ArticleJournal of surgical oncology2025
Are Access Costs and Income Associated With Treatment Decision-Making and Clinical Outcomes in Rural Patients Presenting With Upper Gastrointestinal Malignancy?
Article in Journal of surgical oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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.
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.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
Abstract
BACKGROUND AND OBJECTIVE(S): Few studies evaluate the price elasticity of demand or the relationships between costs of access, patient income, treatment decision making and outcome in rural patients with upper gastrointestinal malignancy.
methodsWe queried the National Cancer Database to identify rural patients presenting with clinical stages I-III esophagus, stomach, pancreas, hepatocellular (HCC) and cholangiocarcinoma between 2004 and 2020. Access cost was defined as (distance to treating center) × (regional gas price)/(regional vehicle fuel efficiency). Patients within the highest (HAC) and lowest (LAC) cost quintiles were selected for analysis. These were subcategorized based on income quartile: High income/High Access Cost (HI/HAC), High Income/Low Access Cost (HI/LAC), Low Income/High Access Cost (LI/HAC), Low Income/Low Access Cost (LI/LAC).
resultsA total of 9582 patients met inclusion criteria. Median access cost was $26.61 (IQR: [$10.57-$73.70]). Patients in the HI/HAC cohort were more likely to undergo treatment at academic centers (79.5%, HI/HAC, 49.6%, HI/LAC, 78.5%, LI/HAC, 38.0%, LI/LAC), undergo neoadjuvant chemotherapy (23.8%, 12.6%, 17.7%, 10.4%) undergo surgery (46.6%, 29.6%, 39.7%, 20.8%), undergo liver transplantation for HCC (30.2%, 5.86%, 18.1%, 2.04%) and demonstrated higher rates of 5-year overall survival (42.4%, 25.6%, 32.2%, 19.0%) than those with HI/LAC, LI/HAC, and LI/LAC cohorts (all p < 0.01).
conclusionsAmong rural patients undergoing treatment for upper gastrointestinal malignancy elasticity of demand for service varies. Patients willing and able to pay for travel are more likely to receive neoadjuvant chemotherapy, undergo resection and demonstrate improved overall survival.
Indexed as
Identifiers
What OpenQuestion holds
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.