The distances that patients have to travel can influence their access to cancer treatment. We investigated the determinants of travel time, separately for journeys by car and public transport, to centres providing radical surgery or radiotherapy for prostate cancer.
Using national cancer registry records linked to administrative hospital data, we identified patients who had radical surgery or radiotherapy for prostate cancer between January 2017 and December 2018 in the English National Health Service. Estimated travel times from the patients' residential area to the nearest specialist surgical or radiotherapy centre were estimated for journeys by car and by public transport.
We included 13,186 men who had surgery and 26,581 who had radiotherapy. Estimated travel times by public transport (74.4 mins for surgery and 69.4 mins for radiotherapy) were more than twice as long as by car (33.4 mins and 29.1mins, respectively). Patients living in more socially deprived neighbourhoods in rural areas had the longest travel times to the nearest cancer treatment centres by car (62.0 mins for surgery and 52.1 mins for radiotherapy). Conversely patients living in more affluent neighbourhoods in urban conurbations had the shortest (18.7 mins for surgery and 17.9 mins for radiotherapy).
Travel times to cancer centres vary widely according to mode of transport, socioeconomic deprivation, and rurality. Policies changing the geographical configuration of cancer services should consider the impact on the expected travel times both by car and by public transport to avoid enhancing existing inequalities in access to treatment and patient outcomes.
Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology. 2024 Jan 12 [Epub ahead of print]
Lu Han, Richard Sullivan, Alison Tree, Daniel Lewis, Pat Price, Vijay Sangar, Jan van der Meulen, Ajay Aggarwal
Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK., Institute of Cancer Policy, King's College London, UK., Royal Marsden Hospital and The Institute for Cancer Research, London, UK., Department of Surgery and Cancer, Imperial College, London, UK., The Christie NHS Trust and Manchester University NHS Foundation Trust, Manchester, UK; Manchester University, UK., Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK; Department of Oncology, Guy's and St Thomas' NHS Foundation Trust, London, UK. Electronic address: .