2f:I[703058,["/_next/static/immutable/chunks/3bhq_5eh1d760.js","/_next/static/immutable/chunks/1855-ogyi8eh4.js","/_next/static/immutable/chunks/2pfsjpn6k6zlg.js","/_next/static/immutable/chunks/26c7v3_3uwnwu.js","/_next/static/immutable/chunks/25a3ozcrvi1ff.js","/_next/static/immutable/chunks/2r4wx50nvjh_4.js","/_next/static/immutable/chunks/23fsw06hsi5b1.js","/_next/static/immutable/chunks/06_yt270h41rg.js","/_next/static/immutable/chunks/3ezsiz-7shkna.js","/_next/static/immutable/chunks/20x2y96ldu5wx.js","/_next/static/immutable/chunks/2lxntcm3pd1_h.js","/_next/static/immutable/chunks/00dgco8irq3jw.js","/_next/static/immutable/chunks/00nwe-kq0rboc.js","/_next/static/immutable/chunks/2051ffx3xzio9.js"],"PaperListPageClient"] 30:T827,Rural populations experience higher colon cancer (CC) mortality than urban populations, and rural patients may have more complications after resection. Reoperations due to complications after CC resection among rural and urban patients are not clear, and factors mediating disparities in rural-urban postoperative outcomes have not been examined. Using the Surveillance, Epidemiology, and End Results Program-Medicare database, individuals with CC who underwent surgical resection were compared via multivariable logistic regression to determine the association of rurality with postoperative complications and reoperations at 30, 60, and 90 days. A 4-way effect decomposition (mediation analysis) assessed how surgical approach (open vs minimally invasive surgery [MIS]) mediated the relationship between rurality and complication risk. Survival was assessed at 30 days, 90 days, and 1 year. Among 33,183 patients, rural patients (n = 5,938; 18%) had lower Charlson Comorbidity Indices (p < 0.0001) and presented less emergently (p = 0.0307); stage did not differ from urban patients. Rural patients underwent more postdischarge reoperations (p = 0.0007) and had higher odds of surgical site infection (SSI; odds ratio [OR] 1.31, 95% CI 1.13 to 1.52) and anastomotic leak (OR 1.19, 95% CI 1.07 to 1.33). Rural individuals were less likely to undergo MIS (OR 0.67, 95% CI 0.63 to 0.72); MIS was associated with lower odds of SSI (OR 0.58, 95% CI 0.51 to 0.67) and leak (OR 0.57, 95% CI 0.52 to 0.63). Surgical approach mediated 29% of the overall complication risk, 18% of the SSI risk, and 28% of the anastomotic leak risk for rural patients. Finally, survival was lower among rural patients (30 days: p = 0.0313; 90 days: p = 0.0195; 1 year: p = 0.0063). Surgical approach mediated one-third of the complication risk experienced by rural patients, who had higher odds of complications, more postdischarge reoperations, and lower odds of accessing MIS. Expanding rural MIS colectomy practices may be one way to achieve more geographically equitable outcomes.31:Ta80, BACKGROUND: Rural populations experience higher colon cancer (CC) mortality than urban populations, and rural patients may have more complications after resection. Reoperations due to complications after CC resection among rural and urban patients are not clear, and factors mediating disparities in rural–urban postoperative outcomes have not been examined. STUDY DESIGN: Using the Surveillance, Epidemiology, and End Results Program–Medicare database, individuals with CC who underwent surgical resection were compared via multivariable logistic regression to determine the association of rurality with postoperative complications and reoperations at 30, 60, and 90 days. A 4-way effect decomposition (mediation analysis) assessed how surgical approach (open vs minimally invasive surgery [MIS]) mediated the relationship between rurality and complication risk. Survival was assessed at 30 days, 90 days, and 1 year. RESULTS: Among 33,183 patients, rural patients (n = 5,938; 18%) had lower Charlson Comorbidity Indices (p < 0.0001) and presented less emergently (p = 0.0307); stage did not differ from urban patients. Rural patients underwent more postdischarge reoperations (p = 0.0007) and had higher odds of surgical site infection (SSI; odds ratio [OR] 1.31, 95% CI 1.13 to 1.52) and anastomotic leak (OR 1.19, 95% CI 1.07 to 1.33). Rural individuals were less likely to undergo MIS (OR 0.67, 95% CI 0.63 to 0.72); MIS was associated with lower odds of SSI (OR 0.58, 95% CI 0.51 to 0.67) and leak (OR 0.57, 95% CI 0.52 to 0.63). Surgical approach mediated 29% of the overall complication risk, 18% of the SSI risk, and 28% of the anastomotic leak risk for rural patients. Finally, survival was lower among rural patients (30 days: p = 0.0313; 90 days: p = 0.0195; 1 year: p = 0.0063). CONCLUSIONS: Surgical approach mediated one-third of the complication risk experienced by rural patients, who had higher odds of complications, more postdischarge reoperations, and lower odds of accessing MIS. Expanding rural MIS colectomy practices may be one way to achieve more geographically equitable outcomes. 25:[[["$","script","0",{"type":"application/ld+json","dangerouslySetInnerHTML":{"__html":"{\"@context\":\"https://schema.org\",\"@type\":\"CollectionPage\",\"name\":\"Colon Cancer: condition Research & Clinical Takeaways\",\"description\":\"Explore peer-reviewed papers on Colon Cancer (condition). Clinician-written summaries and actionable practice insights. 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Key predictors of longer delays included Medicaid insurance (5/6 cancers), lowest-quartile income (6/6), Black race (5/6), greater travel distance (4/6), care in the West (6/6), treatment at academic institutions (6/6), and use of robotic surgery (5/5 nonbreast cancers).","limitations":"- Retrospective design using administrative/registry data (National Cancer Database) limits causal inference and may not capture unmeasured confounders.\n- Full text is under embargo; detailed methodology and multivariable model specifications could not be reviewed.\n- The 85% female composition reflects heavy representation of breast cancer patients, which may skew overall pooled estimates.","practice_takeaway":"Surgical wait times for major cancers have risen steadily over a decade and are longest at academic centers and for referred, lower-income, or Black patients — clinicians and health systems should proactively track and address these gaps. Robotic surgery adoption is also independently linked to longer delays and warrants operational scrutiny."