Increasing Distance From Treatment Centers Associated With Advanced Stage Colorectal Cancer
Douglas K. Rex, MD, MASGE, reviewing Brand NR, et al. JAMA Netw Open 2022 Sep 1.
In a study of the National Cancer Database, the distance of patients from their medical facility was found to be associated with a risk of presenting with advanced (stage III or IV) colon cancer at initial diagnosis.
Compared with people living within 20.2 km of their treatment center, the odds ratio (OR) for advanced cancer was 1.11 for persons living 20.2 to 80 km from the center, 1.39 for those living 81 to 400 km away, and 1.78 for patients farther than 400 km from the facility. Having no insurance (OR, 1.33) or having only Medicaid (OR, 1.22) was also associated with advanced pathology stage. These findings were evident in all parts of the country except the South Atlantic and Mid-Atlantic states.
COMMENTOther data have shown that factors such as compliance with colonoscopy for a positive fecal blood test are associated with distance from the treating center. This factor could impact survival for CRC as more rural hospitals in the United States close.
Note to readers: At the time we reviewed this paper, its publisher noted that it was not in final form and that subsequent changes might be made.
CITATION(S)
Brand NR, Greenberg AL, Chiou SH, Adam M, Sarin A. Association of distance, region, and insurance with advanced colon cancer at initial diagnosis. JAMA Netw Open 2022;5:e2229954. (https://doi.org/10.1001/jamanetworkopen.2022.29954)
