Rurality and cancer surgery in the United States

Academic Article


  • Background: Rurality adversely impacts the continuum of cancer care. However, investigations of rural cancer surgery are notably absent. We examined patterns and outcomes of oncologic resections at rural US hospitals. Methods: We identified 928,370 hospital admissions in which 1 of 20 oncologic resections was performed using the 1998 to 2009 Nationwide Inpatient Sample. Logistic regression examined predictors of rurality and the adjusted likelihood of in-hospital mortality at rural and urban hospitals. Results: The fraction of procedures performed at rural hospitals decreased from 12% to 6%. Older age, non-Hispanic white race, and fewer comorbidities predicted rurality. Rural hospitals did not have worse mortality, however, rurality significantly augmented mortality among recipients of complex cancer surgery. Conclusions: Rural hospitals had comparable mortality overall, but delivered poorer outcomes for certain groups. Future research should explore these variations as cancer care is increasingly centralized. © 2012 Elsevier Inc. All rights reserved.
  • Published In

    Digital Object Identifier (doi)

    Author List

  • Markin A; Habermann EB; Chow CJ; Zhu Y; Vickers SM; Al-Refaie WB
  • Start Page

  • 569
  • End Page

  • 573
  • Volume

  • 204
  • Issue

  • 5