study From a Tertiary Hospital in Indonesia.International journal of women's health · 2026Article
- Rurality and Use of Metastasis-Directed Therapies for Medicare Beneficiaries with Metastatic Colon Cancer: A Retrospective Cohort Study.Annals of surgical oncology · 2026Article
- Article
- Subspecialization of Surgical Specialties in the US.JAMA health forum · 2025Article
- Colorectal cancer survival disparities in persistent poverty areas.The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association · 2025Article
- The microbiological and metabolic traits associated with pT3 colorectal cancer metastasis to lymph nodes.Frontiers in physiology · 2025Article
- Review
- Estimating the Impact of Rurality in Disparities in Cancer Mortality.JCO oncology practice · 2024Article
- Comparison of US Oncologist Rurality by Practice Setting and Patients Served.JAMA network open · 2024Article
- Epidemiology of childhood acute leukemias in marginalized populations of the central-south region of Mexico: results from a population-based registry.Frontiers in oncology · 2024Article
- Implementation studio: implementation support program to build the capacity of rural community health educators serving immigrant communities to implement evidence-based cancer prevention and control interventions.Cancer causes & control : CCC · 2023Article
- Reduction in the diagnostic interval after the introduction of cancer patient pathways for colorectal cancer in northern Sweden.Scandinavian journal of primary health care · 2023Article
- Textbook outcome contributes to long-term prognosis in elderly colorectal cancer patients.Langenbeck's archives of surgery · 2023Article
- Does race influence the attainment of the principles of oncologic surgical resection in colon adenocarcinoma? A retrospective cohort analysis from the national cancer database.Annals of medicine and surgery (2012) · 2023Article
- Rural-Urban Disparities in Patient Care Experiences among Prostate Cancer Survivors: A SEER-CAHPS Study.Cancers · 2023Article
Corrections and comments
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Authors and funding
8 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundMore than 50 million people reside in rural America. However, the impact of patient rurality on colon cancer care has been incompletely characterized, despite its known impact on screening.
objectiveOur study sought to examine the impact of patient rurality on quality and comprehensive colon cancer care.
designWe constructed a retrospective cohort of 123,129 patients with stage 0 to IV colon cancer. Rural residence was established based on the patient medical service study area designated by the registry. SETTINGS: The study was conducted using the 1996-2008 California Cancer Registry. PATIENTS: All of the patients diagnosed between 1996 and 2008 with tumors located in the colon were eligible for inclusion in this study.
main outcome measuresBaseline characteristics were compared by rurality status. Multivariate regression models then were used to examine the impact of rurality on stage in the entire cohort, adequate lymphadenectomy in stage I to III disease, and receipt of chemotherapy for stage III disease. Proportional-hazards regression was used to examine the impact of rurality on cancer-specific survival.
resultsOf all of the patients diagnosed with colon cancer, 18,735 (15%) resided in rural areas. Our multivariate models demonstrate that rurality was associated with later stage of diagnosis, inadequate lymphadenectomy in stage I to III disease, and lower likelihood of receiving chemotherapy for stage III disease. In addition, rurality was associated with worse cancer-specific survival. LIMITATIONS: We could not account for socioeconomic status directly, although we used insurance status as a surrogate. Furthermore, we did not have access to treatment location or distance traveled. We also could not account for provider or hospital case volume, patient comorbidities, or complications.
conclusionsA significant portion of patients treated for colon cancer live in rural areas. Yet, rural residence is associated with modest differences in stage, adherence to quality measures, and survival. Future endeavors should help improve care to this vulnerable population (see video, Supplemental Digital Content 1, http://links.lww.com/DCR/A143).
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