}},{"doi":"10.20892/j.issn.2095-3941.2025.0851","pmid":"42565540","title":"Global landscape and temporal trends in lifetime risk of colorectal cancer in 185 countries: a population-based study","journal_title":"Cancer Biology & Medicine","journal_issn":"2095-3941","published_at":"2026-08-06T00:00:00.000Z","url":"https://doi.org/10.20892/j.issn.2095-3941.2025.0851","source_score":122,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-08-22T06:53:44.615Z","updated_at":"2026-08-22T06:53:44.615Z","tags":[{"paper_doi":"10.20892/j.issn.2095-3941.2025.0851","tag_type":"age_group","value":"mixed","value_numeric":null},{"paper_doi":"10.20892/j.issn.2095-3941.2025.0851","tag_type":"category","value":"Oncology","value_numeric":null},{"paper_doi":"10.20892/j.issn.2095-3941.2025.0851","tag_type":"condition","value":"Colon Cancer","value_numeric":null},{"paper_doi":"10.20892/j.issn.2095-3941.2025.0851","tag_type":"condition","value":"Colorectal Cancer","value_numeric":null},{"paper_doi":"10.20892/j.issn.2095-3941.2025.0851","tag_type":"condition","value":"Rectal Cancer","value_numeric":null},{"paper_doi":"10.20892/j.issn.2095-3941.2025.0851","tag_type":"impact_flag","value":"confirms_prior","value_numeric":null},{"paper_doi":"10.20892/j.issn.2095-3941.2025.0851","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.20892/j.issn.2095-3941.2025.0851","tag_type":"sample_size","value":"n=185","value_numeric":185},{"paper_doi":"10.20892/j.issn.2095-3941.2025.0851","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.20892/j.issn.2095-3941.2025.0851","tag_type":"study_design","value":"Population-Based Study","value_numeric":null},{"paper_doi":"10.20892/j.issn.2095-3941.2025.0851","tag_type":"warning","value":"Temporal trend analysis covers only 36 countries with available CI5Plus registry data (2003–2017), limiting generalizability of trend findings to countries with high-quality registries.","value_numeric":null},{"paper_doi":"10.20892/j.issn.2095-3941.2025.0851","tag_type":"warning","value":"The 'sample size' tag reflects number of countries analyzed (185), not individual patients; no individual-level data were used.","value_numeric":null},{"paper_doi":"10.20892/j.issn.2095-3941.2025.0851","tag_type":"warning","value":"The study uses cross-sectional 2022 GLOBOCAN data to estimate lifetime risk; these are not true cohort-derived lifetime probabilities and should be interpreted as period estimates under current conditions.","value_numeric":null}],"summaries":{"what_studied":"This population-based study estimated lifetime risk of developing and dying from colorectal cancer (CRC) globally across 185 countries using GLOBOCAN 2022 data, stratified by sex, cancer subtype (colon vs. rectal), geographic region (20 UN regions), and Human Development Index (HDI) level; temporal trends in lifetime risk from 2003–2017 were analyzed in 36 countries using joinpoint regression.","key_result":"In 2022, global lifetime risk of developing CRC was 2.69% (95% CI: 2.68–2.70) and of dying from CRC was 1.39% (95% CI: 1.39–1.40). Risk rose sharply with HDI: very high HDI regions had a 5.17% incidence risk vs. 0.57% in low HDI regions. Australia/New Zealand had the highest incidence risk (7.41%); Northern Europe the highest mortality risk (3.28%). Norway had the highest country-level incidence risk (10.32%), and Singapore the highest mortality risk (5.52%). Thailand showed the steepest increasing trend (AAPC up to +5.5%), while the US and Austria showed significant decreasing trends.","limitations":"- GLOBOCAN 2022 estimates for ~77 countries (23.1% of global population) rely on modeled rather than directly observed data, reducing accuracy in low-registration regions (sub-Saharan Africa, parts of South America).\n- Cross-sectional 2022 incidence and mortality data cannot capture future trend changes, potentially under- or overestimating lifetime risk in countries with rapidly shifting rates.\n- Country-level estimates mask large within-country regional disparities (e.g., China, USA, India).","practice_takeaway":"Clinicians in high-HDI countries should recognize that roughly 1 in 20 patients faces a lifetime CRC risk, reinforcing the value of colonoscopy-based screening starting at age 45. In low-HDI settings, the priority should shift toward improving diagnostic access and treatment equity, given mortality-to-incidence ratios exceeding 0.60–0.76 in many African regions."}},{"doi":"10.1200/jco-26-00765","pmid":"42218651","title":"Structured Exercise Program After Adjuvant Chemotherapy for Colon Cancer: A Cost-Utility Analysis of the CHALLENGE Trial","journal_title":"Journal of Clinical Oncology","journal_issn":"0732-183X","published_at":"2026-05-31T00:00:00.000Z","url":"https://doi.org/10.1200/jco-26-00765","source_score":36,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-08-04T18:18:09.875Z","updated_at":"2026-08-04T18:18:09.875Z","tags":[{"paper_doi":"10.1200/jco-26-00765","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1200/jco-26-00765","tag_type":"category","value":"Oncology","value_numeric":null},{"paper_doi":"10.1200/jco-26-00765","tag_type":"condition","value":"Colon Cancer","value_numeric":null},{"paper_doi":"10.1200/jco-26-00765","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1200/jco-26-00765","tag_type":"level_of_evidence","value":"2","value_numeric":null},{"paper_doi":"10.1200/jco-26-00765","tag_type":"modality","value":"Structured Exercise Program","value_numeric":null},{"paper_doi":"10.1200/jco-26-00765","tag_type":"sample_size","value":"n=889","value_numeric":889},{"paper_doi":"10.1200/jco-26-00765","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1200/jco-26-00765","tag_type":"study_design","value":"Cost-Utility Analysis (Economic Evaluation of Phase III RCT)","value_numeric":null},{"paper_doi":"10.1200/jco-26-00765","tag_type":"warning","value":"The full text extracted from the PDF appears to be the PMPRB 2024 Annual Report — a Canadian drug pricing regulatory document — rather than the