SOCIAL VULNERABILITY, RURALITY, AND EMERGENCY COLON CANCER CARE: A NARRATIVE REVIEW

Michał Babicz; Oliwer Muller; Katarzyna Rosa; Agata Słoma; Jagoda Pałubska; Natalia Malatyńska; Anna Szot; Dominik Szydełko; Daria Danielczyk; Paweł Żurek

doi:10.31435/ijitss.1(49).2026.6092

Authors

Michał Babicz Jan Kochanowski University, Kielce, Poland https://orcid.org/0009-0007-7611-4695
Oliwer Muller Kielce Hospital of St. Aleksandra Sp. z o.o., Kielce, Poland https://orcid.org/0009-0005-6197-8461
Katarzyna Rosa Uniwersyteckie Centrum Kliniczne, Gdańsk, Poland https://orcid.org/0009-0005-9307-4774
Agata Słoma Uniwersyteckie Centrum Kliniczne, Gdańsk, Poland https://orcid.org/0009-0004-6807-7706
Jagoda Pałubska Independent Public Health Care Institution of the Ministry of the Interior and Administration in Kielce named after St. John Paul II, Kielce, Poland https://orcid.org/0009-0000-3833-7977
Natalia Malatyńska Jan Kochanowski University, Kielce, Poland https://orcid.org/0009-0005-3824-8225
Anna Szot Jan Kochanowski University, Kielce, Poland https://orcid.org/0009-0003-2613-1068
Dominik Szydełko Wojewódzki Szpital Zespolony w Kielcach, Kielce, Poland https://orcid.org/0009-0002-9907-858X
Daria Danielczyk Wojewódzki Szpital Zespolony w Kielcach, Kielce, Poland https://orcid.org/0009-0002-4955-4883
Paweł Żurek Medical University of Warsaw, Warsaw, Poland https://orcid.org/0009-0006-3023-5128

DOI:

https://doi.org/10.31435/ijitss.1(49).2026.6092

Keywords:

Colon Cancer, Social Vulnerability, Rural Health, Emergency Surgery, Treatment Inequities, Public Health

Abstract

Objective: To integrate recent evidence on the ways neighborhood social vulnerability and rural residence influence emergency presentation in colon cancer and the care trajectory that follows surgery.

Methodology: This narrative review examined PubMed-indexed literature identified through a targeted search on March 5, 2026. Systematic reviews, multicenter observational studies, and intervention studies published in English between 2013 and 2026 were prioritized, with preference for colon-specific evidence and selective inclusion of colorectal studies when directly applicable to colon cancer pathways.

Results: The literature points to a consistent pathway: socially vulnerable and rural populations are screened less often, enter care later, undergo non-elective surgery more frequently, and face greater difficulty completing postoperative and adjuvant care. Studies also suggest that provider availability, Commission on Cancer accreditation, patient navigation, and telehealth-supported follow-up can mitigate part of this disadvantage, although digital strategies remain constrained by broadband access, language barriers, and digital literacy.

Conclusion: Emergency colon cancer surgery is best interpreted as a downstream marker of inequity across the care continuum. Efforts to reduce it should connect public-health outreach, access planning, perioperative care, and technology-enabled continuity rather than treating the emergency operation as an isolated event.

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