ArticleAnnals of surgical oncology2026
Rurality and Use of Metastasis-Directed Therapies for Medicare Beneficiaries with Metastatic Colon Cancer: A Retrospective Cohort Study.
Article in Annals of surgical oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
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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.
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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.
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Who cites it
1 citing paper in PubMed.
- Colorectal Cancer Care Delivery in Rural and Socioeconomically Deprived Areas of Maine.Journal of Maine Medical Center · 2026Article
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Authors and funding
8 authors.
Funding
Abstract
backgroundLiver- and lung-directed local therapies can eradicate metastatic disease and prolong survival for selected patients with oligometastatic colon cancer. Evidence about the association of rurality with access to metastasis-directed therapies and survival outcomes is limited.
methodsA retrospective study analyzed fee-for-service Medicare beneficiaries with colon cancer metastatic to liver and/or lung using claims from 2016-2019. The exposure of interest was residential rurality, categorized as metropolitan versus non-metropolitan (i.e., rural). The study evaluated the association of rurality with use of metastasis-directed therapies (surgery, stereotactic radiation, and ablation) via multivariable logistic regression. Survival analyses used proportional hazards regression and treated receipt of metastasis-directed therapy as a time-varying covariate.
resultsThe study identified 11,796 beneficiaries with colon cancer metastatic to liver and/or lung, 26.6% of whom lived in rural areas. Overall, 7.3% of the beneficiaries received any metastasis-directed therapy. Rural residence was not significantly associated with metastasis-directed therapy (adjusted odds ratio [OR], 1.11; 95% confidence interval [CI], 0.93-1.31). However, Medicare-Medicaid dual eligibility and greater area deprivation were significantly associated with lower odds of metastasis-directed therapy. Metastasis-directed therapy was associated with a decreased hazard of death (adjusted hazard ratio [HR], 0.41 for beneficiaries receiving metastasis-directed therapy within 90 days after cancer diagnosis; 95% CI, 0.35-0.49). Rural residence was not independently associated with mortality (adjusted HR, 1.00; 95% CI, 0.96-1.06).
conclusionsMetastasis-directed therapy was associated with decreased mortality from metastatic colon cancer. Medicare-Medicaid dual eligibility and greater area deprivation both were associated with lower use of metastasis-directed therapy, but residential rurality was not. New care delivery approaches are needed to extend equitable access to metastasis-directed therapies.
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