Evidence map›Paper›PMID 38047230›Full record

ArticleAdvances in radiation oncology

The Association of Rural Residence With Surgery and Adjuvant Radiation in Medicare Beneficiaries With Rectal Cancer.

Sybil T Sha, Benjamin Usadi, Qianfei Wang, Marisa Tomaino, Gabriel A Brooks, Andrew P Loehrer, Sandra L Wong, Anna N A Tosteson, Carrie H Colla, Nirav S Kapadia

Abstract read
In one paragraph

Article in Advances in radiation oncology. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–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

1 citing paper in PubMed.

  1. Review
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

10 authors.

Sybil T ShaGeisel School of Medicine at Dartmouth, Hanover, New Hampshire.
Benjamin UsadiGeisel School of Medicine at Dartmouth, Hanover, New Hampshire.
Qianfei WangGeisel School of Medicine at Dartmouth, Hanover, New Hampshire.
Marisa TomainoGeisel School of Medicine at Dartmouth, Hanover, New Hampshire.
Gabriel A BrooksGeisel School of Medicine at Dartmouth, Hanover, New Hampshire.
Andrew P LoehrerGeisel School of Medicine at Dartmouth, Hanover, New Hampshire.
Sandra L WongGeisel School of Medicine at Dartmouth, Hanover, New Hampshire.
Anna N A TostesonGeisel School of Medicine at Dartmouth, Hanover, New Hampshire.
Carrie H CollaGeisel School of Medicine at Dartmouth, Hanover, New Hampshire.
Nirav S KapadiaGeisel School of Medicine at Dartmouth, Hanover, New Hampshire.

Funding

Disparities in access to and outcomes of cancer surgery for rural Medicare patientsR01CA248470 · NCI · DARTMOUTH COLLEGE · PI TOSTESON, ANNA N. A., WONG, SANDRA L · 2021 to 2023
$1.9M
NCI NIH HHS R01 CA248470
6 · The paper itself

Abstract

Purpose: Radiation therapy and surgery are fundamental site-directed therapies for nonmetastatic rectal cancer. To understand the relationship between rurality and access to specialized care, we characterized the association of rural patient residence with receipt of surgery and radiation therapy among Medicare beneficiaries with rectal cancer. Methods and Materials: We identified fee-for-service Medicare beneficiaries aged 65 years or older diagnosed with nonmetastatic rectal cancer from 2016 to 2018. Beneficiary place of residence was assigned to one of 3 geographic categories (metropolitan, micropolitan, or small town/rural) based on census tract and corresponding rural urban commuting area codes. Multivariable regression models were used to determine associations between levels of rurality and receipt of both radiation and proctectomy within 180 days of diagnosis. In addition, we explored associations between patient rurality and characteristics of surgery and radiation such as minimally invasive surgery (MIS) or intensity modulated radiation therapy (IMRT). Results: Among 13,454 Medicare beneficiaries with nonmetastatic rectal cancer, 3926 (29.2%) underwent proctectomy within 180 days of being diagnosed with rectal cancer, and 1792 (13.3%) received both radiation and proctectomy. Small town/rural residence was associated with an increased likelihood of receiving both radiation and proctectomy within 180 days of diagnosis (adjusted subhazard ratio, 1.15; 95% CI, 1.02-1.30). Furthermore, small town/rural radiation patients were significantly less likely to receive IMRT (adjusted odds ratio, 0.62; 95% CI, 0.48-0.80) or MIS (adjusted odds ratio, 0.80; 95% CI, 0.66-0.97) than metropolitan patients. Conclusions: Although small town/rural Medicare beneficiaries were overall more likely to receive both radiation and proctectomy for their rectal cancer, they were less likely to receive preoperative IMRT or MIS as part of their treatment regimen. Together, these findings clarify that among Medicare beneficiaries, there appeared to be a similar utilization of radiation resources and time to radiation treatment regardless of rural/urban status.

Identifiers

PMID38047230
PMCPMC10692300

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

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.