A retrospective study on accessibility of palliative radiation therapy in the management of prostate cancer in British Columbia

Soo, Jenny; French, John; McGahan, Colleen; Duncan, Graeme; Lengoc, Sonca

doi:10.1017/s1460396910000348

Cited by 5 publications

(13 citation statements)

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“…Another was that North East and East Kootenay HSDAs are close to the neighbouring province of Alberta. It is possible that some decedents were referred to the radiotherapy centres in Alberta, which would not be captured in our data [15]. These findings were consistent with other studies that showed the detrimental effect of increased travel time on reduced PRT use existed previously, affecting patients as early as 1986 [15, 16].…”

Section: Discussionsupporting

confidence: 80%

Palliative radiotherapy utilization for cancer patients at end of life in British Columbia: retrospective cohort study

et al. 2014

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BackgroundThe use of palliative radiotherapy (PRT) is variable in advanced cancer. Little is known about PRT utilization by end-of-life (EOL) cancer patients in Canada. This study examined the PRT utilization rates and factors associated with its use in a cohort of cancer patients who died in British Columbia (BC).MethodsBC residents with invasive cancer who died between April 1, 2010 and March 31, 2011 were included in the study. Their cancer registry and radiotherapy treatment records were extracted from the BC Cancer Agency information systems and linked for the analysis. The PRT utilization rates by age, sex, primary cancer diagnosis, geographic region, survival time and travel time to the cancer centre were examined. Multivariable logistic regression was used to determine the factors that influenced the PRT utilization rates.ResultsOf the 12,300 decedents in the study 2,669 (21.7%) had received at least one course of PRT in their last year of life. The utilization rates dropped to 5.0% and 2.2% in the last 30 and 14 days of life, respectively. PRT utilization varied across diagnosis and was highest for lung cancer (45.7%) and lowest for colorectal cancer (8.9%). The rates also varied by age, survival time and travel time to the nearest radiotherapy centre. There was a greater odds of receiving PRT for those with primary lung cancer, survival time between 1.5-26 months from diagnosis or living within 2 hours from a cancer centre. The 85+ age group was least likely to receive PRT in their last year of life.ConclusionsThis study found PRT utilization rates of EOL cancer decedents to be variable across the province of BC. Age, diagnosis, survival time and travel time to the nearest radiotherapy centre were found to influence the odds of PRT treatment. Further work is still needed to establish the appropriate PRT utilization rates for the EOL cancer population.Electronic supplementary materialThe online version of this article (doi:10.1186/1472-684X-13-49) contains supplementary material, which is available to authorized users.

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Section: Discussionsupporting

confidence: 80%

Palliative radiotherapy utilization for cancer patients at end of life in British Columbia: retrospective cohort study

et al. 2014

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“…Individuals living in the Circumpolar North may have to travel extensive distances to reach other cities or even other countries for the health services they need, especially if these are specialised services [11,[14][15][16]20,22,28,31,32]. For example, researchers found that some patients living in Greenland must endure 6 to 7 h of travel time to gain access to advanced care in Denmark [15].…”

Section: Distance To Urban Centresmentioning

confidence: 99%

Identifying barriers to healthcare delivery and access in the Circumpolar North: important insights for health professionals

Huot

et al. 2019

International Journal of Circumpolar Health

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Lack of access to healthcare services for people living in the Circumpolar North may have important consequences for their health and well-being, both in terms of the actual treatment and other possible health-related consequences intertwined with their life situation. The aim of the present study was to identify the specific challenges to healthcare service delivery and access for populations in the Circumpolar North that are addressed in contemporary literature. A scoping review of literature published between 2005 and 2016 was conducted and 43 articles were selected for inclusion into the review. The review findings address 4 main themes identified in the literature: (1) the influence of physical geography, (2) healthcare provider-related barriers, (3) the importance of culture and language and (4) the impact of systemic factors. The review of the literature enabled us to identify existing gaps in both health service access and issues discussed in the available literature, particularly for informing healthcare services in the Circumpolar North, as well as point towards opportunities for future research. The thematic findings drawn from interdisciplinary and international literature inform understandings of the impact of health system barriers on healthcare services and the opportunities for Northern residents to support their own health.

