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Poster display session

655 - Effect of rural residence (RD) and distance travel to the cancer center (DTC) on neoadjuvant chemoradiation (NCRT) in localized rectal cancer.


10 Sep 2017


Poster display session


Cancers in Adolescents and Young Adults (AYA);  Bioethical Principles and GCP;  Colon and Rectal Cancer


Aleksi Suo


Annals of Oncology (2017) 28 (suppl_5): v511-v520. 10.1093/annonc/mdx385


A. Suo1, A. Talat2, D. Le3, N. Iqbal2, S.C. Kanthan4, S. Ahmed5

Author affiliations

  • 1 Oncology, University of Calgary, T2N 4N2 - Calgary/CA
  • 2 Medicine, University of Saskatchewan, S7N4H4 - Saskatoon/CA
  • 3 Oncology, Saskatchewan Cancer Agency, Saskatoon Cancer Center, University of Saskatchewan, S7N 4H4 - Saskatoon/CA
  • 4 Surgery, University of Saskatchewan, S7N4H4 - Saskatoon/CA
  • 5 Oncology, Tom Baker Cancer Center, T2N 4N2 - Calgary/CA


Abstract 655


Neoadjuvant chemoradiation therapy (NCRT) has been associated with a lower rate of local recurrence and represents an accepted standard of care. Yet, access to treatment or decisions about treatment can be affected by contextual factors such as rural residence (RD) and distance travel to cancer center (DTC). In the current study, we evaluated relationship between RD and DTC and NCRT.


A cohort of patients diagnosed with localized rectal cancer during 2009-2013 in the province of Saskatchewan was studied. The logistic regression analyses were performed to assess relationship between RD and DTC and lack of NCRT.


Total 279 patients were identified with median age of 66 yrs (IQR:59-76) and M:F of 1:0.71. 94 (33.6) had a major comorbid illness. 183 (65%) were rural resident. The median DTC was 141 km (IQR 7-233). Of 279 patients, 116 (41%) were referred for NCRT, 161 (58%) underwent upfront surgery, and 2 declined surgery. The mean DTC for group treated with NCRT was 111.5 ±122km compared with 169.0±176km if they did not receive NCRT (p = 0.001). Of urban resident, 52/96 (54%) were referred for NCRT compared with 64/183 (35%) of rural resident (p = 0.002). After excluding 33 (12%) patients who had clinical stage I disease and underwent upfront surgery, a univariate regression analysis revealed that both DTC (OR 1.92, 95% CI: 1.15-3.20) and RD (OR 2.51, 95%CI: 1.46-4.32) were significantly correlated with lack of NCRT. On multivariate analysis following relationships were noted with lack of NCRT. Age ≥ 70 yrs (OR 1.45, 95%CI: 0.84-2.45), comorbid illness (OR 1.52, 0.86-2.67), ECOG performance status of > 1 (OR 1.25, 0.49-3.17), DTC (OR 1.07, 0.51-2.23), and RD (OR 2.56, 1.17-5.57).


Our results revealed that RD but not DTC is associated with a lower rate of NCRT in patients with localized rectal cancer. Future studies are required to explore the underlying cause of differential referral.

Clinical trial identification

Not applicable

Legal entity responsible for the study

Saskatchewan Cancer Agency




All authors have declared no conflicts of interest.

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