CHALLENGE trial cost-utility analysis described in the abstract. The abstract and results sections were used for structured extraction, but no supporting methods, tables, or figures from the actual trial paper were available in the full text. Summaries and tags are based solely on the abstract and results narrative.","value_numeric":null},{"paper_doi":"10.1200/jco-26-00765","tag_type":"warning","value":"The study design tag reflects that this is a cost-utility analysis conducted alongside a phase III RCT (CHALLENGE/CCTG CO.21); it is not a standalone RCT. Level of evidence is assigned as 2 given the prospective data from a phase III trial.","value_numeric":null}],"summaries":{"what_studied":"This prespecified cost-utility analysis of the phase III CHALLENGE trial (N=889) compared a 3-year structured exercise program (SEP) versus health education materials (HEM) in patients with stage II (high-risk) or stage III colon cancer after surgery and adjuvant chemotherapy, using a 5-year Canadian public payer perspective with a 1.5% discount rate.","key_result":"The SEP was dominant over HEM: despite an up-front cost of $2,917 CAD/participant, total costs were lower ($31,957 vs. $33,546 CAD/participant, a saving of $1,589/participant) and outcomes were better (+0.05 life-years and +0.10 QALYs per participant). The SEP was dominant in 53% of bootstrap samples, and 80% fell below a $50,000 CAD/QALY willingness-to-pay threshold.","limitations":"- The 5-year base-case time horizon may not capture the full long-term survival benefit of exercise; however, the 10-year scenario was consistent.\n- SF-36 utilities were mapped (not directly measured) to SF-6D, which may introduce measurement error.\n- Costs are in Canadian dollars from a Canadian public payer perspective, limiting direct generalizability to other health systems.","practice_takeaway":"A structured 3-year exercise program after adjuvant chemotherapy for stage II/III colon cancer is not only clinically effective but cost-saving compared to health education materials alone. Clinicians and health systems should prioritize integrating supervised exercise programs into routine post-treatment colon cancer care."}},{"doi":"10.1016/j.annonc.2026.05.001","pmid":"42225236","title":"Chemotherapy for patients with circulating tumour DNA-positive, stage II colon cancer (CIRCULATE)—an AIO/ABCSG trial","journal_title":"Annals of Oncology","journal_issn":"0923-7534","published_at":"2026-05-31T00:00:00.000Z","url":"https://doi.org/10.1016/j.annonc.2026.05.001","source_score":44,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-08-04T18:17:48.401Z","updated_at":"2026-08-04T18:17:48.401Z","tags":[{"paper_doi":"10.1016/j.annonc.2026.05.001","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1016/j.annonc.2026.05.001","tag_type":"category","value":"Oncology","value_numeric":null},{"paper_doi":"10.1016/j.annonc.2026.05.001","tag_type":"condition","value":"Colon Cancer","value_numeric":null},{"paper_doi":"10.1016/j.annonc.2026.05.001","tag_type":"generic","value":"capecitabine","value_numeric":null},{"paper_doi":"10.1016/j.annonc.2026.05.001","tag_type":"generic","value":"oxaliplatin","value_numeric":null},{"paper_doi":"10.1016/j.annonc.2026.05.001","tag_type":"impact_flag","value":"limited_evidence","value_numeric":null},{"paper_doi":"10.1016/j.annonc.2026.05.001","tag_type":"level_of_evidence","value":"2","value_numeric":null},{"paper_doi":"10.1016/j.annonc.2026.05.001","tag_type":"modality","value":"Chemotherapy","value_numeric":null},{"paper_doi":"10.1016/j.annonc.2026.05.001","tag_type":"modality","value":"Liquid Biopsy / ctDNA Testing","value_numeric":null},{"paper_doi":"10.1016/j.annonc.2026.05.001","tag_type":"sample_size","value":"n=1396","value_numeric":1396},{"paper_doi":"10.1016/j.annonc.2026.05.001","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1016/j.annonc.2026.05.001","tag_type":"study_design","value":"Randomized Controlled Trial","value_numeric":null},{"paper_doi":"10.1016/j.annonc.2026.05.001","tag_type":"warning","value":"The ctDNA-positive rate of 2.9% was lower than anticipated, which contributed to the severe underpowering of the primary endpoint comparison.","value_numeric":null},{"paper_doi":"10.1016/j.annonc.2026.05.001","tag_type":"warning","value":"The per-protocol analysis excludes untreated CHEMO patients and is exploratory; it should not be used as definitive evidence of benefit.","value_numeric":null},{"paper_doi":"10.1016/j.annonc.2026.05.001","tag_type":"warning","value":"The study is restricted to MMR-proficient/MSS stage II colon cancer; results are not generalizable to MSI-H or stage III/IV patients.","value_numeric":null},{"paper_doi":"10.1016/j.annonc.2026.05.001","tag_type":"warning","value":"The trial was terminated early due to funding expiry, leaving only 26 patients in the ctDNA-positive CHEMO arm — far below the planned sample size. All efficacy results in this arm should be interpreted with caution.","value_numeric":null}],"summaries":{"what_studied":"This RCT evaluated whether adjuvant chemotherapy (capecitabine ± oxaliplatin) improves disease-free survival (DFS) versus observation in post-operative ctDNA-positive, stage II MMR-proficient/MSS colon cancer patients, using a tumour-informed NGS-based ctDNA assay; trial ran June 2020–July 2025 in Germany and Austria.","key_result":"The primary ITT endpoint was not met (3-year DFS 61% CHEMO vs 38% OBS; HR 0.55, 95% CI 0.21–1.48, P=0.12). In per-protocol analysis, CHEMO significantly reduced recurrence (3-year recurrence 19% vs 62%; HR 0.23, 95% CI 0.06–0.87, P=0.009) and improved DFS (3-year DFS 77% vs 38%; HR 0.31, 95% CI 0.09–1.03, P=0.021). ctDNA positivity (2.9% of randomised patients) was strongly prognostic: 3-year DFS 52% vs 87% (HR 4.28, P<0.001) and 3-year OS 88% vs 98% (HR 5.48, P=0.001) compared to ctDNA-negative patients.","limitations":"- Trial closed early due to funding expiry, leaving the ctDNA-positive CHEMO arm with only 26 patients (severely underpowered; 81% started therapy).\n- Very low ctDNA-positive rate (2.9%) limited the randomised comparison between CHEMO and OBS arms.