Shorter survival with rectal cancer if living further from facilities

January 01, 0001

Shorter survival with rectal cancer if living further from facilities

The aim of this descriptive population-based study using data from the Queensland Cancer Registry, involving all patients aged 20-79 years (n = 6848) diagnosed with invasive rectal cancer between 1 January 1996 and 31 December 2006, by researchers from Australia was to determine whether an association exists between distance from radiotherapy facilities and survival outcomes of people diagnosed with rectal cancer.

The 5-year cause-specific survival was 62%; it was strongly influenced by stage at diagnosis (American Joint Committee on Cancer, Stages I-IV), ranging from 86% (Stage I) to 9% (Stage IV). After adjusting for age, sex, and stage at diagnosis, patients who lived 100-199 km, 200-399 km and 400 km or more from a radiotherapy facility were 16%, 30%, and 25%, respectively, more likely to die from rectal cancer than patients living within 50 km of such a facility. On average, there was a 6% increase in mortality risk for each 100 km increment in distance from the nearest radiotherapy facility. Shared frailty models showed that this association persisted after adjusting for the correlation between individual cancer patients living in the same remoteness or area-level socioeconomic status categories.

The researchers concluded: "While centralisation of cancer treatment services has merit, our study provides evidence of a shorter survival for people with rectal cancer who live relatively far from radiotherapy facilities. It remains a priority to develop and implement policy, cultural and clinical measures to reduce the burden faced by rural and remote patients with rectal cancer."

Same taxes … not the same services.


For the full abstract, click here.

MJA 195(6):350-354, 19 September 2011 © The Medical Journal of Australia 2010
Distance to the closest radiotherapy facility and survival after a diagnosis of rectal cancer in Queensland. Peter D Baade, Paramita Dasgupta, Joanne F Aitken and Gavin Turrell. Correspondence to Peter Baade: peterbaade@ cancerqld.org.au

Category: HSR. Health Services Research. Keywords: distance, radiotherapy, survival, rectal cancer, treatment, descriptive population-based study, journal watch.
Synopsis edited by Dr Stephen Wilkinson, Melbourne, Australia. Posted on Global Family Doctor 14 October 2011

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.

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