ArticleHealth services research2021
Spatial accessibility to colonoscopy and its role in predicting late-stage colorectal cancer.
Article in Health services research, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.
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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
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Who cites it
10 citing papers in PubMed, 1 synthesis or guideline pooled it, 19 citations in OpenAlex.
- Gravity models for potential spatial healthcare access measurement: a systematic methodological review.International journal of health geographics · 2023Pooled it
- Rural-Urban and Appalachian Disparities in Geographic Access to Colonoscopy and Screening Prevalence Across the Contiguous US.Preventing chronic disease · 2026Article
- Application of Spatial Methods in Rural Cancer Control Research in the United States.Current epidemiology reports · 2026Review
- Quantifying the primary care workforce in the U.S.: A validation study with and without an imperfectly measured referent standard.Annals of epidemiology · 2025Article
- Spatiotemporal trends and geographic disparities in spatial accessibility to maternal and child health services in Nanning, China: impact of two-child policies.BMC health services research · 2024Article
- Comprehensive analysis of the potential role and prognostic value of sine oculis homeobox homolog family in colorectal cancer.World journal of gastrointestinal oncology · 2022Article
- Potential of six-transmembrane epithelial antigen of the prostate 4 as a prognostic marker for colorectal cancer.World journal of gastrointestinal oncology · 2022Article
- Geographic determinants of colorectal cancer in Louisiana.Cancer causes & control : CCC · 2022Article
- Diverse expression patterns of mucin 2 in colorectal cancer indicates its mechanism related to the intestinal mucosal barrier.World journal of gastroenterology · 2021Article
- Spatial accessibility to colonoscopy and its role in predicting late-stage colorectal cancer.Health services research · 2021Article
Corrections and comments
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Authors and funding
4 authors at 2 institutions in 1 country.
Funding
Abstract
objectiveTo better determine the relationship between spatial access to colonoscopy and colorectal cancer (CRC) outcomes, our objective was to examine the agreement of the classic, enhanced, and variable two-step floating catchment area (2SFCA) methods in evaluating spatial access to colonoscopy and to compare the predictive validity of each method related to late-stage CRC. 2SFCA methods simultaneously consider supply/demand of services and impedance (ie, travel time). DATA SOURCES: Colonoscopy provider locations were obtained from the South Carolina Ambulatory Surgery Database. ZIP code tabulation area (ZCTA) level population estimates and area-level poverty level were obtained from the American Community Survey. Rurality was determined by the United States Department of Agriculture's Rural-Urban Commuting Area codes. Individual-level CRC data were obtained from the South Carolina Central Cancer Registry. STUDY
designUsing the classic, enhanced, and variable 2SFCA methods, we calculated ZCTA-level spatial access to colonoscopy. We assessed agreement between the three methods by calculating Spearman's rank coefficients and weighted Kappas (Κ). Global and Local Moran's I were used to assess spatial clustering of accessibility scores across 2SFCA methods. We performed multilevel logistic regression analyses to examine the association between spatial accessibility to colonoscopy, area- and individual-level factors, and late-stage CRC. PRINCIPAL
findingsWe found strong agreement (Weighted Κ = 0.82; 95% CI = 0.79-0.86) and identified similar clustering patterns with the classic and enhanced 2SFCA methods. There was negligible agreement among the classic/enhanced 2SFCA and the variable 2SFCA. Across all 2SFCA methods, regression models showed that spatial access to colonoscopy, rurality, and poverty level were not associated with greater odds of late-stage CRC, though Black race was associated with late-stage CRC across all models.
conclusionsNone of the 2SFCA methods showed an association with late-stage CRC. Future studies should explore which elements (spatial or nonspatial) of access to care have the greatest impact on CRC outcomes.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.