Distance Matters for Quality Rectal Cancer Care

- Patients who must travel long distances for rectal cancer radiotherapy are less likely to get the potentially lifesaving treatment, a new study shows.
"Travel burden clearly creates a barrier to radiation therapy access for rectal cancer patients," said study author Chun Chieh Lin, director of health services research at the American Cancer Society.
The findings were published in the March issue of the International Journal of Radiation Oncology Biology Physics.
In the study, Lin's teamed tracked data on more than 26,800 Americans with stage II or III rectal cancer. The researchers found that 30 percent did not receive radiation therapy within the recommended time or did not receive the treatment at all.
Overall, more than two-thirds (69 percent) of the patients received radiation therapy within 180 days of their diagnosis, or within 90 days of surgery. The average time elapsed was 38 days from diagnosis and 84 days between surgery and the start of radiation therapy, the study found.
Why the delays? Some patients didn't get radiation therapy because it was not deemed to be part of the first course of treatment (86 percent), or they received it outside of the specified time frame (7 percent), the patient refused (6 percent), or the doctor refused due to patient risk factors (3 percent).
However, after accounting for a number of other factors, the researchers still found that in certain cases, the distance a patient had to travel to receive radiation therapy affected the likelihood of receiving the treatment.
Among patients diagnosed and treated at the same facility, those who traveled 50 miles or more were less likely to undergo radiation therapy than those who traveled less than 12.5 miles, Lin's team reported.
In a news release from the journal, Lin said that while travel times may keep some patients from care, "this barrier is far from absolute." He noted that some patients decide to get radiation at an often closer facility -- one different from where they are otherwise diagnosed and treated.
When that happens, the likelihood that they receive radiotherapy remains high, Lin said, suggesting that the determination of the patient to get radiotherapy may counteract "the influence of factors such as travel burden and physician availability."
SOURCE: International Journal of Radiation Oncology Biology Physics, news release, March 21, 2016