Factors affecting radiotherapy utilisation in geriatric oncology patients in NSW, Australia

Mackenzie, Penny; Vajdic, Claire M.; Delaney, Geoff P.; Gabriel, Gabriel; Agar, Meera; Comans, Tracy; Bartoň, Michael

doi:10.1016/j.tipsro.2020.09.003

Cited by 7 publications

(10 citation statements)

References 39 publications

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“…However, the association of these factors and RTU12 varied for different cancer types. Most of the earlier studies have reported lower RTU in older patients for all cancers, 4,9,21,22 and we observed this in patients with lung cancer in our study. However, for men with prostate cancer, there was higher RTU12 in older men, similar to that reported in the NSW 45 and Up Study, 23 given that younger men were more likely to opt for surgery instead of RT for prostate cancer.…”

Section: Discussionsupporting

confidence: 83%

Disparities in radiation therapy utilization for cancer patients in Victoria

et al. 2022

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Introduction: To evaluate the proportion of cancer patients who received radiation therapy (RT) within 12 months of cancer diagnosis (RTU12) and identify factors associated with RTU12. Methods: This is a population-based cohort of individuals with incident cancer, diagnosed between 2013 and 2017 in Victoria. Data linkages were performed between the Victorian Cancer Registry and Victorian Radiotherapy Minimum Dataset. The primary outcome was the proportion of patients who had RTU12. For the three most common cancers (i.e., prostate, breast and lung cancer), the time trend in RTU12 and factors associated with RTU12 were evaluated. Results: The overall RTU12 in our study cohort was 26-20% radical RT and 6% palliative RT. Of the 21,735 men with prostate cancer, RTU12 was 17%, with no significant change over time (P-trend = 0.53). In multivariate analyses, increasing age and lower socioeconomic status were independently associated with higher RTU12 for prostate cancer. Of the 20,883 women with breast cancer, RTU12 was 64%, which increased from 62% in 2013 to 65% in 2017 (Ptrend < 0.05). In multivariate analyses, age, socioeconomic status and area of residency were independently associated with RTU12 for breast cancer. Of the 13,093 patients with lung cancer, RTU12 was 42%, with no significant change over time (P-trend = 0.16). In multivariate analyses, younger age, male and lower socioeconomic status were independently associated with higher RTU12. Conclusion:In this large population-based state-wide cohort of cancer patients, only 1 in 4 had RT within 12 months of diagnosis. There were marked sociodemographic disparities in RTU12 for prostate, breast and lung cancer patients.

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Section: Discussionsupporting

confidence: 83%

Disparities in radiation therapy utilization for cancer patients in Victoria

et al. 2022

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“…Thirty studies used GIS to associate geographic measures to patient and/or health system outcomes (Table 4), such as incidence, latency for diagnosis, tumor size at diagnosis, use of primary surgery, RT utilization/interruption, delay in RURs decreased with increasing distances to nearest RT centers. This was demonstrated for palliative RT, 40,51 adjuvant RT for breast cancer, 3,4,34,35,39,45,46,[49][50][51]59,60 rectal cancer, 4,22,40,49,60,61 lung cancer, 4,22,34,40,49,51,60 colon cancer, 47,49 and prostate cancer. 22,49,60 Regional differences were noted in Norway, Australia, the United Kingdom, and the United States.…”

Section: Gis Used To Analyze Health Systems or Patient Outcomesmentioning

confidence: 91%

“…This was demonstrated for palliative RT, 40,51 adjuvant RT for breast cancer, 3,4,34,35,39,45,46,[49][50][51]59,60 rectal cancer, 4,22,40,49,60,61 lung cancer, 4,22,34,40,49,51,60 colon cancer, 47,49 and prostate cancer. 22,49,60 Regional differences were noted in Norway, Australia, the United Kingdom, and the United States. 3,34,40,50,56,62,63 Other covariates such as sex, 22,34,38,40,47,49,51,61 age, 3,22,34,35,…”

Section: Gis Used To Analyze Health Systems or Patient Outcomesmentioning

confidence: 91%

Value of Geographical Information Systems in Analyzing Geographic Accessibility to Inform Radiotherapy Planning: A Systematic Review

Hande

Chan

Polo

2022

JCO Global Oncology

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PURPOSE Vulnerable populations face geographical barriers in accessing radiotherapy (RT) facilities, resulting in heterogeneity of care received and cancer burden faced. We aimed to explore the current use of Geographical Information Systems (GIS) in access to RT and use these findings to create sustainable solutions against barriers for access in low- and middle-income countries. MATERIALS AND METHODS A systematic review using the PRISMA search strategy was done for studies using GIS to explore outcomes among patients with cancer. Included studies were reviewed and classified into three umbrella categories of how GIS has been used in studying access to RT. RESULTS Forty articles were included in the final review. Thirty-eight articles were set in high-income countries and two in upper-middle–income countries. Included studies were published from 2000 to 2020, and were comprised of patients with all-cancers combined, breast, colon, skin, lung, prostate, ovarian, and rectal carcinoma patients. Studies were categorized under three groups on the basis of how they used GIS in their analyses: to describe geographic access to RT, to associate geographic access to RT with outcomes, and for RT planning. Most studies fell under multiple categories. CONCLUSION Although this field is relative nascent, there is a wide array of functions possible through GIS for RT planning, including identifying high-risk populations, improving access in high-need areas, and providing valuable information for future resource allocation. GIS should be incorporated in future studies, especially set in low- and middle-income countries, which evaluate access to RT.

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“…So, for example, early prostate cancer rates will always be affected by the availability of surgery, what options and toxicities the urologists discuss with their patients prior to (if at all) a radiotherapy appointment pre‐surgery and whether a consultation takes place 13,14 . While attempts are being made to refine our models using data on age, frailty and co‐morbidity, there are also studies showing that older patients with good life expectancy are still missing out on radiotherapy 15 …”

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confidence: 99%

“…13,14 While attempts are being made to refine our models using data on age, frailty and co-morbidity, there are also studies showing that older patients with good life expectancy are still missing out on radiotherapy. 15 Where patients are missing out on more significant treatment benefits identified from clinical trials, this should remain a major cause for concern. For example, Ong et al in this current report show that approximately 1 in 5 patients with Stage 3 breast cancer did not receive radiotherapy.…”

mentioning

confidence: 99%