The surgical outcomes of adults with lung or colon cancer treated locally are equal to those who travelled to more distant urban facilities for care, a study shows.
Adults living in rural communities often travel long distances when seeking cancer treatment, but distant travel may not always be necessary to receive high-quality surgical care.
This is according to a new analysis published in the Journal of the American College of Surgeons.
The analysis, focused on adults with colon or lung cancer living in rural communities, found that patients who underwent surgery for their cancer closer to their home had similar outcomes to those who travelled to more distant urban facilities.
The findings provide promising preliminary evidence that complex surgery for certain cancers can be performed safely and with just as good results at smaller community hospitals.
First author Michael E Egger, an associate professor of surgery at the University of Louisville School of Medicine in Louisville, Kentucky, said: ‘Cancer patients in rural areas often have a harder time accessing high-quality, multidisciplinary cancer care. But travelling long distances for surgery is not practical for all patients, nor is it sustainable for high-volume urban facilities already at capacity.
‘To better address health care disparities in rural communities, we wanted to understand where rural cancer patients seek surgical care and whether receiving it locally or farther away affected their outcomes.’
His team analysed the surgical outcomes of 10,383 rural colon cancer patients and 6,006 with lung cancer. Surgical outcomes and 90-day mortality rates were similar in rural and urban facilities: about 5% for lung and 7% for colon cancer. Readmission rates were 10% for lung and 14% for colon. Rural patients travelling to urban centres travelled farther – about 33 more miles and 35 more minutes for colon cancer, and 26 miles and 23 minutes for lung cancer.
Dr Egger cautioned that although some patients in rural communities may still need to travel for cancer treatment, by necessity or preference, this study provides preliminary evidence that complex surgical care can be delivered successfully at local hospitals.
He said: ‘Long travel times and costs associated with travel can be a significant burden for many cancer patients living in rural communities. As hospital systems regionalise care, it will be important to determine which patients can receive care more locally and who may benefit from more centralised care.’
