Does patient rurality predict quality colon cancer care?: A population-based study

Diseases of the Colon and Rectum
Christopher J ChowElizabeth B Habermann

Abstract

More than 50 million people reside in rural America. However, the impact of patient rurality on colon cancer care has been incompletely characterized, despite its known impact on screening. Our study sought to examine the impact of patient rurality on quality and comprehensive colon cancer care. We constructed a retrospective cohort of 123,129 patients with stage 0 to IV colon cancer. Rural residence was established based on the patient medical service study area designated by the registry. The study was conducted using the 1996-2008 California Cancer Registry. All of the patients diagnosed between 1996 and 2008 with tumors located in the colon were eligible for inclusion in this study. Baseline characteristics were compared by rurality status. Multivariate regression models then were used to examine the impact of rurality on stage in the entire cohort, adequate lymphadenectomy in stage I to III disease, and receipt of chemotherapy for stage III disease. Proportional-hazards regression was used to examine the impact of rurality on cancer-specific survival. Of all of the patients diagnosed with colon cancer, 18,735 (15%) resided in rural areas. Our multivariate models demonstrate that rurality was associated with later stage of ...Continue Reading

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Citations

Mar 19, 2016·The Journal of Rural Health : Official Journal of the American Rural Health Association and the National Rural Health Care Association·Yan Lin, Michael C Wimberly
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