结肠癌（CC）的发病率和死亡率在农村人口中更高。本研究旨在确定农村居住是否与治疗区域性CC患者的指南一致性医疗方面存在差异。在国家癌症数据库中鉴定了2006至2016年阶段I-III的CC患者。指南一致性医疗（GCC）的定义包括切除肿瘤、负面切缘、充足的淋巴结检查以及对高风险阶段II或III病人施行辅助性化疗。进行多元逻辑回归（MVR）以评估农村居住和接受GCC的几率之间的关联。使用农村和城市患者的保险状态来评估效果修正。 在320,719位鉴定的患者中，有6191人（2％）是农村居民。农村患者的收入和教育水平低于城市患者，而且更多的人使用医疗保险（p <0.001）。农村患者的旅行距离更远（44.5英里与7.5英里; p <0.001），但手术时间相似（8与9天）。两个队列具有相似的切除率（98.8%与98.0%）、切缘阳性率（5.4%与4.8%）、淋巴结检查合格率（80.9%与83.0%）、辅助化疗率（III阶段：69.2%与68.7%）和接受GCC（66.5%与68.3%）。在MVR中，接受GCC的几率在农村和城市患者之间没有差异（几率比0.99；95％置信区间0.94-1.05）。保险状态并没有影响农村患者和城市患者接受GCC的差异（交互作用：p = 0.83）。 区域性CC的农村和城市患者同样可能接受GCC，说明癌症治疗差异并不解释农村与城市之间的不平等差距。© 2023。外科肿瘤学会。

Incidence and mortality rates of colon cancer (CC) are higher in rural populations. This study aimed to determine whether rural residence is associated with differences in guideline-concordant care for patients with locoregional CC.Patients with stages I-III CC from 2006 to 2016 were identified in the National Cancer Database. Guideline-concordant care (GCC) was defined as resection with negative margins, adequate nodal harvest, and receipt of adjuvant chemotherapy for patients with high-risk stage II or III disease. Multivariable logistic regression (MVR) was performed to evaluate the association between rural residence and the odds of receiving GCC. Effect modification was evaluated using a two-way interaction for rurality by insurance status.Of 320,719 identified patients, 6191 (2%) were rural. The rural patients had lower income and lower educational status than the urban patients and were more often Medicare-insured (p < 0.001). The rural patients traveled farther (44.5 vs. 7.5 miles; p < 0.001), although time to surgery was similar (8 vs. 9 days). The two cohorts had similar resection rates (98.8% vs. 98.0%), margin positivity (5.4% vs. 4.8%), adequate lymphadenectomy (80.9% vs. 83.0%), adjuvant chemotherapy (stage III: 69.2% vs. 68.7%), and receipt of GCC (66.5% vs. 68.3%). In the MVR, the odds of receiving GCC did not differ between the rural and urban patients (odds ratio, 0.99; 95% confidence interval, 0.94-1.05%). Insurance status did not differentially influence the receipt of GCC by the rural versus the urban patients (interaction: p = 0.83).Rural and urban patients with locoregional CC are equally likely to receive GCC, suggesting that differences in cancer care delivery may not explain rural-urban disparities.© 2023. Society of Surgical Oncology.