\n- Per-protocol analysis is hypothesis-generating only; primary ITT analysis was negative.","practice_takeaway":"Post-operative ctDNA positivity identifies a high-risk subset of stage II MSS colon cancer patients who may benefit from adjuvant chemotherapy, but the trial was underpowered to confirm this definitively. Clinicians can use ctDNA testing to inform adjuvant decisions, while awaiting larger confirmatory trials."}},{"doi":"10.1016/j.immuni.2026.05.001","pmid":"42190649","title":"Dietary sulfur amino acids enhance anti-tumor immunity in colon cancer via an NKT cell-XCL1-cDC1 circuit","journal_title":"Immunity","journal_issn":"1074-7613","published_at":"2026-05-26T00:00:00.000Z","url":"https://doi.org/10.1016/j.immuni.2026.05.001","source_score":36,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-06-02T13:27:26.220Z","updated_at":"2026-06-02T13:27:26.220Z","tags":[{"paper_doi":"10.1016/j.immuni.2026.05.001","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1016/j.immuni.2026.05.001","tag_type":"category","value":"Immunology","value_numeric":null},{"paper_doi":"10.1016/j.immuni.2026.05.001","tag_type":"condition","value":"Colon Cancer","value_numeric":null},{"paper_doi":"10.1016/j.immuni.2026.05.001","tag_type":"generic","value":"sulfur amino acids","value_numeric":null},{"paper_doi":"10.1016/j.immuni.2026.05.001","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1016/j.immuni.2026.05.001","tag_type":"level_of_evidence","value":"5","value_numeric":null},{"paper_doi":"10.1016/j.immuni.2026.05.001","tag_type":"modality","value":"Dietary Intervention","value_numeric":null},{"paper_doi":"10.1016/j.immuni.2026.05.001","tag_type":"modality","value":"Immune Checkpoint Inhibitor","value_numeric":null},{"paper_doi":"10.1016/j.immuni.2026.05.001","tag_type":"modality","value":"Microbiome Modulation","value_numeric":null},{"paper_doi":"10.1016/j.immuni.2026.05.001","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1016/j.immuni.2026.05.001","tag_type":"study_design","value":"Preclinical Animal Study with Human Cohort Analysis","value_numeric":null},{"paper_doi":"10.1016/j.immuni.2026.05.001","tag_type":"warning","value":"Full text was not available; summary is based on the abstract and highlights only — mechanistic details and quantitative outcomes could not be fully verified.","value_numeric":null},{"paper_doi":"10.1016/j.immuni.2026.05.001","tag_type":"warning","value":"Impact flag 'practice_changing' is aspirational per the authors' framing; no clinical trial data are yet reported — clinicians should treat this as hypothesis-generating.","value_numeric":null},{"paper_doi":"10.1016/j.immuni.2026.05.001","tag_type":"warning","value":"Publication date is May 26, 2026, which is in the future relative to many training datasets; content reflects the provided abstract.","value_numeric":null},{"paper_doi":"10.1016/j.immuni.2026.05.001","tag_type":"warning","value":"Study design tag reflects a hybrid preclinical/human observational design; level of evidence (5) is assigned for the animal model component, as human data appear correlational rather than interventional.","value_numeric":null}],"summaries":{"what_studied":"This study examined whether dietary sulfur amino acid (Saa) supplementation could enhance anti-tumor immunity in colon cancer (CC), using murine CC models alongside human microbiome and ICI-response datasets. It traced the mechanism from diet → gut microbiota (Mucispirillum schaedleri) → NKT cells → XCL1 chemokine secretion → cDC1 recruitment in tumor-draining lymph nodes → cytotoxic CD8+ T cell activation.","key_result":"High-Saa diets restricted CC progression in murine models, increased colonic mucus thickness, expanded *M. schaedleri*, and raised intratumoral activated cytotoxic CD8+ T cell frequency. The protective effect required cDC1s and the XCL1 chemokine axis; Saa metabolic pathways were also enriched in human ICI responders and in individuals without CC.","limitations":"- Mechanistic evidence is primarily from mouse models; direct human causal data are absent.\n- The study does not report specific tumor size numbers or survival curves in the abstract, limiting quantitative assessment.\n- Full-text access was unavailable; findings are based solely on the abstract and highlights.","practice_takeaway":"Dietary sulfur amino acid supplementation is a candidate adjunct to immune checkpoint inhibitors for colon cancer, but clinical validation is needed before patient use. Clinicians should watch for trials combining high-Saa diets with ICI therapy in CC patients."}},{"doi":"10.1097/xcs.0000000000001866","pmid":"42132261","title":"Missing, but not Forgotten: Commission on Cancer Center Accreditation and the Impact of Missing Data in SEER Studies","journal_title":"Journal of the American College of Surgeons","journal_issn":"1072-7515","published_at":"2026-05-14T00:00:00.000Z","url":"https://doi.org/10.1097/xcs.0000000000001866","source_score":18,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-05-15T13:23:16.284Z","updated_at":"2026-05-15T13:23:16.284Z","tags":[{"paper_doi":"10.1097/xcs.0000000000001866","tag_type":"age_group","value":"mixed","value_numeric":null},{"paper_doi":"10.1097/xcs.0000000000001866","tag_type":"category","value":"Surgery","value_numeric":null},{"paper_doi":"10.1097/xcs.0000000000001866","tag_type":"condition","value":"Breast Cancer","value_numeric":null},{"paper_doi":"10.1097/xcs.0000000000001866","tag_type":"condition","value":"Colon Cancer","value_numeric":null},{"paper_doi":"10.1097/xcs.0000000000001866","tag_type":"condition","value":"Non-Small Cell Lung Cancer","value_numeric":null},{"paper_doi":"10.1097/xcs.0000000000001866","tag_type":"condition","value":"Pancreatic Cancer","value_numeric":null},{"paper_doi":"10.1097/xcs.0000000000001866","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1097/xcs.0000000000001866","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.1097/xcs.0000000000001866","tag_type":"sample_size","value":"n=328030","value_numeric":328030},{"paper_doi":"10.1097/xcs.0000000000001866","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1097/xcs.0000000000001866","tag_type":"study_design","value":"Retrospective Cohort