A new study conducted by ASCO in collaboration with the American Cancer Society (ACS) and the American Society for Radiation Oncology (ASTRO) and published in the Journal of Clinical Oncology1 found that patients who have to travel farther to appointments are less likely to receive adjuvant chemotherapy, regardless of whether or not they are insured.
Evidence-based treatment guidelines recommend the use of adjuvant chemotherapy in many cancer patients within 90 days after surgery. But studies show that in many cases, patients do not receive it.
To explore the role geographic access to care plays, researchers compared patients’ travel distance, insurance status, and an area’s density of oncologists to the likelihood patients received adjuvant chemotherapy within 90 days of surgery for colon cancer. The data used in the study captured about 70% of newly diagnosed cancer cases in the United States.
Of 34,694 patients in the study cohort, three-quarters (75.7%) received adjuvant chemotherapy within 90 days of surgery. Patients who traveled 50 to 249 miles were 13% less likely to receive adjuvant chemotherapy than those whose travel distance was less than 12.5 miles. Patients who had to travel 250 miles or more were nearly two-thirds less likely to receive adjuvant chemotherapy.
While density level of oncologists alone was not statistically associated with receipt of adjuvant chemotherapy, patients who had either no insurance or public (nonprivate) insurance and also resided in areas with low density of oncologists were 15% less likely to receive adjuvant chemotherapy.
To read the full article, go to: jco.ascopubs.org/content/early/2015/08/21/JCO.2015.61.1558. ■
© 2015. American Society of Clinical Oncology. All rights reserved.
1. Lin CC, Bruinooge SS, Kirkwood MK, et al: Association between geographic access to cancer, insurance, and receipt of chemotherapy: Geographic distribution of oncologists and travel distance. J Clin Oncol. August 24, 2015 (early release online).