Influence of socioeconomic factors and distance to radiotherapy on breast‐conserving surgery rates for early breast cancer in regional Australia; implications of change

Collins, Ian M.; Lum, Caroline; Versace, Vincent L.

doi:10.1111/ajco.12828

Cited by 12 publications

(8 citation statements)

References 27 publications

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“…This is especially pressing for radiotherapy as the nature of fractionated radiotherapy requires patients to travel to the centres more frequently. For many patients, travel to cancer treatment is described as an inconvenience and a practical hardship [3, 4]. It is not surprising that studies have found that distance plays a major role in acceptance of radiotherapy, whereby its utilisation relies fairly on convenience and proximity to the radiotherapy facilities [5–9].…”

Section: Introductionmentioning

confidence: 99%

How many roads must a Malaysian walk down? Mapping the accessibility of radiotherapy facilities in Malaysia

et al. 2019

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BackgroundThe accessibility to radiotherapy facilities may affect the willingness to undergo treatment. We sought to quantify the distance and travel time of Malaysian population to the closest radiotherapy centre and to estimate the megavoltage unit (MV)/million population based on the regions.Materials & methodsData for subdistricts in Malaysia and radiotherapy services were extracted from Department of Statistics Malaysia and Directory of Radiotherapy Centres (DIRAC). Data from DIRAC were validated by direct communication with centres. Locations of radiotherapy centres, distance and travel time to the nearest radiotherapy were estimated using web mapping service, Google Map.ResultsThe average distance and travel time from Malaysian population to the closest radiotherapy centre were 82.5km and 83.4mins, respectively. The average distance and travel were not homogenous; East Malaysia (228.1km, 236.1mins), Central (14.4km, 20.1mins), East Coast (124.2km, 108.8mins), Northern (42.9km, 42.8mins) and Southern (36.0km, 39.8mins). The MV/million population for the country is 2.47, East Malaysia (1.76), Central (4.19), East Coast (0.54), Northern (2.40), Southern (2.36). About 25% of the population needs to travel >100 km to get to the closest radiotherapy facility.ConclusionOn average, Malaysians need to travel far and long to reach radiotherapy facilities. The accessibility to radiotherapy facilities is not equitable. The disparity may be reduced by adding centres in East Malaysia and the East Coast.

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Section: Introductionmentioning

confidence: 99%

How many roads must a Malaysian walk down? Mapping the accessibility of radiotherapy facilities in Malaysia

et al. 2019

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“…29 For rural patients with breast cancer (living > 100 km from radiotherapy), the higher rate of mastectomy is largely influenced by the location of their treatment services, not cancer pathology. 30 Improving MDTs will require both Commonwealth and state government investment to ensure a whole-of-hospital service. There have been successful initiatives, such as the NT Plastic Surgeons Program, where breast cancer services and training can be done locally.…”

Section: Multidisciplinary Teammentioning

confidence: 99%

The provision of general surgery in rural Australia: a narrative review

Paynter,

Qin,

Brennan

et al. 2024

Medical Journal of Australia

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Summary Rural surgery is most commonly provided by general surgeons to the 29% of people (7 million) living in rural Australia. The provision of rural general surgery to enable equitable and safe surgical care for rural Australians is a multifaceted issue concerning recruitment, training, retention, surgical procedures and surgical outcomes. Sustaining the rural general surgical workforce will be dependent upon growing an increased number of resident rural general surgeons, as well as changed models of care, with a need for ongoing review to track the outcomes of these changes. To increase recruitment, rural general surgical training must improve to be less stressful for trainees and to be incorporated alongside a rural‐facing generalist curriculum. Rural general surgical outcomes (excluding some oncology conditions) achieve comparable results to metropolitan centres. Access to, and outcomes of, surgical oncology services continues to be inequitable for rural Australians and should be a major focus for improved service delivery.

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“… 100 However, regional women who lived ≥100–200 km away (vs <100 km) from a radiotherapy service were twice as likely to have a mastectomy. 101 …”

Section: Patient and Tumour Characteristicsmentioning

confidence: 99%

Variations in outcomes by residential location for women with breast cancer: a systematic review

et al. 2018

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ObjectivesTo systematically assess the evidence for variations in outcomes at each step along the breast cancer continuum of care for Australian women by residential location.DesignSystematic review.MethodsSystematic searches of peer-reviewed articles in English published from 1 January 1990 to 24 November 2017 using PubMed, EMBASE, CINAHL and Informit databases. Inclusion criteria were: population was adult female patients with breast cancer; Australian setting; outcome measure was survival, patient or tumour characteristics, screening rates or frequencies, clinical management, patterns of initial care or post-treatment follow-up with analysis by residential location or studies involving non-metropolitan women only. Included studies were critically appraised using a modified Newcastle–Ottawa Scale.ResultsSeventy-four quantitative studies met the inclusion criteria. Around 59% were considered high quality, 34% moderate and 7% low. No eligible studies examining treatment choices or post-treatment follow-up were identified. Non-metropolitan women consistently had poorer survival, with most of this differential being attributed to more advanced disease at diagnosis, treatment-related factors and socioeconomic disadvantage. Compared with metropolitan women, non-metropolitan women were more likely to live in disadvantaged areas and had differing clinical management and patterns of care. However, findings regarding geographical variations in tumour characteristics or diagnostic outcomes were inconsistent.ConclusionsA general pattern of poorer survival and variations in clinical management for Australian female patients with breast cancer from non-metropolitan areas was evident. However, the wide variability in data sources, measures, study quality, time periods and geographical classification made direct comparisons across studies challenging. The review highlighted the need to promote standardisation of geographical classifications and increased comparability of data systems. It also identified key gaps in the existing literature including a lack of studies on advanced breast cancer, geographical variations in treatment choices from the perspective of patients and post-treatment follow-up.

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Influence of socioeconomic factors and distance to radiotherapy on breast‐conserving surgery rates for early breast cancer in regional Australia; implications of change

Abstract: A strong association between distance to radiotherapy and the type of surgery for early breast cancer was found. Improving access to radiotherapy therefore has the potential to improve breast cancer outcomes for women in regional Australia.

Cited by 12 publications

References 27 publications

How many roads must a Malaysian walk down? Mapping the accessibility of radiotherapy facilities in Malaysia

How many roads must a Malaysian walk down? Mapping the accessibility of radiotherapy facilities in Malaysia

The provision of general surgery in rural Australia: a narrative review

Variations in outcomes by residential location for women with breast cancer: a systematic review

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