Background:
Modelling suggests that 48% of cancer patients will need radiotherapy at least once in their illness1-2. Previous studies indicated that radiotherapy utilisation (RTU) rates decreased with increasing travel distance from patient residence to the nearest radiotherapy departments (RTD)3. Actual RTU rates are usually lower than the optimal rates.
Aims:
To compare access to RT facilities in 2009-2011 to access in 2004-2006 in NSW and to quantify the effect of the additional radiotherapy facilities on patient accessibility to RT in NSW.
Methods:
Data from Central Cancer Registry were linked to APDC and RT datasets in NSW for the period 2009–11. Data were compared to the 2004-06 data available. Data for the period 2009-11 included five new RTDs in Coffs Harbour, Port Macquarie, Lismore, Orange and Macquarie University Hospital.
Geographic Information System software4 was used to calculate road distance between patient residence and the closest RTD. Patients were excluded from the study if their nearest RTD was outside NSW.
Results:
The overall RTU rate was 29% during the period 2009-11 compared to 26% for 2004-06.
The average distance for cancer patients to travel from their residence to the nearest radiotherapy facility was 34 km (range: <1-654km) in 2009-11 compared to 47 km (range: <1 – 772km) in 2004-06. During the period 2009-11, 0.9% of patients (1,114 of 119,536) lived >300 km from the nearest RTD compared to 3.3% of patients (2,938 of 90,161) in 2004-06.
The proportion of cancer patients who resided within 50 kilometres from the nearest RTD during 2009-11 was 80% compared to 74% for the period 2004-06 and the difference was statistically significant (p<0.001). Similarly, the proportion of patients residing within 100 km from the nearest RTD was 90% in 2009-11 compared to 81% for the period 2004-06 and the difference was statistically significant (p<0.001).
Univariate and multivariate logistic regression models showed a negative association between receiving radiotherapy and increasing distance from patient residence to the nearest radiotherapy facility and positive association between receiving radiotherapy and younger age and female gender.
Conclusions:
The addition of the five new radiotherapy departments in NSW reflected positively on patient accessibility to the nearest radiotherapy departments.
Logistic regression showed that female gender, younger age and shorter travel distance were significantly associated with receiving radiotherapy.