Poster Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2018

Impact of rural and remoteness on overall survival in Australian patients with Stage I-III colorectal cancer (#168)

Christina M Mullany 1 2 , June Rose 1 , Marie Ranson 2 , Daniel Brungs 1
  1. The Wollongong Hospital, Wollongong, NSW, Australia
  2. University of Wollongong, Wollongong, NSW, Australia

Colorectal cancer is a leading cause of cancer related morbidity and mortality within Australia. There is currently limited and inconsistent outcome-related data with regards to colorectal cancer survival according to rurality.This study therefore aimed to identify the impact of remotenesson survivalincolorectal cancer patients across New South Wales. Using the NSW Clinical Cancer Registry, we identified 12905 patients diagnosed with locoregional colorectal cancer during the period from January 2006 to 2013. Treating hospitals were classified as per NSW Hospital peer groups into principle referral, major hospitals or district hospitals, and each patients “remoteness” was classified using the ARIA+ remote index for postcode of residence. Cox proportional hazards regression analyses were used to assess association between 5 year overall survival and corresponding ARIA+ remoteness index.  Those in major metropolitan centres had better overall survival than those living in regional and remote areas (univariate HR 1.1 95%CI 1.02 – 1.2, p=0.035), most marked in patients with stage III disease (HR 1.2 95%CI 1.04 – 1.3, p=0.007).  Patients treated at district hospitals had a poorer overall survival compared to those treated in a Primary or Major Hospital (HR 1.18 95%CI 1.1 – 1.2, p<0.0001).Patients with stage III disease living in outer regional/remote/very remote areas were significantly less likely to receive adjuvant chemotherapy (52% versus 74%, p<0.0001) than those in major cities and inner regional areas. This study confirmed remoteness to have a significant impact on survival of colorectal cancer patients, particularly in those with advanced cancers.