Understanding differences in rural versus urban time to diagnosis and time to treatment among patients with colorectal cancer

Colorectal cancer (CRC) is one of the most common cancers in the U.S. Even though more people in urban areas are diagnosed with CRC, people living in rural areas are more likely to die from it. This may be due to challenges rural residents face in accessing medical care, like long travel distances, fewer specialists, and limited local resources. These challenges could lead to delays in getting diagnosed or starting treatment.

This dissertation includes three studies on rural-urban differences in how quickly people with CRC are diagnosed and treated. In the first study, we reviewed all published research comparing treatment delays in rural and urban residents. We found five studies, and the combined results showed that rural residents were actually less likely to experience delays in starting treatment.

In the second study, we used Medicare insurance data to identify people who had symptoms of CRC before being diagnosed. We looked at how long it took to get diagnosed after the first reporting a symptom. Rural residents were less likely to have a delayed diagnosis, although delays were common for everyone.

In the third study, we again used Medicare data to examine how long it took to start treatment after diagnosis. Similar to the other studies, rural residents were less likely to have treatment delays compared to urban residents.

Overall, these findings suggest that, despite facing many challenges, rural residents with colorectal cancer are not more likely to experience delays in diagnosis or treatment than people who live in urban areas.