Evidence map›Paper›PMID 39966272›Full record

ArticleAnnals of surgical oncology2025

Patterns of Referral for Common Cancer Surgery in the United States.

Kelsey B Montgomery, Elizabeth Ross, Chimaraije Amu-Nnadi, Smita Bhatia, Kristy K Broman

Abstract read
In one paragraph

Article in Annals of surgical oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing 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

4 citing papers in PubMed.

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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

5 authors.

Kelsey B MontgomeryDepartment of Surgery, University of Alabama at Birmingham, Birmingham, AL, USA. kmontgomery@uabmc.edu.ORCID http://orcid.org/0000-0002-1284-1830
Elizabeth RossInstitute for Cancer Outcomes and Survivorship, University of Alabama at Birmingham, Birmingham, AL, USA.
Chimaraije Amu-NnadiRutgers University, New Brunswick, NJ, USA.
Smita BhatiaInstitute for Cancer Outcomes and Survivorship, University of Alabama at Birmingham, Birmingham, AL, USA.
Kristy K BromanDepartment of Surgery, University of Alabama at Birmingham, Birmingham, AL, USA.

Funding

DEEP SOUTH TRANSLATIONAL RESEARCH MENTORED CAREER DEVELOPMENT PROGRAMKL2TR003097 · NCATS · UNIVERSITY OF ALABAMA AT BIRMINGHAM · PI SAAG, KENNETH G · 2019 to 2023
$5.2M
Leveraging Health Systems to Increase Implementation of Evidence-Based Surgical Cancer CareK08CA283001 · NCI · UNIVERSITY OF TX MD ANDERSON CAN CTR · PI BROMAN, KRISTY KUMMEROW · 2023 to 2025
$592k
AHRQ HHS T32 HS013852NCATS NIH HHS KL2 TR003097NCI NIH HHS 1K08CA283001NCI NIH HHS K08 CA283001
6 · The paper itself

Abstract

backgroundShifts in healthcare delivery have resulted in most U.S. hospitals participating in integrated health systems, many of which selectively refer complex cancer surgery to high-volume centers. However, this centralization may exacerbate barriers to access and may not be necessary for all cancer types. This study describes the prevalence and pattern of referral for surgery for common cancers and evaluate associated factors.

methodsThe National Cancer Database was used to identify adult patients who underwent curative-intent surgical resection between 2010 and 2020 for 12 common cancers (bladder, breast, colon, kidney, lung, melanoma, oral cavity, pancreas, prostate, rectum, thyroid, and uterus). The primary outcome was receipt of referred surgical cancer care.

resultsOverall, 5,406,813 patients underwent surgical resection for common cancers, with 33.7% referred for surgery after diagnosis elsewhere. Rates of referred surgery varied by disease site, ranging from 13.7% (bladder) to 58.2% (melanoma). On multivariable analysis, patients with melanoma, oral cavity, prostate, rectal, and uterine cancers (referent = breast), higher clinical stages, and increasing year of diagnosis had higher adjusted odds of referred surgical care. Nonacademic facility types, lower facility volume, higher comorbidity burden, and nonprivate insurance were associated with reduced odds of referred surgical care.

conclusionsLikelihood of referred surgical cancer care increased over time for 11 of 12 common cancers, with the prevalence of referred care varying significantly based on disease site and sociodemographic factors. Future work evaluating associated clinical outcomes will aid in decisions regarding allocation of referral of surgical cancer care within health systems.

Indexed as

NeoplasmsReferral and ConsultationAdultAgedFemaleFollow-Up StudiesHumansMaleMiddle AgedPrognosisUnited StatesCancer care deliveryCancer hospitalsCentralizationReferral careSurgical cancer care

Identifiers

PMID39966272
PMCPMC11976353

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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.