ArticleThe Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association2025
Travel burden and bypassing closest site for surgical cancer treatment for urban and rural oncology patients.
Article in The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed.
- Factors associated with long-distance travel among patients undergoing radical prostatectomy at a German high-volume tertiary prostate cancer centre.World journal of urology · 2026Article
- Patient Preferences for Cancer Care Within Hub-and-Spoke Networks: A Discrete Choice Experiment.Journal of the American College of Surgeons · 2026Article
- Comparing Trends in Telemedicine Use and Geographic Disparities in Utilization Among Patients With Cancer in the United States.JCO oncology practice · 2026Article
- Geographic access as a modifiable determinant of cancer care: perspectives on hub-and-spoke oncology networks, travel burden and time toxicity.Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2026Review
- Outcomes Among Medicare Beneficiaries After Cancer Surgery in Hospitals That Subsequently Closed.JAMA network open · 2026Article
- Travel burden and bypassing closest site for surgical cancer treatment for urban and rural oncology patients.The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association · 2025Article
Corrections and comments
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Authors and funding
11 authors.
Funding
Abstract
purposeWe examined the relationship between travel burden for surgical cancer care and rurality, geographic bypass of the nearest surgical facility, cancer type, and mortality outcomes.
methodsUsing Medicare claims and enrollment data (2016-2018) from beneficiaries with cancer of the colon, rectum, lung, or pancreas, we measured travel times to: the nearest surgical facility and facility used. For those who bypassed the nearest, we examined travel time and rurality in relation to surgical rates. Using multivariable regression modeling, we estimated associations of bypass with 90-day postoperative- and one-year mortality; rurality was examined as an effect modifier.
findingsAmong 211,025 beneficiaries with cancer, 25.5% resided in non-metropolitan areas. About 66% of metropolitan/micropolitan, and 78% of small town/rural patients bypassed their closest facility. Increasing rurality was significantly associated with increased likelihood of bypass (Referent = metropolitan, OR; 95%CI: micropolitan 1.10; 1.04-1.16, small town/rural 2.08; 1.96-2.20. Bypassing the nearest facility was associated with decreased likelihood of both 90-day postoperative mortality (OR = 0.79; 95%CI 0.74-0.85) and 1-year mortality (OR = 0.81; 95%CI 0.77-0.86). The greatest decrement in 1-year mortality was for pancreatic cancer across all rural-urban categories (OR; 95%CI: metropolitan 0.63; 0.53-0.76; micropolitan 0.53; 0.29-0.97); small town/rural 0.46; 0.25-0.86).
conclusionsMost Medicare beneficiaries with lung, colon, rectal, or pancreatic cancer bypassed the closest facility providing surgical cancer care, especially rural patients. Bypassing was associated with a lower likelihood of 90-day postoperative, and 1-year mortality. Understanding determinants of bypassing, particularly among rural patients, may reveal potential mechanisms to improve cancer outcomes and reduce rural cancer disparities.
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