Analysing the impact of living in a rural setting on the presentation and outcome of colorectal cancer: A prospective single centre observational study
E. MacVicar* (Corresponding Author), D. Ritchie, P. Murchie, C. Parnaby, C. MacKay, G. Ramsay
Centre for Health Data Science
Data Safe Haven
The Rowett Institute of Nutrition and Health
Institute of Medical Sciences
Introduction Approximately 17% of the Scottish population lives in a remote or rural location. Current research is contradictory as to whether living a rural location leads to poorer outcomes or affects survival from colorectal cancer (CRC). We aimed to assess if living in a rural location influences outcome of CRC patients in 21st century UK medicine. Methods A prospective single-centre observational study was conducted. All patients who underwent resection for colorectal cancer 2005–2016 in NHS Grampian were included. Patients were split into two groups for comparison (urban post-code vs rural) using the Scottish government two-tier classification system. Tumour location, one-year survival, lymph node involvement and extra-mural vascular invasion was recorded and compared between the groups. Results Of 2463 patients, 843 (34.2%) lived in a rural area. Rural patients were more likely to be detected through screening (17.4% versus 14.6%, p = 0.04). There were no differences in pathology between rural and urban groups if detected through screening. However, rural patients detected through symptomatic pathways were more likely to be node positive p = 0.015. On multivariable analysis, rurality did not independently predict for node positive presentation. Furthermore, there were no differences in cumulative survival between the two groups. Conclusion Although there were some differences in pathological characteristics between rural and urban patients, place of residence did not independently predict for outcome in this cohort. Rurality had previously been shown to impact on outcome up to 20 years ago. Improvements in infrastructure and rural healthcare may have influenced this change.
https://doi.org/10.1016/j.surge.2020.02.001
Colorectal cancer survival
Single centre
Urban vs rural
10.1016/j.surge.2020.02.001Licence: Unspecified
MacVicar_et_al_TS_AnalysingTheImpactOfLiving_AAM
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Colorectal Neoplasms Medicine & Life Sciences
Observational Studies Medicine & Life Sciences
Medicine Medicine & Life Sciences
Lymph Nodes Medicine & Life Sciences
Pathology Medicine & Life Sciences
MacVicar, E., Ritchie, D., Murchie, P., Parnaby, C., MacKay, C., & Ramsay, G. (2020). Analysing the impact of living in a rural setting on the presentation and outcome of colorectal cancer: A prospective single centre observational study. The Surgeon, 18(6), 354-359. https://doi.org/10.1016/j.surge.2020.02.001
Analysing the impact of living in a rural setting on the presentation and outcome of colorectal cancer : A prospective single centre observational study. / MacVicar, E. (Corresponding Author); Ritchie, D.; Murchie, P.; Parnaby, C.; MacKay, C.; Ramsay, G.
In: The Surgeon, Vol. 18, No. 6, 12.2020, p. 354-359.
MacVicar, E, Ritchie, D, Murchie, P, Parnaby, C, MacKay, C & Ramsay, G 2020, 'Analysing the impact of living in a rural setting on the presentation and outcome of colorectal cancer: A prospective single centre observational study', The Surgeon, vol. 18, no. 6, pp. 354-359. https://doi.org/10.1016/j.surge.2020.02.001
MacVicar E, Ritchie D, Murchie P, Parnaby C, MacKay C, Ramsay G. Analysing the impact of living in a rural setting on the presentation and outcome of colorectal cancer: A prospective single centre observational study. The Surgeon. 2020 Dec;18(6):354-359. https://doi.org/10.1016/j.surge.2020.02.001
MacVicar, E. ; Ritchie, D. ; Murchie, P. ; Parnaby, C. ; MacKay, C. ; Ramsay, G. / Analysing the impact of living in a rural setting on the presentation and outcome of colorectal cancer : A prospective single centre observational study. In: The Surgeon. 2020 ; Vol. 18, No. 6. pp. 354-359.