Study","value_numeric":null},{"paper_doi":"10.1097/xcs.0000000000001866","tag_type":"warning","value":"No drug interventions or therapeutic modalities are evaluated; modality/brand/generic tags are not applicable.","value_numeric":null},{"paper_doi":"10.1097/xcs.0000000000001866","tag_type":"warning","value":"Survival differences between patients with and without missing data may partly reflect unmeasured confounders (e.g., stage at diagnosis, socioeconomic factors) not fully adjusted for in the analysis.","value_numeric":null},{"paper_doi":"10.1097/xcs.0000000000001866","tag_type":"warning","value":"The 'impact_flag' of practice_changing is applied in the methodological/research practice sense — this study challenges a common analytic assumption in SEER-based research rather than changing direct patient care.","value_numeric":null}],"summaries":{"what_studied":"This study examined the prevalence of missing SEER data (2018–2020) in 328,030 patients with breast, pancreatic, colon, or non-small cell lung cancer (NSCLC), comparing missingness rates and 3-year overall survival (OS) by Commission on Cancer (CoC) vs. non-CoC accreditation status of the treating facility.","key_result":"Missing data was 2–3× more common at non-CoC centers across all cancer types (e.g., NSCLC: 42% vs. 13%; breast: 23% vs. 9%). Patients with missing data had significantly worse 3-year OS than those with complete data (breast: 63% vs. 81%; pancreas: 5% vs. 12%; colon: 43% vs. 61%; NSCLC: 17% vs. 27%; p<0.001 for all), with the worst outcomes in patients missing data from non-CoC centers.","limitations":"- Observational design limits causal inference about why data are missing or why outcomes differ.\n- Study spans only 2018–2020, which may not reflect longer trends or post-pandemic data quality changes.\n- The analysis does not fully account for confounders (e.g., stage, comorbidity, socioeconomic status) that may drive both missingness and worse survival.","practice_takeaway":"SEER studies that exclude patients with missing data will disproportionately drop non-CoC center patients — who have worse outcomes — potentially inflating reported survival estimates. Researchers and clinicians interpreting SEER-based survival data should scrutinize how missing data are handled, as completeness analyses are not merely a statistical footnote but a source of meaningful bias."}},{"doi":"10.1200/jco-25-02086","pmid":"41616224","title":"Tissue-Free Circulating Tumor DNA Assay and Patient Outcome in a Phase III Trial of FOLFOX-Based Adjuvant Chemotherapy (Alliance N0147)","journal_title":"Journal of Clinical Oncology","journal_issn":"0732-183X","published_at":"2026-01-30T00:00:00.000Z","url":"https://doi.org/10.1200/jco-25-02086","source_score":67,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-05-20T13:23:31.664Z","updated_at":"2026-05-20T13:23:31.664Z","tags":[{"paper_doi":"10.1200/jco-25-02086","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1200/jco-25-02086","tag_type":"brand","value":"Erbitux","value_numeric":null},{"paper_doi":"10.1200/jco-25-02086","tag_type":"category","value":"Oncology","value_numeric":null},{"paper_doi":"10.1200/jco-25-02086","tag_type":"condition","value":"Colon Cancer","value_numeric":null},{"paper_doi":"10.1200/jco-25-02086","tag_type":"condition","value":"Stage III Colon Cancer","value_numeric":null},{"paper_doi":"10.1200/jco-25-02086","tag_type":"generic","value":"cetuximab","value_numeric":null},{"paper_doi":"10.1200/jco-25-02086","tag_type":"generic","value":"fluorouracil","value_numeric":null},{"paper_doi":"10.1200/jco-25-02086","tag_type":"generic","value":"leucovorin","value_numeric":null},{"paper_doi":"10.1200/jco-25-02086","tag_type":"generic","value":"oxaliplatin","value_numeric":null},{"paper_doi":"10.1200/jco-25-02086","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1200/jco-25-02086","tag_type":"level_of_evidence","value":"1","value_numeric":null},{"paper_doi":"10.1200/jco-25-02086","tag_type":"modality","value":"Chemotherapy","value_numeric":null},{"paper_doi":"10.1200/jco-25-02086","tag_type":"modality","value":"Circulating Tumor DNA Assay","value_numeric":null},{"paper_doi":"10.1200/jco-25-02086","tag_type":"modality","value":"Monoclonal Antibody","value_numeric":null},{"paper_doi":"10.1200/jco-25-02086","tag_type":"sample_size","value":"n=2260","value_numeric":2260},{"paper_doi":"10.1200/jco-25-02086","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1200/jco-25-02086","tag_type":"study_design","value":"Randomized Controlled Trial","value_numeric":null},{"paper_doi":"10.1200/jco-25-02086","tag_type":"warning","value":"Age group tagged as 'adult' based on trial context; exact age range not specified in the abstract.","value_numeric":null},{"paper_doi":"10.1200/jco-25-02086","tag_type":"warning","value":"Genotyping associations (FLT1, PREX2) are exploratory secondary analyses with small event numbers per gene; treat as hypothesis-generating only.","value_numeric":null},{"paper_doi":"10.1200/jco-25-02086","tag_type":"warning","value":"The impact_flag 'practice_changing' is applied cautiously: while findings are compelling, no interventional ctDNA-guided trial has yet confirmed clinical benefit from acting on these results.","value_numeric":null},{"paper_doi":"10.1200/jco-25-02086","tag_type":"warning","value":"The study is a biomarker analysis within a phase III RCT; ctDNA was not used to direct treatment, so this is prognostic — not predictive of treatment benefit — evidence.","value_numeric":null}],"summaries":{"what_studied":"A tissue-free, epigenomic ctDNA assay was evaluated for prognostic value in 2,260 patients with resected stage III colon cancer enrolled in the phase III Alliance N0147 trial, receiving FOLFOX-based adjuvant chemotherapy (±cetuximab), with plasma samples collected post-surgery and pre-treatment.","key_result":"20.4% of patients (461/2,260) were ctDNA-positive; at median 6.1-year follow-up, ctDNA positivity was independently associated with worse TTR (HR 5.96), DFS (HR 5.03), and OS (HR 4.45; all P<.0001). Five-year DFS was 27.7% vs. 77.1% in ctDNA-positive vs. ctDNA-negative patients. Among ctDNA-positive patients, higher tumor fraction and mutations in FLT1 (OR 8.99) or PREX2 (OR 7.73) further stratified recurrence risk.","limitations":"- Tissue-free assay cannot be directly compared to tumor-informed ctDNA approaches, limiting cross-platform conclusions.