Rural Colon Cancer Patients Fare Worse

Study shows they are diagnosed later and get fewer treatments than urban patients

By Robert Preidt

Wednesday, October 3, 2012

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WEDNESDAY, Oct. 3 (HealthDay News) -- Colon cancer patients in rural areas of the United States are more likely to die than those in cities, a new study reports.
The study also found that rural patients with colon cancer tend to be diagnosed at a later stage and are less likely to receive chemotherapy or thorough surgical treatment.
Surgeons at the University of Minnesota and the Minneapolis Veterans Affairs Medical Center analyzed data from more than 123,000 patients in the California Cancer Registry who were diagnosed with colon cancer between 1996 and 2008. About 15 percent of the patients lived in rural areas.
Rural patients were 4 percent more likely than urban patients to be diagnosed with stage 3 or 4 cancer, the study found. Rural patients with stages 1 to 3 colon cancer were 18 percent less likely than urban patients to have an adequate number of lymph nodes removed during colon cancer surgery.
Inadequate lymph node removal can be a sign of a lower-quality cancer care team, according to the researchers.
They also found that rural patients with stage 3 colon cancer were 17 percent less likely than urban patients to receive chemotherapy, and were 5 percent more likely to die from cancer.
The study is scheduled for presentation Wednesday at the American College of Surgeons' Annual Clinical Congress in Chicago.
"These findings do not mean that if you're a rural patient and you've been diagnosed with colon cancer that you should move," study author Dr. Christopher Chow, a general surgery resident at the University of Minnesota, said in an ACS news release. "What they mean is that we as surgeons who treat both rural and urban patients need to start targeting rural patients to ensure that they receive care that is as high quality as urban patients."
The findings also show that further research is needed to determine the reasons for the differences in rural and urban colon cancer patient care, the researchers said.
"Future studies have to look at the reasons why," Chow said. "Are rural patients not traveling and missing appointments, or are they missing appointments because they are traveling? We have to address the underlying reasons, since we know from the start that these patients tend to fare worse."
Data and conclusions presented at meetings should be viewed as preliminary until published in a peer-reviewed medical journal.

SOURCE: American College of Surgeons, news release, Oct. 3, 2012

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