ASO Author Reflections: Centralization of High-Risk Cancer Surgery and Implications for Vulnerable Communities

Excerpt

In an effort to improve perioperative and oncologic outcomes, there has been extensive centralization of complex cancer surgery over the past decade.1 High-volume surgical centers have lower morbidity and mortality compared with low-volume centers, especially among patients undergoing more complex and high-risk cancer-related surgical procedures.2 However, high-volume centers are often located in urban areas, which may hinder access to high-quality surgical care for certain patients. Furthermore, centralizing complex surgical procedures to high-volume centers has the potential to create a significant barrier of increased travel burden on potentially vulnerable populations.3 There has been recent emphasis on utilizing publicly available census data to identify disadvantaged neighborhoods. The theory is that neighborhood context directly affects safety, education, health behaviors, and stress levels. To this point, individuals living in areas with greater deprivation and rurality have lower reported rates of recommended cancer screening.4 As high-risk cancer surgery continues to become more centralized, it is important to understand the association of patient neighborhood characteristics with access to surgical care. As such, the objective of the current study was to assess the association utilization of high-volume hospitals and social vulnerability among patients who underwent a high-risk cancer operation.5 …