Length of stay, costs, and mortality in colon cancer: A regional comparison between the northeast and west.

Abstract

e13756 Background: Colorectal cancer is a leading cause of cancer-related mortality in the United States, with an estimated 108,860 new colon cancer (CC) cases in 2026. Despite well-documented regional disparities in healthcare resources, their impact on inpatient outcomes among patients with CC remains unclear. This study compares in-hospital and discharge outcomes across U.S. regions to evaluate the influence of geographic variation on inpatient care. Methods: A retrospective cohort study was conducted using the 2019–2023 National Inpatient Sample (NIS) database. Adult patients (≥18 years) hospitalized with CC were identified using ICD-10 codes and stratified into the Northeast (NE) and West (W) regions, with NE as the reference. Baseline characteristics and outcomes were compared between regions using univariate and multivariate logistic regression analyses. Results: Among 1,306,735 CC hospitalizations, 14.7% (n = 192, 090) occurred in the Northeast (NE) and 15.4% (n = 201, 237) in the West (W). Patients in the W were younger (65 vs. 67 years; CoEff −1.4; P < 0.001). Males predominated in both regions (NE 53%, W 54%), with White patients being the largest racial group (NE 72%, W 60%). The second most common race was Black in the NE (11%) and Hispanic in the W (19%). High-income households were more common in the NE (35% vs. 32%), while 17% in both regions were in the lowest-income quartile (P < 0.05), indicating greater income disparity in the NE. Teaching hospitals were more frequent in the NE (87% vs. 75%), while large-bed hospitals were more common in the W (58% vs. 47%; P < 0.001). Patients in the W had a shorter length of stay (6.5 vs. 7.0 days; CoEff −0.6; P < 0.001) but higher costs ($121,110 vs. $94,522; CoEff $26,587; P < 0.001). In-hospital mortality did not differ significantly (OR 0.96; P = 0.410). Conclusions: Significant regional differences were observed among hospitalized patients with CC. Patients in the W were more frequently treated at large-bed hospitals, had shorter lengths of stay, and incurred higher hospitalization costs, potentially reflecting younger demographics and socioeconomic factors. In-hospital mortality, however, was similar between regions. These findings may reflect regional differences in healthcare utilization, hospital resources, and practice patterns, including variations in access to care. Further region-specific prospective studies are needed to elucidate the underlying drivers of these disparities and their impact on long-term outcomes and quality of care.