Does geography influence the treatment and outcomes of colorectal cancer in the province of Manitoba?
Helewa, Ramzi M.
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Background: Colorectal cancer (CRC) is the third most common cancer in Manitoba. We sought to determine if regional differences exist for treatments, wait times, and quality measures for Manitobans with CRC. Methods: A population-based historical cohort analysis for patients diagnosed with CRC between 2004 and 2006 was undertaken using administrative databases. Results: 2086 patients were diagnosed with Stage I-IV CRC between 2004 and 2006. Diagnosis wait times and treatment wait times were longer in Winnipeg than rural Manitoba. There were no differences between Winnipeg and rural Manitoba in rates of total colonic examination, adequate lymphadenectomy, and consultations with oncologists. Rural patients with rectal cancer experienced higher local recurrence and mortality rates than urban patients. Conclusion: This study establishes population-based benchmarks for the quality of CRC therapy in Manitoba. Minimal geographic differences exist for quality measures. For rectal cancer local recurrence, rural patients represent an important area for quality improvement initiatives.