{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T14:26:21Z","timestamp":1791383181494,"version":"4.3.3"},"reference-count":56,"publisher":"American Society of Clinical Oncology (ASCO)","issue":"7","content-domain":{"domain":["ascopubs.org"],"crossmark-restriction":true},"short-container-title":["JCO Oncol Pract"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:sec>\n                    <jats:title>PURPOSE<\/jats:title>\n                    <jats:p>Studies have shown that rural populations were less likely than urban populations to use telemedicine during and after the COVID-19 pandemic. These trends are not well characterized nationally for patients with cancer.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>This cohort analysis, using 2 years of Medicare fee-for-service claims (2020-2021), identified patients with incident or prevalent lung or colon cancer in 2020. Rurality of patient residence was classified using rural-urban commuting area codes as metropolitan, micropolitan, or small town\/rural. We used generalized estimating equations to model outpatient (telemedicine and in-person) visit trends in 2020 and 2021 by rurality, adjusting for local COVID-19 rates, US region, and clinical and demographic factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>\n                      We identified 355,868 patients (66% lung, 34% colon). Median age was 76 years (standard deviation [SD], 7). 78% of patients lived in metropolitan areas, 85% were White, and 53% female. 44% had at least one instance of chemotherapy, surgery, or radiation treatment in 2020. In 2020, compared with patients residing in metropolitan areas, small town\/rural-residing patients were less likely to use telemedicine (1.28 visits per year [95% CI, 1.27 to 1.29]\n                      <jats:italic toggle=\"yes\">v<\/jats:italic>\n                      2.34 [95% CI, 2.33 to 2.35] for metropolitan patients), had fewer total outpatient in-person visits (12.37 [95% CI, 12.34 to 12.41]\n                      <jats:italic toggle=\"yes\">v<\/jats:italic>\n                      13.71 [95% CI, 13.70 to 13.72]), and had more emergency department (ED) visits (0.85 [95% CI, 0.84 to 0.86]\n                      <jats:italic toggle=\"yes\">v<\/jats:italic>\n                      0.48 [95% CI, 0.48 to 0.48]) while inpatient utilization was similar. Similar trends were seen in 2021 and by cancer type.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION<\/jats:title>\n                    <jats:p>Lower rural telemedicine use continued beyond the pandemic onset. Relatively lower in-person and higher ED use suggests that telemedicine expansion did not improve overall access to care for rural patients with cancer.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1200\/op-24-00751","type":"journal-article","created":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T19:59:28Z","timestamp":1760039968000},"page":"1331-1340","update-policy":"https:\/\/doi.org\/10.1200\/crossmark","source":"Crossref","is-referenced-by-count":4,"title":["Comparing Trends in Telemedicine Use and Geographic Disparities in Utilization Among Patients With Cancer in the United States"],"prefix":"10.1200","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4508-8267","authenticated-orcid":false,"given":"Matthew","family":"Mackwood","sequence":"first","affiliation":[{"name":"Community &amp; Family Medicine, Geisel School of Medicine at Dartmouth, Lebanon, NH"},{"name":"The Dartmouth Institute for Health Policy &amp; Clinical Practice, Geisel School of Medicine at Dartmouth, Lebanon, NH"},{"name":"Dartmouth-Hitchcock Health, Lebanon, NH"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qianfei","family":"Wang","sequence":"additional","affiliation":[{"name":"The Dartmouth Institute for Health Policy &amp; Clinical Practice, Geisel School of Medicine at Dartmouth, Lebanon, NH"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9302-4762","authenticated-orcid":false,"given":"Tor D.","family":"Tosteson","sequence":"additional","affiliation":[{"name":"Community &amp; Family Medicine, Geisel School of Medicine at Dartmouth, Lebanon, NH"},{"name":"The Dartmouth Institute for Health Policy &amp; Clinical Practice, Geisel School of Medicine at Dartmouth, Lebanon, NH"},{"name":"Department of Biomedical Data Science, Geisel School of Medicine at Dartmouth, Lebanon, NH"},{"name":"Dartmouth Cancer Center, Lebanon, NH"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3984-9995","authenticated-orcid":false,"given":"Gabriel","family":"Brooks","sequence":"additional","affiliation":[{"name":"The Dartmouth Institute for Health Policy &amp; Clinical Practice, Geisel School of Medicine at Dartmouth, Lebanon, NH"},{"name":"Dartmouth-Hitchcock Health, Lebanon, NH"},{"name":"Dartmouth Cancer Center, Lebanon, NH"},{"name":"Department of Medicine, Geisel School of Medicine at Dartmouth, Lebanon, NH"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6015-400X","authenticated-orcid":false,"given":"Rebecca E.","family":"Smith","sequence":"additional","affiliation":[{"name":"Community &amp; Family Medicine, Geisel School of Medicine at Dartmouth, Lebanon, NH"},{"name":"The Dartmouth Institute for Health Policy &amp; Clinical Practice, Geisel School of Medicine at Dartmouth, Lebanon, NH"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7718-8943","authenticated-orcid":false,"given":"Anna N.A.","family":"Tosteson","sequence":"additional","affiliation":[{"name":"Community &amp; Family Medicine, Geisel School of Medicine at Dartmouth, Lebanon, NH"},{"name":"The Dartmouth Institute for Health Policy &amp; Clinical Practice, Geisel School of Medicine at Dartmouth, Lebanon, NH"},{"name":"Dartmouth Cancer Center, Lebanon, NH"},{"name":"Department of Medicine, Geisel School of Medicine at Dartmouth, Lebanon, NH"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"233","reference":[{"key":"e_1_3_10_2_2","volume-title":"The Coronavirus Pandemic and the Transformation of Telehealth","author":"Gelburd R","year":"2020","unstructured":"Gelburd R: The Coronavirus Pandemic and the Transformation of Telehealth. 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