Have cancer, will travel? The relationship between distance and radiation treatment rates

The distance a patient must travel to receive radiation therapy treatments for rectal cancer plays a significant role in whether he or she ultimately receives treatment, according to results of a study published in a recent issue of the International Journal of Radiation Oncology: Biology-Physics.

While a combination of chemoradiation and surgery is the recognized standard of care for patients with stage II/III rectal cancer, it’s estimated that nearly one third of qualifying patients never receive radiation therapy.

The underlying reasons for this lack of treatment may be geographical rather than medical, said lead author Chun Chieh Lin, PhD, of the American Cancer Society, and colleagues.

“Because radiation therapy requires access to radiation oncologists and linear accelerators, the receipt of radiation therapy might be partly influenced by geographic access,” they wrote. “The geographic availability of radiation therapy resources can be evaluated by assessing the geographic distribution of radiation oncologists and/or the travel burden experienced by the patients.”

Lin and her team set out to investigate the relationship between the density of radiation oncologists and the distance traveled by patients to receive radiation therapy. They performed a retrospective study on 26,845 patients aged 18 to 80 years with stage II/III rectal cancer who were diagnosed from 2007 to 2010 as identified in the National Cancer Data Base. The researchers then identified radiation oncologists using data obtained through Physician Compare and used hospital service area cluster equations to examine the association between geographic access and receipt of radiation therapy treatment.

Their results showed that patients diagnosed at a reporting facility who traveled 50 miles had a decreased likelihood of receiving radiation therapy when compared to those traveling less than 12.5 miles, although radiation oncologist density had no significant on patients’ receipt of treatment.

“An increased travel burden was associated with a decreased likelihood of receiving radiation therapy for patients with stage II/III rectal cancer, all else being equal; however, radiation oncologist density was not,” the authors concluded. “Further research of geographic access and establishing transportation assistance programs or lodging services for patients with an unmet need might help decrease geographic barriers and improve the quality of rectal cancer care.”