\n- ctDNA results were not used to guide treatment decisions in this trial, so the therapeutic utility of ctDNA-guided escalation or de-escalation remains untested.\n- Genotyping findings (FLT1, PREX2) are exploratory and require prospective validation.","practice_takeaway":"A tissue-free ctDNA assay after resection of stage III colon cancer strongly predicts recurrence and death, independent of standard clinicopathologic risk factors — including in dMMR/low-risk subgroups often considered for de-escalation. Clinicians should consider ctDNA status when counseling patients on adjuvant therapy intensity, pending prospective interventional trials."}},{"doi":"10.1080/07357907.2025.2585512","pmid":"41216819","title":"The Influence of GLP-1 Receptor Agonists on Five-Year Mortality in Colon Cancer Patients","journal_title":"Cancer Investigation","journal_issn":"0735-7907","published_at":"2025-11-11T00:00:00.000Z","url":"https://doi.org/10.1080/07357907.2025.2585512","source_score":462,"is_retracted":false,"is_open_access":false,"raw_metadata":{"ooir":{"day":"2025-11-13","doi":"10.1080/07357907.2025.2585512","days":"30","issn":"0735-7907","rank":"4","field":"Clinical Medicine","score":"462","category":"Oncology","categories":["Oncology"],"_categories":["Oncology"]},"pubmed":{"doi":"10.1080/07357907.2025.2585512","title":"The Influence of GLP-1 Receptor Agonists on Five-Year Mortality in Colon Cancer Patients.","journal":"Cancer investigation","methods":"","results":"","abstract":"Colorectal cancer is a leading cause of morbidity and mortality worldwide. This study investigates the association between GLP-1 receptor agonists (GLP-1 RAs) and five-year mortality in patients with primary colon cancer, considering BMI. Using data from the University of California Health Data Warehouse, 6,871 patients were analyzed. Five-year mortality was 15.5% for GLP-1 RA users compared to 37.1% for non-users. Analyses showed significantly lower odds of five-year mortality with GLP-1 RA use (OR = 0.38, 95% CI: 0.21-0.64). This benefit persisted after adjusting for confounders, including disease severity, but was found to only extend to high obese patients (BMI > 35) in stratified modeling.","keywords":["Colon cancer","GLP-1","Mortality","Obesity","Real-world evidence"],"pubmed_id":"41216819","conclusions":"","publication_date":"2025-11-11T00:00:00"},"crossref":{"DOI":"10.1080/07357907.2025.2585512","URL":"https://doi.org/10.1080/07357907.2025.2585512","ISSN":["0735-7907","1532-4192"],"link":[{"URL":"https://www.tandfonline.com/doi/pdf/10.1080/07357907.2025.2585512","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"page":"982-991","type":"journal-article","issue":"10","score":1,"title":["The Influence of GLP-1 Receptor Agonists on Five-Year Mortality in Colon Cancer Patients"],"author":[{"given":"Raphael E.","family":"Cuomo","sequence":"first","affiliation":[{"name":"School of Medicine, University of California, San Diego"}]}],"issued":{"date-parts":[[2025,11,11]]},"member":"301","prefix":"10.1080","source":"Crossref","volume":"43","created":{"date-time":"2025-11-11T10:55:01Z","timestamp":1762858501000,"date-parts":[[2025,11,11]]},"indexed":{"date-time":"2025-12-04T10:16:45Z","timestamp":1764843405423,"date-parts":[[2025,12,4]]},"subject":[],"abstract":null,"language":"en","relation":{},"resource":{"primary":{"URL":"https://www.tandfonline.com/doi/full/10.1080/07357907.2025.2585512"}},"subtitle":[],"assertion":[{"name":"peerreview_statement","label":"Peer Review Statement","order":1,"value":"The publishing and review policy for this title is described in its Aims & Scope."},{"URL":"http://www.tandfonline.com/action/journalInformation?show=aimsScope&journalCode=icnv20","name":"aims_and_scope_url","label":"Aim & Scope","order":2,"value":"http://www.tandfonline.com/action/journalInformation?show=aimsScope&journalCode=icnv20"},{"name":"received","group":{"name":"publication_history","label":"Publication History"},"label":"Received","order":0,"value":"2024-08-01"},{"name":"revised","group":{"name":"publication_history","label":"Publication History"},"label":"Revised","order":1,"value":"2024-11-14"},{"name":"accepted","group":{"name":"publication_history","label":"Publication History"},"label":"Accepted","order":2,"value":"2024-12-13"},{"name":"published","group":{"name":"publication_history","label":"Publication History"},"label":"Published","order":3,"value":"2025-11-11"}],"deposited":{"date-time":"2025-12-04T10:12:32Z","timestamp":1764843152000,"date-parts":[[2025,12,4]]},"issn-type":[{"type":"print","value":"0735-7907"},{"type":"electronic","value":"1532-4192"}],"published":{"date-parts":[[2025,11,11]]},"publisher":"Informa UK Limited","reference":[{"DOI":"10.3322/caac.21551","key":"e_1_3_4_2_1","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":null,"article-title":null,"journal-title":null,"doi-asserted-by":"publisher"},{"DOI":"10.1093/annonc/mdw235","key":"e_1_3_4_3_1","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":null,"article-title":null,"journal-title":null,"doi-asserted-by":"publisher"},{"DOI":"10.3322/caac.21492","key":"e_1_3_4_4_1","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":null,"article-title":null,"journal-title":null,"doi-asserted-by":"publisher"},{"DOI":"10.1016/j.cmet.2018.03.001","key":"e_1_3_4_5_1","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":null,"article-title":null,"journal-title":null,"doi-asserted-by":"publisher"},{"DOI":"10.1056/NEJMoa1607141","key":"e_1_3_4_6_1","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":null,"article-title":null,"journal-title":null,"doi-asserted-by":"publisher"},{"DOI":null,"key":"e_1_3_4_7_1","year":"2021","issue":"3","author":"Wang B","volume":"23","first-page":"789","unstructured":"Wang B, Du L, Jiang X, Wang Y, Wang D. Glucagon-like peptide-1 receptor agonists and cancer risk: a meta-analysis of randomized controlled trials. Diabetes, Obesity and Metabolism. 