Differences in travel time to cancer surgery for colon versus rectal cancer in a rural state: A new method for analyzing time-to-place data using survival analysis

Details

• Alternative Title:
  J Rural Health
• Personal Author:
  Matthews, Kevin A. ; Kahl, Amanda R. ; Gaglioti, Anne H. ; Charlton, Mary E.
• Description:
  Introduction:
  
  Rectal cancer is rarer than colon cancer and is a technically more difficult tumor for surgeons to remove. Thus, rectal cancer patients may travel longer amounts of time for specialized treatment compared to colon cancer patients.
  
  Methods:
  
  A secondary data analysis of colorectal cancer (CRC) incidence data from the Iowa Cancer Registry data was conducted. Travel times along a street network from all residential ZIP codes to all cancer surgery facilities were calculated using a geographic information system. A new method for analyzing “time-to-place” data using the same type of survival analysis method commonly used to analyze “time-to-event” data is introduced. Cox proportional hazard model was used to analyze travel time differences for colon versus rectal cancer patients.
  
  Results:
  
  5,844 CRC patients met inclusion criteria. Median travel time to the nearest surgical facility was 9 minutes, median travel time to the actual cancer surgery facilities was 22 minutes, and the median number of facilities bypassed was 3 facilities. While travel times to the nearest surgery facility were not significantly different for colon versus rectal cancer patients, rectal cancer patients traveled 15 minutes longer to their actual surgery facility and bypassed 2 more facilities to obtain surgery.
  
  Discussion:
  
  In general, the survival analysis method used to analyze the time-to-place data as described here could be applied to a wide variety of health services and be used to compare travel patterns among different groups.
  
  
• Subjects:
  Article Colon Colorectal Cancer Health Services Health Services Accessibility Humans Rectal Neoplasms Surgery Survival Analysis Travel Travel Time

  More +
• Source:
  J Rural Health. 36(4):506-516
• Pubmed ID:
  32501619
• Pubmed Central ID:
  PMC7553200
• Document Type:
  Journal Article
• Funding:
  CC999999/ImCDC/Intramural CDC HHSUnited States/ ; U54 MD008173/MD/NIMHD NIH HHSUnited States/ ; HHSN261201800012I/HHSN26100001/CA/NCI NIH HHSUnited States/
• Volume:
  36
• Issue:
  4
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:355ca67d0638dc71e4ae3226fc65b8eee5c6d5a5ddcb4c1dda1f2085a6e0ae51
• Download URL:
  https://stacks.cdc.gov/view/cdc/95635/cdc_95635_DS1.pdf
• File Type:
  [PDF - 969.36 KB ]