Does Travel Time to a Radiation Facility Impact Patient Decision‐Making Regarding Treatment for Prostate Cancer? A Study of the New Hampshire State Cancer Registry

Ghali, Fady; Celaya, Maria O.; Laviolette, M; Ingimarsson, Johann P.; Carlos, Heather A.; Rees, Judy R.; Hyams, Elias S.

doi:10.1111/jrh.12224

Cited by 6 publications

(9 citation statements)

References 16 publications

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“…While eight of the USA-based studies, reported higher incidence rates among urban residents (or those from areas with higher density of urologists) (25, 38, 40–44, 46), two found no geographical differentials (39, 45). Similarly, two Australian studies reported no significant differences (31, 54), three studies found higher prostate cancer incidence among urban males (32, 52, 53) and one study recorded the reverse pattern (55).…”

Section: Resultsmentioning

confidence: 95%

“…Of the 23 studies included, 14 (six high, eight moderate quality) reported higher prostate cancer incidence rates in urban areas (25, 32, 36, 38, 40–44, 46, 47, 49, 52, 53), two (moderate) higher rates in rural areas (50, 55) and seven (one high, six moderate) no urban rural differences (31, 37, 39, 45, 48, 51, 54) (Figure 2; Table 3). Six studies used a mixture of data collected both prior to and after the widespread use of PSA testing, which combined with varying time-periods for analysis, could lead to conflicting patterns (31, 32, 39, 49, 51, 55).…”

Section: Resultsmentioning

confidence: 99%

“…Patterns for RP varied with two USA-based (44, 77) and five Australian studies (31, 32, 115, 147, 148) reporting higher rates among urban men or those living closer to major treatment facilities (148). Whereas, two other studies from the USA (144, 145) as well as one each from Australia (108) and England (146) reported no geographical differentials.…”

Section: Resultsmentioning

confidence: 99%

“…Included studies gave mixed results for differentials in RT rates for localized or early stage prostate cancer in the USA, with two finding no significant differences (144, 145), one higher rates of BB among rural (77) and one among urban residents (44). Rural men were also 83% less likely to receive intensity-modulated RT (IMRT) for localized prostate cancer (149).…”

Section: Resultsmentioning

confidence: 99%

“…A study from South Korea (153) and two from the USA (151, 152) found no association between residential rurality and the type of curative treatment received (i.e., RP vs. RT). Moreover, among men with early stage prostate cancer who underwent curative treatment in the USA, urban and rural residents were about equally as likely to receive a one-time treatment (RP or BB) (77), whereas urban residence was associated with greater use of one-time RP or BB rather than daily EBRT for localized disease in another study (44). However, there was no difference by residential location in the use of combined radiotherapies (EBRT and BB vs. EBRT) for intermediate or high-risk disease (116).…”

Section: Resultsmentioning

confidence: 99%

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Geographical Variations in Prostate Cancer Outcomes: A Systematic Review of International Evidence

et al. 2019

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Background: Previous reviews of geographical disparities in the prostate cancer continuum from diagnosis to mortality have identified a consistent pattern of poorer outcomes with increasing residential disadvantage and for rural residents. However, there are no contemporary, systematic reviews summarizing the latest available evidence. Our objective was to systematically review the published international evidence for geographical variations in prostate cancer indicators by residential rurality and disadvantage. Methods: Systematic searches of peer-reviewed articles in English published from 1/1/1998 to 30/06/2018 using PubMed, EMBASE, CINAHL, and Informit databases. Inclusion criteria were: population was adult prostate cancer patients; outcome measure was PSA testing, prostate cancer incidence, stage at diagnosis, access to and use of services, survival, and prostate cancer mortality with quantitative results by residential rurality and/or disadvantage. Studies were critically appraised using a modified Newcastle-Ottawa Scale. Results: Overall 169 studies met the inclusion criteria. Around 50% were assessed as high quality and 50% moderate. Men from disadvantaged areas had consistently lower prostate-specific antigen (PSA) testing and prostate cancer incidence, poorer survival, more advanced disease and a trend toward higher mortality. Although less consistent, predominant patterns by rurality were lower PSA testing, prostate cancer incidence and survival, but higher stage disease and mortality among rural men. Both geographical measures were associated with variations in access and use of prostate cancer-related services for low to high risk disease. Conclusions: This review found substantial evidence that prostate cancer indicators varied by residential location across diverse populations and geographies. While wide variations in study design limited comparisons across studies, our review indicated that internationally, men living in disadvantaged areas, and to a lesser extent more rural areas, face a greater prostate cancer burden. This review highlights the need for a better understanding of the complex social, environmental, and behavioral reasons for these variations, recognizing that, while important, geographical access is not the only issue. Implementing research strategies to help identify these processes and to better understand the central role of disadvantage to variations in health outcome are crucial to inform the development of evidence-based targeted interventions.

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Section: Resultsmentioning

confidence: 95%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 3 more Smart Citations

Geographical Variations in Prostate Cancer Outcomes: A Systematic Review of International Evidence

et al. 2019

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Is Centralisation of Cancer Services Associated With Under‐Treatment of Patients With High‐Risk Prostate Cancer?—A National Population‐Based Study

Han,

Mayne,

Dodkins

et al. 2024

Cancer Medicine

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BackgroundCentralising prostate cancer surgical and radiotherapy services, requires some patients to travel longer to access treatment, but its impact on actual treatment utilisation and outcomes is unknown.MethodsUsing national cancer registry records linked to administrative hospital data, we identified all patients with high risk and locally advanced prostate cancer diagnosed between 1 April 2019 and 31 March 2020 in the English National Health Service (n = 15,971). Estimated travel times from the patient residential areas to the nearest hospital providing surgery or radiotherapy were estimated for journeys by car and by public transport. Multivariable logistic regression was used to model relationships between travel time and receipt of care with adjustment for patient characteristics.Results10,693 (67%) men received radical surgery or radiotherapy (RT) within 12 months of diagnosis. Average travel time to the nearest hospital providing prostatectomy or RT was 23.2 min by private car and 58.2 min by public transport. We found no association between travel time, either by car or public transport and the likelihood of receiving curative treatment. Patients living in the most socially deprived areas, those aged over 70, those with two or more comorbidities, and those of black ethnic origin, were less likely to receive curative treatment (p& =& 0.001 for all associations).ConclusionsThe current configuration of national prostate cancer services is not associated with the likelihood of receiving curative treatment. Further increases in capacity will unlikely improve utilisation rates beyond addressing sociodemographic barriers.

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Disparities in the Utilization of Radiation Therapy for Prostate Cancer in the United States: A Comprehensive Review

Gardner

McClelland

Deville

2022

Advances in Radiation Oncology

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Does Travel Time to a Radiation Facility Impact Patient Decision‐Making Regarding Treatment for Prostate Cancer? A Study of the New Hampshire State Cancer Registry

Abstract: Overall, further travel time to a radiation facility was not associated with lower utilization of XRT. These data are encouraging regarding access to care for CaP in New Hampshire.

Cited by 6 publications

References 16 publications

Geographical Variations in Prostate Cancer Outcomes: A Systematic Review of International Evidence

Geographical Variations in Prostate Cancer Outcomes: A Systematic Review of International Evidence

Is Centralisation of Cancer Services Associated With Under‐Treatment of Patients With High‐Risk Prostate Cancer?—A National Population‐Based Study

Disparities in the Utilization of Radiation Therapy for Prostate Cancer in the United States: A Comprehensive Review

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