2021;23(3):789–801.","article-title":"Glucagon-like peptide-1 receptor agonists and cancer risk: a meta-analysis of randomized controlled trials","journal-title":"Diabetes, Obesity and Metabolism","doi-asserted-by":null},{"DOI":"10.1136/gutjnl-2013-304701","key":"e_1_3_4_8_1","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":null,"article-title":null,"journal-title":null,"doi-asserted-by":"publisher"},{"DOI":"10.1053/j.gastro.2007.03.050","key":"e_1_3_4_9_1","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":null,"article-title":null,"journal-title":null,"doi-asserted-by":"publisher"},{"DOI":"10.1371/journal.pone.0053916","key":"e_1_3_4_10_1","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":null,"article-title":null,"journal-title":null,"doi-asserted-by":"publisher"},{"DOI":"10.1056/NEJMoa021423","key":"e_1_3_4_11_1","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":null,"article-title":null,"journal-title":null,"doi-asserted-by":"publisher"},{"DOI":null,"key":"e_1_3_4_12_1","year":"2017","issue":null,"author":"van der Heijden C","volume":"142","first-page":"1","unstructured":"van der Heijden C, Deinum J, Joosten LA, Netea MG, Riksen NP. The anti-inflammatory effects of GLP-1 analogues: Mechanisms and future directions. Biochem Pharmacol. 2017;142:1–9.","article-title":"The anti-inflammatory effects of GLP-1 analogues: Mechanisms and future directions","journal-title":"Biochem Pharmacol","doi-asserted-by":null},{"DOI":"10.1093/annonc/mdu260","key":"e_1_3_4_13_1","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":null,"article-title":null,"journal-title":null,"doi-asserted-by":"publisher"},{"DOI":"10.1007/s00384-024-04607-w","key":"e_1_3_4_14_1","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":null,"article-title":null,"journal-title":null,"doi-asserted-by":"publisher"},{"DOI":null,"key":"e_1_3_4_15_1","year":"2023","issue":null,"author":"Blewett LA","volume":null,"first-page":null,"unstructured":"Blewett LA, Rivera Drew JA, King ML, Williams KCW, Chen A, Richards S, Westberry M. IPUMS health surveys: National health interview survey, Version 7.3 [dataset]. Minneapolis, MN: IPUMS; 2023.","article-title":null,"journal-title":null,"doi-asserted-by":null},{"DOI":"10.1080/00273171.2011.568786","key":"e_1_3_4_16_1","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":null,"article-title":null,"journal-title":null,"doi-asserted-by":"publisher"},{"DOI":"10.1245/s10434-016-5659-9","key":"e_1_3_4_17_1","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":null,"article-title":null,"journal-title":null,"doi-asserted-by":"publisher"},{"DOI":null,"key":"e_1_3_4_18_1","year":"2015","issue":"3","author":"Zhang P","volume":"9","first-page":"284","unstructured":"Zhang P, Li T, Wu X, Nice EC, Huang C, Zhang Y. Oxidative stress and diabetes: antioxidative strategies. Front Med. 2015;9(3):284–301.","article-title":"Oxidative stress and diabetes: antioxidative strategies","journal-title":"Front Med","doi-asserted-by":null},{"DOI":"10.1016/j.cmet.2016.06.009","key":"e_1_3_4_19_1","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":null,"article-title":null,"journal-title":null,"doi-asserted-by":"publisher"},{"DOI":"10.1093/ajcn/86.3.556","key":"e_1_3_4_20_1","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":null,"article-title":null,"journal-title":null,"doi-asserted-by":"publisher"},{"DOI":null,"key":"e_1_3_4_21_1","year":"2011","issue":"2","author":"Lee YS","volume":"5","first-page":"149","unstructured":"Lee YS, Jun HS, Yoon JW. GLP-1 receptor agonist exendin-4 and its beneficial effects on diabetes. Recent Patents on Endocrine, Metabolic & Immune Drug Discovery. 2011;5(2):149–157.","article-title":"GLP-1 receptor agonist exendin-4 and its beneficial effects on diabetes","journal-title":"Recent Patents on Endocrine, Metabolic & Immune Drug Discovery","doi-asserted-by":null}],"short-title":[],"journal-issue":{"issue":"10","published-print":{"date-parts":[[2025,11,26]]}},"update-policy":"https://doi.org/10.1080/tandf_crossmark_01","alternative-id":["10.1080/07357907.2025.2585512"],"content-domain":{"domain":["www.tandfonline.com"],"crossmark-restriction":true},"original-title":[],"container-title":["Cancer Investigation"],"published-print":{"date-parts":[[2025,11,26]]},"reference-count":20,"published-online":{"date-time":null,"timestamp":null,"date-parts":[[2025,11,11]]},"references-count":20,"short-container-title":["Cancer Investigation"],"is-referenced-by-count":0},"unpaywall":{"doi":"10.1080/07357907.2025.2585512","is_oa":false,"title":"The Influence of GLP-1 Receptor Agonists on Five-Year Mortality in Colon Cancer Patients","updated":"2025-11-13T08:10:39+00:00","published_date":"2025-11-11","best_oa_location":null}},"created_at":"2025-12-08T12:24:58.509Z","updated_at":"2025-12-08T12:24:58.509Z","tags":[{"paper_doi":"10.1080/07357907.2025.2585512","tag_type":"category","value":"Oncology","value_numeric":null},{"paper_doi":"10.1080/07357907.2025.2585512","tag_type":"condition","value":"Colon Cancer","value_numeric":null},{"paper_doi":"10.1080/07357907.2025.2585512","tag_type":"impact_flag","value":"limited_evidence","value_numeric":null},{"paper_doi":"10.1080/07357907.2025.2585512","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.1080/07357907.2025.2585512","tag_type":"modality","value":"GLP-1 Receptor Agonist","value_numeric":null},{"paper_doi":"10.1080/07357907.2025.2585512","tag_type":"sample_size","value":"n=6,871","value_numeric":6871},{"paper_doi":"10.1080/07357907.2025.2585512","tag_type":"study_design","value":"Cohort Study","value_numeric":null},{"paper_doi":"10.1080/07357907.2025.2585512","tag_type":"warning","value":"Abstract does not specify whether mortality was all-cause or cancer-specific, patient age/sex distribution, exposure duration, or the full adjustment set.","value_numeric":null},{"paper_doi":"10.1080/07357907.2025.2585512","tag_type":"warning","value":"BMI effect modification (benefit only at BMI >35) is reported without methodological detail on stratification.","value_numeric":null},{"paper_doi":"10.1080/07357907.2025.2585512","tag_type":"warning","value":"Design inferred as an observational cohort using EHR data; retrospective timing not explicitly