A new study by researchers at the University of Louisville, published this week in the Journal of the American College of Surgeons, examined the perioperative outcomes of rural-dwelling patients undergoing lung and colon cancer surgeries in a rural facility ... and found no significant differences, save for a lot less travel to access the care.
Acknowledging that cancer patients in rural areas often encounter significant barriers to accessing cancer care, the study evaluated whether Medicare-aged patients can safely undergo lung and colon cancer surgery at their local rural hospital in order to limit their travel burden.
Using SEER-Medicare files, patients with stage I-III colon and lung cancers were identified, with patients and facilities residing in ZIP codes defined as rural. The researchers then compared patients undergoing elective colon or lung cancer surgery at rural and urban facilities. Unadjusted and risk-adjusted complication and mortality rates were compared using multivariate logistic regression, while driving distances between patients’ residences and their surgery facilities were calculated based on ZIP codes.
The study identified 10,383 rural colon cancer patients and 6,006 rural lung cancer patients and found “no clinically significant differences between rural and urban treatment in either colon or lung cohorts in terms of demographics or cancer stage.” Comorbidity risks, mortality and complication rates were comparable across urban and rural facilities, while travel distance was significantly greater for patients treated at urban facilities.
The researchers concluded that “rural patients can achieve comparable short-term surgical outcomes for lung and colon cancer when treated at local rural facilities, decreasing the travel burden of treatment at higher volume urban facilities."
