ArticleThe Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association2016
Is Travel Time to Colonoscopy Associated With Late-Stage Colorectal Cancer Among Medicare Beneficiaries in Iowa?
Article in The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
20 citing papers in PubMed, 1 synthesis or guideline pooled it, 25 citations in OpenAlex.
- The Impact of Travel Distance on Cancer Stage at Diagnosis for Cancer: A Systematic Review.International journal of environmental research and public health · 2025Pooled it
- Rural-Urban and Appalachian Disparities in Geographic Access to Colonoscopy and Screening Prevalence Across the Contiguous US.Preventing chronic disease · 2026Article
- Transportation-related factors, cancer screening, and stage at diagnosis: A scoping review.PloS one · 2026Article
- Association of distance to diagnosis and area-based social measures with stage at diagnosis among Iowans with HPV-related cancers.Cancer causes & control : CCC · 2025Article
- Association of Distance to Diagnosis and Area-Based Social Measures with Stage at Diagnosis among Iowans with HPV-Related Cancers.Journal of registry management · 2025Article
- Geographic Accessibility and Completion of Initial Low-Dose CT-Based Lung Cancer Screening in an Urban Safety-Net Population.Journal of the National Comprehensive Cancer Network : JNCCN · 2024Article
- Examining the roles of travel distance, medical mistrust, and cancer fatalism in the uptake of clinical cancer prevention among women in rural and urban US communities: A secondary data analysis.Preventive medicine reports · 2024Article
- The Impact of Commission on Cancer Accreditation Status, Hospital Rurality and Hospital Size on Quality Measure Performance Rates.Annals of surgical oncology · 2022Observational
- The impact of patient travel time on disparities in treatment for early stage lung cancer in California.PloS one · 2022Article
- Residential history in cancer research: Utility of the annual billing ZIP code in the SEER-Medicare database and mobility among older women with breast cancer in the United States.SSM - population health · 2021Article
- Spatial accessibility to colonoscopy and its role in predicting late-stage colorectal cancer.Health services research · 2021Article
- Lung Cancer Staging at Diagnosis in the Veterans Health Administration: Is Rurality an Influencing Factor? A Cross-Sectional Study.The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association · 2020Article
- Differences in Travel Time to Cancer Surgery for Colon versus Rectal Cancer in a Rural State: A New Method for Analyzing Time-to-Place Data Using Survival Analysis.The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association · 2020Article
- Updated Overview of the SEER-Medicare Data: Enhanced Content and Applications.Journal of the National Cancer Institute. Monographs · 2020Review
- The Outcome of Unscreened Population in Colorectal Cancer: The Impact of Sex and Other Determinants on Cancer Stage.Cancer management and research · 2020Article
- The impact of travel time on colorectal cancer stage at diagnosis in a privately insured population.BMC health services research · 2019Article
- Using spatially adaptive floating catchments to measure the geographic availability of a health care service: Pulmonary rehabilitation in the southeastern United States.Health & place · 2019Article
- Quality of Colonoscopy Performed in Rural Practice: Experience From the Clinical Outcomes Research Initiative and the Oregon Rural Practice-Based Research Network.The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association · 2018Article
- Geographic and population-level disparities in colorectal cancer testing: A multilevel analysis of Medicaid and commercial claims data.Preventive medicine · 2017Article
- Exploring Big Data in Hematological Malignancies: Challenges and Opportunities.Current hematologic malignancy reports · 2016Review
Corrections and comments
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Authors and funding
7 authors at 1 institution in 1 country.
Funding
Abstract
backgroundColorectal cancer (CRC) screening has been shown to decrease the incidence of late-stage colorectal cancer, yet a substantial proportion of Americans do not receive screening. Those in rural areas may face barriers to colonoscopy services based on travel time, and previous studies have demonstrated lower screening among rural residents. Our purpose was to assess factors associated with late-stage CRC, and specifically to determine if longer travel time to colonoscopy was associated with late-stage CRC among an insured population in Iowa.
methodsSEER-Medicare data were used to identify individuals ages 65 to 84 years old diagnosed with CRC in Iowa from 2002 to 2009. The distance between the centroid of the ZIP code of residence and the ZIP code of colonoscopy was computed for each individual who had continuous Medicare fee-for-service coverage for a 3- to 4-month period prior to diagnosis, and a professional claim for colonoscopy within that time frame. Demographic characteristics and travel times were compared between those diagnosed with early- versus late-stage CRC. Also, demographic differences between those who had colonoscopy claims identified within 3-4 months prior to diagnosis (81%) were compared to patients with no colonoscopy claims identified (19%).
resultsA total of 5,792 subjects met inclusion criteria; 31% were diagnosed with early-stage versus 69% with late-stage CRC. Those divorced or widowed (vs married) were more likely to be diagnosed with late-stage CRC (OR: 1.20, 95% CI: 1.06-1.37). Travel time was not associated with diagnosis of late-stage CRC. DISCUSSION: Among a Medicare-insured population, there was no relationship between travel time to colonoscopy and disease stage at diagnosis. It is likely that factors other than distance to colonoscopy present more pertinent barriers to screening in this insured population. Additional research should be done to determine reasons for nonadherence to screening among those with access to CRC screening services, given that over two-thirds of these insured individuals were diagnosed with late-stage CRC.
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Registered trials
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