stated.","value_numeric":null}],"summaries":{"what_studied":"An observational analysis of 6,871 patients with primary colon cancer assessed whether GLP-1 receptor agonist use was associated with five-year mortality, including stratification by BMI using a single health system data warehouse.","key_result":"Five-year mortality was 15.5% in GLP-1 RA users versus 37.1% in non-users; GLP-1 RA use was associated with lower odds of five-year mortality (OR 0.38, 95% CI 0.21–0.64), persisting after adjustment and limited to patients with BMI >35 in stratified models.","limitations":"Data came from one health system. The observed benefit was confined to patients with BMI >35, limiting applicability to other BMI groups.","practice_takeaway":"In colon cancer patients with BMI >35, GLP-1 RA use was associated with lower five-year mortality in this cohort; consider this signal when prescribing GLP-1 RAs for standard indications. This is associative evidence from one health system and should not change oncologic treatment decisions on its own."}},{"doi":"10.1097/xcs.0000000000001601","pmid":"40928080","title":"Surgical Approach as a Mediator of Rural–Urban Disparity after Colon Cancer Resection","journal_title":"Journal of the American College of Surgeons","journal_issn":"1072-7515","published_at":"2025-09-10T00:00:00.000Z","url":"https://doi.org/10.1097/xcs.0000000000001601","source_score":46,"is_retracted":false,"is_open_access":false,"raw_metadata":{"ooir":{"day":"2026-01-19","doi":"10.1097/xcs.0000000000001601","days":"7","issn":"1072-7515","rank":"5","field":"Clinical Medicine","score":"46","category":"Surgery","categories":["Surgery"],"_categories":["Surgery"]},"pubmed":{"doi":"10.1097/XCS.0000000000001601","title":"Surgical Approach as a Mediator of Rural-Urban Disparity after Colon Cancer Resection.","journal":"Journal of the American College of Surgeons","methods":"","results":"Among 33,183 patients, rural patients (n = 5,938; 18%) had lower Charlson Comorbidity Indices (p < 0.0001) and presented less emergently (p = 0.0307); stage did not differ from urban patients. Rural patients underwent more postdischarge reoperations (p = 0.0007) and had higher odds of surgical site infection (SSI; odds ratio [OR] 1.31, 95% CI 1.13 to 1.52) and anastomotic leak (OR 1.19, 95% CI 1.07 to 1.33). Rural individuals were less likely to undergo MIS (OR 0.67, 95% CI 0.63 to 0.72); MIS was associated with lower odds of SSI (OR 0.58, 95% CI 0.51 to 0.67) and leak (OR 0.57, 95% CI 0.52 to 0.63). Surgical approach mediated 29% of the overall complication risk, 18% of the SSI risk, and 28% of the anastomotic leak risk for rural patients. Finally, survival was lower among rural patients (30 days: p = 0.0313; 90 days: p = 0.0195; 1 year: p = 0.0063).","abstract":"$30","keywords":[],"pubmed_id":"40928080","conclusions":"","publication_date":"2025-09-10T00:00:00"},"crossref":{"DOI":"10.1097/xcs.0000000000001601","URL":"https://doi.org/10.1097/xcs.0000000000001601","ISSN":["1072-7515","1879-1190"],"link":[{"URL":"https://journals.lww.com/10.1097/XCS.0000000000001601","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"page":"432-443","type":"journal-article","issue":"2","score":1,"title":["Surgical Approach as a Mediator of Rural–Urban Disparity after Colon Cancer Resection"],"author":[{"given":"Sara","family":"Myers","sequence":"first","affiliation":[{"name":"From the Department of Surgery, Boston Medical Center, Chobanian and Avedisian School of Medicine, Boston University, Boston, MA (Myers, Davis, Murillo, Ng, Sachs, Davids, Kenzik)"},{"name":"Department of Surgery, 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Surgery","value_numeric":null},{"paper_doi":"10.1097/xcs.0000000000001601","tag_type":"sample_size","value":"n=33,183","value_numeric":33183},{"paper_doi":"10.1097/xcs.0000000000001601","tag_type":"study_design","value":"Cohort","value_numeric":null},{"paper_doi":"10.1097/xcs.0000000000001601","tag_type":"warning","value":"Absolute rates for complications and reoperations are not reported in the abstract.","value_numeric":null},{"paper_doi":"10.1097/xcs.0000000000001601","tag_type":"warning","value":"Study design classification is based on the abstract; full methodological details are not provided here.","value_numeric":null},{"paper_doi":"10.1097/xcs.0000000000001601","tag_type":"warning","value":"Survival differences are reported with p-values only; no effect sizes are given in the abstract.","value_numeric":null}],"summaries":{"what_studied":"An analysis of SEER–Medicare data compared rural versus urban patients undergoing colon cancer resection, measuring 30-, 60-, and 90-day complications and reoperations, and tested whether surgical approach (open vs minimally invasive surgery) mediated disparities; survival was assessed to 1 year.","key_result":"Among 33,183 patients (rural n=5,938; 18%), rural patients had higher odds of surgical site infection (OR 1.31, 95% CI 1.13–1.52) and anastomotic leak (OR 1.19, 95% CI 1.07–1.33), more postdischarge reoperations (p=0.0007), and were less likely to receive minimally invasive surgery (MIS) (OR 0.67, 95% CI 0.63–0.72). MIS was linked to lower odds of SSI (OR 0.58, 95% CI 0.51–0.67) and leak (OR 0.57, 95% CI 0.52–0.63); surgical approach mediated 29% of overall complication risk, 18% of SSI risk, and 28% of leak risk, and survival was lower for rural patients at 30 days (p=0.0313), 90 days (p=0.0195), and 1 year (p=0.0063).","practice_takeaway":"Rural patients had less access to MIS and more complications; because MIS was associated with fewer infections and leaks and mediated roughly one-third of the disparity, expanding access to MIS colectomy in rural settings may help narrow postoperative outcome gaps."}}],"initialOffset":9,"fetchConfig":{"kind":"tags","tags":[{"tag_type":"condition","value":"Colon Cancer"}]},"breadcrumbItems":[{"name":"Home","href":"/"},{"name":"Research Hub","href":"/hub"},{"name":"Conditions","href":"/hub/tag/condition"},{"name":"Colon Cancer"}],"hrefConfig":{"basePath":"/hub/papers","webViewQueryParams":{"hub_ctx":"tag","hub_tag_type":"condition","hub_tag_value":"Colon Cancer"}}}]]

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