Association Between Geographic Access to Cancer Care, Insurance, and Receipt of Chemotherapy: Geographic Distribution of Oncologists and Travel Distance

Lin, Chun Chieh; Bruinooge, Suanna S.; Kirkwood, M. Kelsey; Olsen, Christine; Jemal, Ahmedin; Bajorin, Dean F.; Giordano, Sharon H.; Goldstein, Michael A.; Guadagnolo, B. Ashleigh; Kosty, Michael P.; Hopkins, Shane; Yu, James B.; Arnone, Anna; Hanley, Amy; Stevens, Stephanie; Hershman, Dawn L.

doi:10.1200/jco.2015.61.1558

Cited by 198 publications

(180 citation statements)

References 41 publications

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“…In this study, living >100 miles from the treatment center resulted in three times higher odds of nonadherence with surveillance. Distance was also associated with adherence with treatment in the study by Deutschmann et al Poor treatment adherence has been demonstrated in other studies due to distance traveled for care . However, treatment at centers with higher facility and surgeon volumes have been demonstrated to result in improved overall outcomes .…”

Section: Discussionmentioning

confidence: 73%

Adherence with National Comprehensive Cancer Network posttreatment surveillance guidelines in patients with head and neck cancer

et al. 2019

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Background Surveillance in head and neck cancer (HNC) is essential to detect recurrent or new lesions and to optimize function. This study describes drivers of surveillance adherence in patients with HNC and its effect on prognosis. Methods Adherence with surveillance of HNC patients was determined using the National Comprehensive Cancer Network HNC guidelines. Logistic regression and Cox proportional hazards models were used to determine predictors of adherence and overall survival (OS). Results Results showed that 110 of 221 patients (50.2%) were adherent with surveillance. Distance from the treatment center was the only significant association. Adherence was not associated with OS following multivariate adjustment (adjusted hazard ratio [aHR] = 0.68, 95% confidence interval [CI] = 0.43‐1.09). However, 5‐10 years after treatment completion, adherence was an independent predictor of survival (aHR = 0.24, 95% CI = 0.09‐0.61). Conclusion Adherence with surveillance is important in improving survival in patients with HNC, especially in the long term.

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Section: Discussionmentioning

confidence: 73%

Adherence with National Comprehensive Cancer Network posttreatment surveillance guidelines in patients with head and neck cancer

et al. 2019

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“…(7, 8) Worse outcomes with increasing distance or rural residence may be caused by barriers to health care utilization both for primary treatment and follow-up care. (9-11) Other studies have found either no association or improved outcomes with longer distances travelled, suggesting that the availability of specialized care at high volume or comprehensive cancer centers overcomes the hardship of travel and lack of proximity to personal support systems, even after adjusting for better social resources of patients who can travel (wealthier and more educated patients may travel longer distances to specialized cancer centers). (12, 13)…”

Section: Discussionmentioning

confidence: 99%

Association of Distance from Transplantation Center and Place of Residence on Outcomes after Allogeneic Hematopoietic Cell Transplantation

Khera

Gooley

Flowers

et al. 2016

Biology of Blood and Marrow Transplantation

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Regionalization of specialized health services can deliver high-quality care but may have an adverse impact on access and outcomes due to distance from the regional centers. In case of hematopoietic cell transplantation (HCT), the effect of increased distance from transplant center and rural/ urban residence is unclear due to conflicting results from the existing studies. We examined the association between distance from primary residence to the transplant center and rural vs. urban residence with clinical outcomes following allogeneic HCT in a large cohort of patients. Overall mortality (OM), non-relapse mortality (NRM) and relapse in all patients and those that survived for 200 days after HCT was assessed in 2849 patients who received their first allogeneic HCT between 2000 and 2010 at Fred Hutchinson Cancer Research Center (FHCRC) /Seattle Cancer Care Alliance (SCCA). Median distance from FHCRC was 263 miles (range 0 to 2740 miles), and 83% were urban residents. The association between distance and the hazard of OM varied according to conditioning intensity: myeloablative (MA) vs. non-myeloablative (NMA). Among MA patients, there was no evidence of an increased risk of mortality with increased distance, but NMA patients did show a suggestion of increased risk of mortality for some distances, although globally the difference was not statistically significant. In the subgroup of patients who survived till 200 days, there was no evidence that the risk of OM, relapse or NRM was increased with increasing distance. We did not find any association between longer distance from transplant center and urban/ rural residence and outcomes after MA HCT. In patients undergoing NMA transplants, this relationship and how it is influenced by factors such as age, payors and comorbidities needs to be further investigated.

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“…Thus, geographic access should be considered as a significant variable associated with the receipt of treatment for LARC patients, whereas the density level of radiation oncologists cannot. Moreover, patients with nonprivate insurance who lived in low-density oncologist areas were less likely to receive the standard treatment [5,6]. socioeconomic status, age, and comorbidities.…”

Section: The Us National Cancer Database (Ncdb)mentioning

confidence: 99%

Why is neoadjuvant chemoradiation therapy underused for locally advanced rectal cancer?

Molinari

Passardi

2016

Expert Review of Gastroenterology & Hepatology

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Association Between Geographic Access to Cancer Care, Insurance, and Receipt of Chemotherapy: Geographic Distribution of Oncologists and Travel Distance

Cited by 198 publications

References 41 publications

Adherence with National Comprehensive Cancer Network posttreatment surveillance guidelines in patients with head and neck cancer

Adherence with National Comprehensive Cancer Network posttreatment surveillance guidelines in patients with head and neck cancer

Association of Distance from Transplantation Center and Place of Residence on Outcomes after Allogeneic Hematopoietic Cell Transplantation

Why is neoadjuvant chemoradiation therapy underused for locally advanced rectal cancer?

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