Geographic factors associated with time-to-treatment outcomes for radiation therapy among localized prostate cancer patients in Saskatchewan

Andkhoie, Mustafa; Szafron, Michael

doi:10.1016/j.jcpo.2020.100259

Cited by 3 publications

(7 citation statements)

References 24 publications

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“…For each GA, the closest PCa assessment centre was categorized as Regina or Saskatoon, based on the shortest Euclidean distance between the centroid of the GA and the centroids of Saskatoon and Regina. Further details regarding remoteness index and closest PCa assessment centre variables used in this study can be found in the literature (3,4).…”

Section: Independent Variablesmentioning

confidence: 99%

“…In addition, the Saskatchewan age-standardized PCa incidence rates have remained higher than the national Canadian rates for the majority of the past 10 years (1,2). Previous studies have shown geographic factors in uence PCa outcomes in Saskatchewan, (3,4) hence this study explores the in uence of geographic patterns on PCa incidence rates in Saskatchewan.…”

Section: Introductionmentioning

confidence: 99%

“…The low population density of Saskatchewan results in the geographic factors of remoteness and commute time being healthcare access barriers for Saskatchewan residents (3,4,11,12). The low population density also impacts the distribution of physicians in the province.…”

Section: Introductionmentioning

confidence: 99%

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Geographic Disparities in Saskatchewan Prostate Cancer Incidence and its Association with Physician Density: Analysis Using Bayesian Models.

Andkhoie

Szafron

2021

Preprint

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Background: Saskatchewan has one of the highest incidence of prostate cancer (PCa) in Canada. This study assesses if geographic factors in Saskatchewan, including location of where patients live and physician density are affecting the PCa incidence. First, the objective of this study is to estimate the PCa standardized incidence ratio (SIRs) in Saskatchewan stratified by PCa risk-level. Second, this study identifies clusters of higher than and lower than expected PCa SIRs in Saskatchewan. Lastly, this study identifies the association (if any) between family physician density and estimated PCa SIRs in Saskatchewan. Methods: First, using Global Moran’s I, Local Moran’s I, and the Kuldorff’s Spatial Scan Statistic, the study identifies clusters of PCa stratified by risk-levels. Then this study estimates the SIRs of PCa and its association with family physician density in Saskatchewan using the Besag, York, and Mollie (BYM) Bayesian method.Results: Higher than expected clusters of crude estimated SIR for metastatic PCa were identified in north-east Saskatchewan and lower than expected clusters were identified in south-east Saskatchewan. Areas in north-west Saskatchewan have lower than expected crude estimated SIRs for both intermediate-risk and low-risk PCa. Family physician density was negatively associated with SIRs of metastatic PCa (IRR: 0.935 [CrI: 0.880 to 0.998]) and SIRs of high-risk PCa (IRR: 0.927 [CrI: 0.880 to 0.975]). Conclusions: This study identifies the geographical disparities in risk-stratified PCa incidence in Saskatchewan. The study identifies areas with a lower family physician density have a higher-than-expected incidences of metastatic and high-risk PCa. Hence policies to increase the number of physicians should ensure an equitable geographic distribution of primary care physicians to support early detection of diseases, including PCa.

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Section: Independent Variablesmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Geographic Disparities in Saskatchewan Prostate Cancer Incidence and its Association with Physician Density: Analysis Using Bayesian Models.

Andkhoie

Szafron

2021

Preprint

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“…In addition, the Saskatchewan age-standardized PCa incidence rates have remained higher than the national Canadian rates for the majority of the past 10 years [ 1 , 2 ]. Previous studies have shown geographic factors influence PCa outcomes in Saskatchewan [ 3 , 4 ], hence this study explores the influence of geographic patterns on PCa incidence rates in Saskatchewan.…”

Section: Introductionmentioning

confidence: 99%

“…The low population density of Saskatchewan results in the geographic factors of remoteness and commute time being healthcare access barriers for Saskatchewan residents [ 3 , 4 , 11 , 12 ]. The low population density also impacts the distribution of physicians in the province.…”

Section: Introductionmentioning

confidence: 99%

Geographic disparities in Saskatchewan prostate cancer incidence and its association with physician density: analysis using Bayesian models

Andkhoie

Szafron

2021

BMC Cancer

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Background Saskatchewan has one of the highest incidence of prostate cancer (PCa) in Canada. This study assesses if geographic factors in Saskatchewan, including location of where patients live and physician density are affecting the PCa incidence. First, the objective of this study is to estimate the PCa standardized incidence ratio (SIRs) in Saskatchewan stratified by PCa risk-level. Second, this study identifies clusters of higher than and lower than expected PCa SIRs in Saskatchewan. Lastly, this study identifies the association (if any) between family physician density and estimated PCa SIRs in Saskatchewan. Methods First, using Global Moran’s I, Local Moran’s I, and the Kuldorff’s Spatial Scan Statistic, the study identifies clusters of PCa stratified by risk-levels. Then this study estimates the SIRs of PCa and its association with family physician density in Saskatchewan using the Besag, York, and Mollie (BYM) Bayesian method. Results Higher than expected clusters of crude estimated SIR for metastatic PCa were identified in north-east Saskatchewan and lower than expected clusters were identified in south-east Saskatchewan. Areas in north-west Saskatchewan have lower than expected crude estimated SIRs for both intermediate-risk and low-risk PCa. Family physician density was negatively associated with SIRs of metastatic PCa (IRR: 0.935 [CrI: 0.880 to 0.998]) and SIRs of high-risk PCa (IRR: 0.927 [CrI: 0.880 to 0.975]). Conclusions This study identifies the geographical disparities in risk-stratified PCa incidence in Saskatchewan. The study identifies areas with a lower family physician density have a higher-than-expected incidences of metastatic and high-risk PCa. Hence policies to increase the number of physicians should ensure an equitable geographic distribution of primary care physicians to support early detection of diseases, including PCa.

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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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Geographic factors associated with time-to-treatment outcomes for radiation therapy among localized prostate cancer patients in Saskatchewan

Cited by 3 publications

References 24 publications

Geographic Disparities in Saskatchewan Prostate Cancer Incidence and its Association with Physician Density: Analysis Using Bayesian Models.

Geographic Disparities in Saskatchewan Prostate Cancer Incidence and its Association with Physician Density: Analysis Using Bayesian Models.

Geographic disparities in Saskatchewan prostate cancer incidence and its association with physician density: analysis using Bayesian models

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

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