Increased travel burden is associated with a decreased likelihood of receiving adjuvant chemotherapy for treatment of colon cancer, regardless of insurance status.1

Additionally, patients with colon cancer who have non-private health insurance and reside in low-density oncologist areas are less likely to receive adjuvant chemotherapy, according to a recent study published online ahead of print in the Journal of Clinical Oncology.

Researchers led by Chun Chieh Lin, PhD, MBA, of the American Cancer Society in Atlanta, GA, looked at 34,694 patients with stage 3 colon cancer from the National Cancer Data Base who were diagnosed between 2007 and 2010.

Continue Reading

They used generalized estimating equation clustering based on hospital service area while controlling for sociodemographic and clinical characteristics in order to study any possible association between geographic access and oncology care.

Among the patients observed, 75.7% were found to have received adjuvant chemotherapy within 90 days of colectomy. Compared to those who had a travel distance of less than 12.5 miles, patients who had to travel 50 to 249 miles or more than 250 miles had a decreased likelihood of receiving adjuvant chemotherapy.

RELATED: Higher Coffee Intake May Be Linked With Reduced Colon Cancer Recurrence, Death

Upon stratification for insurance status, patients with non-private insurance who resided in areas with low density of oncologists were found to be less likely to receive adjuvant chemotherapy.

“If these findings are validated prospectively, interventions to decrease geographic barriers may improve the timeliness and quality of colon cancer treatment,” the authors concluded.


  1. Lin CC, Bruinooge SS, Kirkwood MK, et al; Association between geographic access to cancer care, insurance, and receipt of chemotherapy: geographic distribution of oncologists and travel distance. [published online ahead of print]. J Clin Oncol. doi: 10.1200/JCO.2015.61.1558.