Does distance to treatment centre influence the rate of palliative radiotherapy in adult cancer patients?

Previous reports suggest that age, household income and travel distance from residence to treatment facility are barriers which influence access to radiotherapy. The purpose of this study was to analyse the utilisation of palliative radiotherapy in a health care system where the main goal is equal access despite place of residence. The Authors collected prospective data on the use of palliative radiotherapy in adult cancer patients over a 12-month period in 2007/2008. All patients were treated in northern Norway and had unlimited, rapid access to treatment. Efforts were made to account for potential overuse. The patients were divided into three groups according to travel distance. The majority of irradiated patients had bone metastases, followed by non-bony thoracic targets and brain metastases. No statistically significant differences in the utilisation rates were detected, the latter ranging from 129 annual treatment courses per 100,000 inhabitants in the region furthest away from the hospital to 142 courses in that closest to it. The median age of the irradiated patients in the three groups was similar. In conclusion, these data suggest that the utilisation of palliative radiotherapy in a health care system without financial barriers to treatment no longer varies with distance between residence and hospital.