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“…Cancer diagnoses were categorised according to the International Classification of Disease (ICD) codes ( n = 19), SEER [ 17 , 18 ] ( n = 2) and the Cancer Agency Information System (CAIS) [ 30 ] ( n = 1). Cancer diagnoses were identified using administrative health database claims ( n = 11), cancer registries ( n = 10), death certificates [ 31 ] ( n = 1), health insurance claims [ 32 ] ( n = 1), palliative program enrolment records [ 33 ] ( n = 1) and linked cancer registry and death certificate data [ 34 ] ( n = 1).…”

Section: Resultsmentioning

confidence: 99%

“…As measures of specialist palliative care two studies examined SPC usage [ 31 , 37 ], 10 studies examined the use of hospice care [ 12 , 14 , 15 , 16 , 17 , 18 , 32 , 38 , 39 , 40 ], two studies assessed receipt of PRT [ 30 , 34 ] and one study assessed receipt of pharmacotherapy [ 13 ] ( Table 1 ). Regarding SPC usage, Burge et al [ 37 ] found residents in rural regions compared with urban were less likely to be registered with a palliative care program (PCP) after controlling for age (0.8 (0.7–1.0)).…”

Section: Resultsmentioning

confidence: 99%

“…Assessed in just two studies, the patterns of PRT treatment rates were observed to be low, geographically-dependent and vary from 14% at any point after prostate cancer diagnosis [ 30 ] to 22.5% in the last 9 months of life in decedents with lung, breast, melanoma and prostate cancer [ 34 ]. Soo et al [ 30 ] found more remote regions to have lower PRT utilisation rates and decedents who resided in areas that were geographically removed from a cancer centre were less likely to receive PRT. Similarly, Lavergne et al [ 34 ] also found, through univariate analysis that living in a rural area was a predictor of lower rates of PRT consultation and treatment.…”

Section: Resultsmentioning

confidence: 99%

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End-of-Life Cancer Care Resource Utilisation in Rural Versus Urban Settings: A Systematic Review

Cerni

Rhee

Hosseinzadeh

2020

IJERPH

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Background: Despite the advances in End-of-life (EOL) cancer care, disparities remain in the accessibility and utilisation of EOL cancer care resources. Often explained by socio-demographic factors, geographic variation exists in the availability and provision of EOL cancer care services among EOL cancer decedents across urban versus rural settings. This systematic review aims to synthesise mortality follow-back studies on the patterns of EOL cancer care resource use for adults (>18 years) during end-of-life cancer care. Methods: Five databases were searched and data analysed using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Inclusion criteria involved; a) original research; b) quantitative studies; c) English language; d) palliative care related service use in adults (>18 years) with any malignancy excluding non-melanoma skin cancers; e) exclusive end of life focus; f) urban-rural focus. Narrative reviews and discussions were excluded. Results: 24 studies met the inclusion criteria. End-of-life cancer care service utilisation patterns varied by rurality and treatment intent. Rurality was strongly associated with higher rates of Emergency Department (ED) visits and hospitalisations and lower rates of hospice care. The largest inequities between urban and rural health service utilisation patterns were explained by individual level factors including age, gender, proximity to service and survival time from cancer diagnosis. Conclusions: Rurality is an important predictor for poorer outcomes in end-of-life cancer care. Findings suggest that addressing the disparities in the urban-rural continuum is critical for efficient and equitable palliative cancer care. Further research is needed to understand barriers to service access and usage to achieve optimal EOL care for all cancer patient populations.

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A retrospective study on accessibility of palliative radiation therapy in the management of prostate cancer in British Columbia

Cited by 5 publications

References 20 publications

Palliative radiotherapy utilization for cancer patients at end of life in British Columbia: retrospective cohort study

Palliative radiotherapy utilization for cancer patients at end of life in British Columbia: retrospective cohort study

Identifying barriers to healthcare delivery and access in the Circumpolar North: important insights for health professionals

End-of-Life Cancer Care Resource Utilisation in Rural Versus Urban Settings: A Systematic Review

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