Signals of inequity in the care pathway: rural lab diagnosis, systemic therapy delays, and RAS mutation differences in metastatic colorectal cancer - Summary - MDSpire
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Signals of inequity in the care pathway: rural lab diagnosis, systemic therapy delays, and RAS mutation differences in metastatic colorectal cancer
To evaluate rural-urban differences in clinical characteristics, biomarker status, treatment delays, and overall survival in patients with stage IV colorectal cancer (CRC) in Saskatchewan.
Key Findings:
Rural patients had higher odds of right-sided tumors (aOR 1.76) and rectal tumors (aOR 1.52) compared to urban residents.
RAS mutations were more frequently identified in rural patients (11.2% vs. 1.6%, p=0.021).
Patients diagnosed in rural laboratories experienced longer delays from diagnosis to chemotherapy initiation (66.5 vs. 55 days, p=0.011).
Overall survival did not differ significantly by residency (median 250 vs. 270 days, p=0.774).
Interpretation:
Limitations:
The study is limited to a specific geographic area (Saskatchewan) and may not be generalizable to other regions.
The analysis does not account for all potential confounding factors influencing treatment delays and outcomes.
