Travel, Treatment Choice, and Survival Among Breast Cancer Patients: A Population-Based Analysis
- Resource Type
- Authors
- Beth A Virnig; Hannah T. Neprash; Colleen F. Longacre; Nathan D. Shippee; Todd M Tuttle
- Source
- Women's Health Reports
- Subject
- Oncology
medicine.medical_specialty
patient decision making
business.industry
Treatment options
Cancer survival
Population based
medicine.disease
travel distance
Breast cancer
breast cancer
Internal medicine
medicine
radiation treatment
Original Article
business
- Language
- English
- ISSN
- 2688-4844
Background: Travel distance to care facilities may shape urban–rural cancer survival disparities by creating barriers to specific treatments. Guideline-supported treatment options for women with early stage breast cancer involves considerations of breast conservation and travel burden: Mastectomy requires travel for surgery, whereas breast-conserving surgery (BCS) with adjuvant radiation therapy (RT) requires travel for both surgery and RT. This provides a unique opportunity to evaluate the impact of travel distance on surgical decisions and receipt of guideline-concordant treatment. Materials and Methods: We included 61,169 women diagnosed with early stage breast cancer between 2004 and 2013 from the Surveillance Epidemiology and End Results (SEER)-Medicare database. Driving distances to the nearest radiation facility were calculated by using Google Maps. We used multivariable regression to model treatment choice as a function of distance to radiation and Cox regression to model survival. Results: Women living farthest from radiation facilities (>50 miles vs.