Minimally Invasive Surgery for Colon Cancer Treatment: A Comparison of Rural vs. Urban Populations in Nebraska

Colorectal cancer (CRC) is ranked third for cancer incidence and mortality in United States and varies by race/ethnicity, gender and rural vs. urban residence. In fact, mortality from colorectal cancer is higher in the Midwestern states compared to other parts of the country, which could be attributed to the large number of rural communities in these states. Health disparities in access to care, screening, and treatment exist in rural populations for CRC and other cancer types. Technological advancements in CRC treatment including minimally invasive techniques such as laparoscopic surgery have shown to have equivalent or even superior outcomes compared to the standard surgical treatment. However, this procedure remains underutilized in rural health facilities. Furthermore, it is currently unknown where and how many physicians in Nebraska perform this procedure and how the treatment received affects patient outcomes. 

Specific Aims:
1. Examine the potential rural-urban health disparities in regards to colon cancer treatment receipt. 
a. Are rural residents less likely to receive laparoscopic surgery for colon cancer treatment compared to urban residents in Nebraska?
2. Identify factors associated with improved patient outcomes after laparoscopic surgery including overall survival and recurrence.
3. Explore barriers to the receipt of laparoscopic surgery in rural Nebraska.

Kelli Gruber
Kelli Gruber Picture

I graduated from the University of Nebraska Lincoln in 2010 with a B.S. degree in Biology. I took a field epidemiology course during undergrad which sparked my interest in public health and epidemiology. I first received my Certificate in Public Health from the University Of Nebraska College Of Public Health in Spring 2012. Upon completion of the certificate, I applied to the MPH Epidemiology program and started in Fall 2012. My anticipated date of graduation is December 20, 2013. After graduation I hope to pursue a career in cancer epidemiology. More specifically, I want to research pediatric cancer etiology and treatment for the newly diagnosed and survivors of childhood cancers.