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International Journal of Colorectal Disease

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Open Access 01-09-2018 | Original Article

Distance to hospital is not a risk factor for emergency colon cancer surgery

Authors: Niillas Blind, Karin Strigård, Ulf Gunnarsson, Fredrik Brännström

Published in: International Journal of Colorectal Disease | Issue 9/2018

Abstract

Purpose

The purpose of this study is to see if the distance to a hospital performing colon cancer surgery is a risk factor for emergency surgical intervention and to determine the variability between defined but demographically divergent catchment areas.

Methods

Data on patients living in Västerbotten County who underwent colon cancer surgery between 2007 and 2010 were extracted from the Swedish Colorectal Cancer Register (SCRCR). Of the 436 registrations matching these criteria, 380 patients were used in the analysis, and their distance to the nearest hospital providing care for colorectal cancer (CRC) was estimated using Google Maps™. The correlations between the risk for emergency surgery and the distance to a hospital, gender, age, income level and hospital catchment area were analysed in uni- and multivariate models.

Results

Distance to the nearest hospital had no significant effect on the proportion of emergency operations for colon cancer. There was significant variability in risk for emergency surgery between hospital catchment areas, where the catchment areas of the university hospital and the most rural hospital had a higher proportion than the other local hospital catchment area (OR, 2.00 (p = 0.038) and OR, 2.97 (p = 0.005)). These results were still significant when analysed with multivariate logistic regression (OR, 2.13 (p = 0.026) and OR, 3.05 (p = 0.013)).

Conclusion

Distance to a hospital performing colon cancer surgery had no effect on the proportion of emergency surgeries. However, a variability between defined catchment areas was seen. Future studies will focus on possible factors behind this variability.

Kodeda K, Nathanaelsson L, Jung B, Olsson H, Jestin P, Sjovall A et al (2013) Population-based data from the Swedish Colon Cancer Registry. Br J Surg 100(8):1100–1107CrossRefPubMed

Oliphant R, Mansouri D, Nicholson G, McMillan D, Horgan P, Morrison D (2014) Emergency presentation of node-negative colorectal cancer treated with curative surgery is associated with poorer short and longer-term survival. Int J Color Dis 29:591–598CrossRef

McArdle CS, Hole DJ (2004) Emergency presentation of colorectal cancer is associated with poor 5-year survival. Br J Surg 91(5):605–609CrossRefPubMed

McArdle CS, McMillan DC, Hole DJ (2006) The impact of blood loss, obstruction and perforation on survival in patients undergoing curative resection for colon cancer. Br J Surg 93:483–488CrossRefPubMed

Jestin P, Nilsson J, Heurgren M, Påhlman L, Glimelius B, Gunnarsson U (2005) Emergency surgery for colonic cancer in a defined population. Br J Surg 92(1):94-100

Mitchell E, Macdonald S, Campbell NC, Weller D, Macleod U (2008) Influences on pre-hospital delay in the diagnosis of colorectal cancer: a systematic review. Br J Cancer 98(1):60–70CrossRefPubMed

Iversen LH, Antonsen S, Laurberg S, Lautrup MD (2009) Therapeutic delay reduces survival of rectal cancer but not of colonic cancer. Br J Surg 96(10):1183–1189CrossRefPubMed

Neal RD, Allgar VL (2005) Sociodemographic factors and delays in the diagnosis of six cancers: analysis of data from the “National Survey of NHS patients: Cancer”. Br J Cancer 92(11):1971–1975CrossRefPubMedPubMedCentral

Gunnarsson H, Ekholm A, Olsson LI (2013) Emergency presentation and socioeconomic status in colon cancer. Eur J Surg Oncol 39(8):831–836CrossRefPubMed

10.

Hansen RP, Olesen F, Sorensen HT, Sokolowski I, Sondergaard J (2008) Socioeconomic patient characteristics predict delay in cancer diagnosis: a Danish cohort study. BMC Health Serv Res 8:49CrossRefPubMedPubMedCentral

11.

Chow CJ, Al-Refaie WB, Abraham A, Markin A, Zhong W, Rothenberger DA et al (2015) Does patient rurality predict quality colon cancer care?: a population-based study. Dis Colon Rectum 58(4):415–422CrossRefPubMedPubMedCentral

12.

SCB Sammanräknad förvärvsinkomst för boende i Sverige den 31/12 resp år (antal personer, medel-och medianinkomst samt totalsumma) efter region, kön, ålder och inkomstklass. År 1991-2015 (n.d.). http://www.statistikdatabasen.scb.se/pxweb/sv/ssd/START__HE__HE0110__HE0110A/SamForvInk2/?rxid=39055bf8-1449-4422-a7dd-81c1ae0b0422

13.

The Swedish Institute (2014) Facts about Sweden: health care. Sweden.se

14.

van Gijn W, Gooiker GA, Wouters MW, Post PN, Tollenaar RA, van de Velde CJ (2010) Volume and outcome in colorectal cancer surgery. Eur J Surg Oncol 36(Suppl 1):S55–S63CrossRefPubMed

15.

Stapley S, Peters TJ, Sharp D, Hamilton W (2006) The mortality of colorectal cancer in relation to the initial symptom at presentation to primary care and to the duration of symptoms: a cohort study using medical records. Br J Cancer 95(10):1321–1325CrossRefPubMedPubMedCentral

16.

Jullumstro E, Lydersen S, Moller B, Dahl O, Edna TH (2009) Duration of symptoms, stage at diagnosis and relative survival in colon and rectal cancer. Eur J Cancer 45(13):2383–2390CrossRefPubMed

17.

Rupassara KS, Ponnusamy S, Withanage N, Milewski PJ (2006) A paradox explained? Patients with delayed diagnosis of symptomatic colorectal cancer have good prognosis. Color Dis 8(5):423–429CrossRef

18.

Massarweh NN, Chiang YJ, Xing Y, Chang GJ, Haynes AB, You YN, Feig BW, Cormier JN (2014) Association between travel distance and metastatic disease at diagnosis among patients with colon cancer. J Clin Oncol 32(9):942–948CrossRefPubMedPubMedCentral

19.

Courtney RJ, Paul CL, Sanson-Fisher RW, Macrae F, Attia J, McEvoy M (2012) Current state of medical-advice-seeking behaviour for symptoms of colorectal cancer: determinants of failure and delay in medical consultation. Color Dis 14(5):e222–e229CrossRef

20.

Olsson L, Bergkvist L, Ekbom A (2009) Symptom duration versus survival in non-emergency colorectal cancer. Scand J Gastroenterol 39(3):252–258CrossRef

21.

Scoggins JF, Fedorenko CR, Donahue SM, Buchwald D, Blough DK, Ramsey SD (2012) Is distance to provider a barrier to care for Medicaid patients with breast, colorectal, or lung cancer? J Rural Health 28(1):54–62CrossRefPubMed

Title: Distance to hospital is not a risk factor for emergency colon cancer surgery
Authors: Niillas Blind
Karin Strigård
Ulf Gunnarsson
Fredrik Brännström
Publication date: 01-09-2018
Publisher: Springer Berlin Heidelberg
Published in: International Journal of Colorectal Disease / Issue 9/2018
Print ISSN: 0179-1958
Electronic ISSN: 1432-1262
DOI: https://doi.org/10.1007/s00384-018-3074-y

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Distance to hospital is not a risk factor for emergency colon cancer surgery

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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