Patients with localized non‐small cell lung cancer miss out on curative surgery with distance from specialist care

Tracey, Elizabeth; McCaughan, Brian C.; Badgery‐Parker, Tim; Young, Jane; Armstrong, Bruce K.

doi:10.1111/ans.12855

Cited by 36 publications

(34 citation statements)

References 28 publications

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“…3 Similar findings have been reported in other regions, for example, the East Anglian region of England. Moreover, in NSW, lack of surgical treatment fully explained the lower rate of survival from lung cancer observed in patients living farthest from an accessible thoracic surgical service.…”

supporting

confidence: 80%

How can we ensure that people with lung cancer living in rural and remote areas are treated surgically when appropriate?

Tracey

McCaughan

Young

et al. 2016

Medical Journal of Australia

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supporting

confidence: 80%

How can we ensure that people with lung cancer living in rural and remote areas are treated surgically when appropriate?

Tracey

McCaughan

Young

et al. 2016

Medical Journal of Australia

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“…Although it was the least important of the attributes studied, one should not consider it to be unimportant. Other studies in the literature suggest that distance traveled for treatment does affect patient decision-making regarding cancer care, and that some patients are not willing to travel for specialist care [28, 29]. In contrast, our results suggest that although still a factor in patient decision-making, travel distance is less important than treatment type and outcomes in this study population.…”

Section: Commentcontrasting

confidence: 68%

Patient Preferences in Treatment Choices for Early-Stage Lung Cancer

Tong

Wallace

Hartwig

et al. 2016

The Annals of Thoracic Surgery

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Background Decision-making for lung cancer treatment can be complex because it involves both provider recommendations based on the patient’s clinical condition and patient preferences. This study describes the relative importance of several considerations in lung cancer treatment from the patient’s perspective. Methods A conjoint preference experiment began by asking respondents to imagine that they had just been diagnosed with lung cancer. Respondents then chose among procedures that differed regarding treatment modalities, the potential for treatment-related complications, the likelihood of recurrence, provider case volume, and distance needed to travel for treatment. Conjoint analysis derived relative weights for these attributes. Results A total of 225 responses were analyzed. Respondents were most willing to accept minimally invasive operations for treatment of their hypothetical lung cancer, followed by stereotactic body radiation therapy (SBRT); they were least willing to accept thoracotomy. Treatment type and risk of recurrence were the most important attributes from the conjoint experiment (each with a relative weight of 0.23), followed by provider volume (relative weight of 0.21), risk of major complications (relative weight of 0.18), and distance needed to travel for treatment (relative weight of 0.15). Procedural and treatment preferences did not vary with demographics, self-reported health status, or familiarity with the procedures. Conclusions Survey respondents preferred minimally invasive operations over SBRT or thoracotomy for treatment of early-stage non-small cell lung cancer. Treatment modality and risk of cancer recurrence were the most important factors associated with treatment preferences. Provider experience outweighed the potential need to travel for lung cancer treatment.

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“…Some studies found that patients living farther from a radiation treatment facility more often underwent mastectomy instead of BCS [23][24][25][27][28][29] or did not undergo radiotherapy after BCS [22,24]. The results reported by Schroen et al [23] suggest that a marked change in geographic access to radiotherapy by opening new facilities might correlate with an increase in the proportion of patients undergoing breast conservation therapy.Tracey et al [30] found that patients with localized NSCLC were most likely to not undergo potentially curative surgery if they lived far from a specialist hospital and only attended a general hospital for their care.…”

Section: Cmementioning

confidence: 99%

Distance as a Barrier to Cancer Diagnosis and Treatment: Review of the Literature

et al. 2015

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The burden of travel from a patient's residence to health care providers is an important issue that can influence access to diagnosis and treatment of cancer. Although several studies have shown that the travel burden can result in delays in diagnosis and treatment of many common cancers, its role appears underestimated in the treatment of patients in clinical practice. Therefore, we performed a review of the published data on the role of travel burden influencing four items: delay of diagnosis, adequate treatment of cancer, outcome, and quality of life of cancer patients. Forty‐seven studies published up to December 2014 were initially identified. Twenty studies were excluded because they did not regard specifically the four items of our review. Twenty‐seven studies formed the basis of our study and involved 716,153 patients. The associations between travel burden and (a) cancer stage at diagnosis (12 studies), (b) appropriate treatment (8 studies), (c) outcome (4 studies), and (d) quality of life (1 study) are reported. In addition, in two studies, the relation between travel burden and compliance with treatment was examined. The results of our review show that increasing travel requirements are associated with more advanced disease at diagnosis, inappropriate treatment, a worse prognosis, and a worse quality of life. These results suggest that clinical oncologists should remember the specific travel burden problem for cancer patients, who often need health care services every week or every month for many years. Implications for Practice: The influence of travel burden on cancer patients has been previously studied, but this is the first comprehensive review of the available literature. This review shows that travel burden negatively influences stage at diagnosis, appropriate treatment, outcome, and quality of life in cancer patients. The results demonstrate that clinical oncologists should keep in mind the specific travel burden problem for cancer patients who often need health care services every week or every month for many years.

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Patients with localized non‐small cell lung cancer miss out on curative surgery with distance from specialist care

Abstract: Patients with localized NSCLC are most likely to have no potentially curative surgery if they live distant from a specialist hospital and attend a general hospital for their care.

Cited by 36 publications

References 28 publications

How can we ensure that people with lung cancer living in rural and remote areas are treated surgically when appropriate?

How can we ensure that people with lung cancer living in rural and remote areas are treated surgically when appropriate?

Patient Preferences in Treatment Choices for Early-Stage Lung Cancer

Distance as a Barrier to Cancer Diagnosis and Treatment: Review of the Literature

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