@article{4e6ce9bf43164ee288b940ff832db3ee,
title = "Analysing the impact of living in a rural setting on the presentation and outcome of colorectal cancer: A prospective single centre observational study",
abstract = "Introduction Approximately 17% of the Scottish population lives in a remote or rural location. Current research is contradictory as to whether living a rural location leads to poorer outcomes or affects survival from colorectal cancer (CRC). We aimed to assess if living in a rural location influences outcome of CRC patients in 21st century UK medicine. Methods A prospective single-centre observational study was conducted. All patients who underwent resection for colorectal cancer 2005–2016 in NHS Grampian were included. Patients were split into two groups for comparison (urban post-code vs rural) using the Scottish government two-tier classification system. Tumour location, one-year survival, lymph node involvement and extra-mural vascular invasion was recorded and compared between the groups. Results Of 2463 patients, 843 (34.2%) lived in a rural area. Rural patients were more likely to be detected through screening (17.4% versus 14.6%, p = 0.04). There were no differences in pathology between rural and urban groups if detected through screening. However, rural patients detected through symptomatic pathways were more likely to be node positive p = 0.015. On multivariable analysis, rurality did not independently predict for node positive presentation. Furthermore, there were no differences in cumulative survival between the two groups. Conclusion Although there were some differences in pathological characteristics between rural and urban patients, place of residence did not independently predict for outcome in this cohort. Rurality had previously been shown to impact on outcome up to 20 years ago. Improvements in infrastructure and rural healthcare may have influenced this change.",
keywords = "Colorectal cancer, Rural, Rurality, Scotland, UK, Urban, Bowel screening, Colorectal cancer survival, Single centre, Observational study, Population, Urban vs rural",
author = "E. MacVicar and D. Ritchie and P. Murchie and C. Parnaby and C. MacKay and G. Ramsay",
doi = "10.1016/j.surge.2020.02.001",
journal = "The Surgeon",
T1 - Analysing the impact of living in a rural setting on the presentation and outcome of colorectal cancer
T2 - A prospective single centre observational study
AU - MacVicar, E.
AU - Ritchie, D.
AU - Murchie, P.
AU - Parnaby, C.
AU - MacKay, C.
AU - Ramsay, G.
N2 - Introduction Approximately 17% of the Scottish population lives in a remote or rural location. Current research is contradictory as to whether living a rural location leads to poorer outcomes or affects survival from colorectal cancer (CRC). We aimed to assess if living in a rural location influences outcome of CRC patients in 21st century UK medicine. Methods A prospective single-centre observational study was conducted. All patients who underwent resection for colorectal cancer 2005–2016 in NHS Grampian were included. Patients were split into two groups for comparison (urban post-code vs rural) using the Scottish government two-tier classification system. Tumour location, one-year survival, lymph node involvement and extra-mural vascular invasion was recorded and compared between the groups. Results Of 2463 patients, 843 (34.2%) lived in a rural area. Rural patients were more likely to be detected through screening (17.4% versus 14.6%, p = 0.04). There were no differences in pathology between rural and urban groups if detected through screening. However, rural patients detected through symptomatic pathways were more likely to be node positive p = 0.015. On multivariable analysis, rurality did not independently predict for node positive presentation. Furthermore, there were no differences in cumulative survival between the two groups. Conclusion Although there were some differences in pathological characteristics between rural and urban patients, place of residence did not independently predict for outcome in this cohort. Rurality had previously been shown to impact on outcome up to 20 years ago. Improvements in infrastructure and rural healthcare may have influenced this change.
AB - Introduction Approximately 17% of the Scottish population lives in a remote or rural location. Current research is contradictory as to whether living a rural location leads to poorer outcomes or affects survival from colorectal cancer (CRC). We aimed to assess if living in a rural location influences outcome of CRC patients in 21st century UK medicine. Methods A prospective single-centre observational study was conducted. All patients who underwent resection for colorectal cancer 2005–2016 in NHS Grampian were included. Patients were split into two groups for comparison (urban post-code vs rural) using the Scottish government two-tier classification system. Tumour location, one-year survival, lymph node involvement and extra-mural vascular invasion was recorded and compared between the groups. Results Of 2463 patients, 843 (34.2%) lived in a rural area. Rural patients were more likely to be detected through screening (17.4% versus 14.6%, p = 0.04). There were no differences in pathology between rural and urban groups if detected through screening. However, rural patients detected through symptomatic pathways were more likely to be node positive p = 0.015. On multivariable analysis, rurality did not independently predict for node positive presentation. Furthermore, there were no differences in cumulative survival between the two groups. Conclusion Although there were some differences in pathological characteristics between rural and urban patients, place of residence did not independently predict for outcome in this cohort. Rurality had previously been shown to impact on outcome up to 20 years ago. Improvements in infrastructure and rural healthcare may have influenced this change.
KW - Colorectal cancer
KW - Rural
KW - Rurality
KW - Scotland
KW - UK
KW - Urban
KW - Bowel screening
KW - Colorectal cancer survival
KW - Single centre
KW - Observational study
KW - Population
KW - Urban vs rural
U2 - 10.1016/j.surge.2020.02.001
DO - 10.1016/j.surge.2020.02.001
JO - The Surgeon
JF - The Surgeon