Evidence map›Paper›PMID 33550518›Full record

ArticleGastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association2021

Geographic impact on access to care and survival for non-curative esophagogastric cancer: a population-based study.

Elliott K Yee, Natalie G Coburn, Victoria Zuk, Laura E Davis, Alyson L Mahar, Ying Liu, Vaibhav Gupta, Gail Darling, Julie Hallet

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In one paragraph

Article in Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
14citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

14 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. The Impact of Travel Distance on Cancer Stage at Diagnosis for Cancer: A Systematic Review.International journal of environmental research and public health · 2025
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  6. Changes in driving distance to specialist physicians in the era of virtual care: a population-based cohort study in Ontario, Canada.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2025
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Elliott K YeeFaculty of Medicine, University of Toronto, Toronto, ON, Canada.
Natalie G CoburnCancer Program, Evaluative Clinical Sciences, Sunnybrook Research Institute, 2075 Bayview Avenue, Toronto, ON, M4N 3M5, Canada.
Victoria ZukCancer Program, Evaluative Clinical Sciences, Sunnybrook Research Institute, 2075 Bayview Avenue, Toronto, ON, M4N 3M5, Canada.
Laura E DavisDepartment of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada.
Alyson L MaharDepartment of Community Health Sciences, University of Manitoba, Winnipeg, MB, Canada.
Ying LiuDepartment of Surgery, University of Toronto, Toronto, ON, Canada.
Vaibhav GuptaCancer Program, Evaluative Clinical Sciences, Sunnybrook Research Institute, 2075 Bayview Avenue, Toronto, ON, M4N 3M5, Canada.
Gail DarlingDepartment of Surgery, University of Toronto, Toronto, ON, Canada.
Julie HalletCancer Program, Evaluative Clinical Sciences, Sunnybrook Research Institute, 2075 Bayview Avenue, Toronto, ON, M4N 3M5, Canada. Julie.hallet@sunnybrook.ca.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAmong patients not undergoing curative-intent therapy for esophagogastric cancer, access to care may vary. We examined the geographic distribution of care delivery and survival and their relationship with distance to cancer centres for non-curative esophagogastric cancer, hypothesising that patients living further from cancer centres have worse outcomes.

methodsWe conducted a population-based analysis of adults with non-curative esophagogastric cancer from 2005 to 2017 using linked administrative healthcare datasets in Ontario, Canada. Outcomes were medical oncology consultation, receipt of chemotherapy, and overall survival. Using geographic information system analysis, we mapped locations of cancer centres and outcomes across census divisions. Bivariate choropleth maps identified regional outcome discordances. Multivariable regression models assessed the relationship between distance from patient residence to the nearest cancer centre and outcomes, adjusting for demographic, clinical, and socioeconomic factors.

resultsOf 10,228 patients surviving a median 5.1 months (IQR: 2.0-12.0), 68.5% had medical oncology consultation and 32.2% received chemotherapy. Certain distances (reference ≤ 10 km) were associated with lower consultation [relative risk 0.79 (95% CI 0.63-0.97) for ≥ 101 km], chemotherapy receipt [relative risk 0.67 (95% CI 0.53-0.85) for ≥ 101 km], and overall survival [hazard ratio 1.07 (95% CI 1.02-1.13) for 11-50 km, hazard ratio 1.13 (95% CI 1.04-1.23) for 51-100 km].

conclusionA third of patients did not see medical oncology and most did not receive chemotherapy. Outcomes exhibited high geographic variability. Location of residence influenced outcomes, with inferior outcomes at certain distances > 10 km from cancer centres. These findings are important for designing interventions to reduce access disparities for non-curative esophagogastric cancer care.

Indexed as

AgedAged, 80 and overAntineoplastic AgentsEsophageal NeoplasmsFacilities and Services UtilizationFemaleGeographyHealth Services AccessibilityHumansMaleMedical OncologyMiddle AgedOntarioOutpatient Clinics, HospitalReferral and ConsultationRetrospective StudiesAntineoplastic AgentsCancerEsophagusGeographyOutcomesStomach

Identifiers

PMID33550518

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Registered trials

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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.