Shahid Ahmed1,2, Mahjabeen Iqbal3, Duc Le1,2, Nayyer Iqbal1,2, Punam Pahwa4. 1. Saskatoon Cancer Center, Saskatchewan Cancer Agency, Saskatoon, Canada. 2. Division of Oncology, University of Saskatchewan, Saskatoon, Canada. 3. King's College London, London, UK. 4. Department of Community Health and Epidemiology, University of Saskatchewan, Saskatoon, Canada.
Abstract
BACKGROUND: Salvage palliative chemotherapy in metastatic colorectal cancer has been associated with significant improvement in survival. However, not all patients receive all available therapies. Travel burden can affect patient access and use of future therapy. The present study aims to determine relationship between travel distance (TD) and salvage palliative chemotherapy in patients with metastatic colorectal cancer. METHOD: A patient cohort diagnosed with metastatic colorectal cancer during 2006-2010 in the province of Saskatchewan, Canada was studied. Logistic regression analyses were performed to assess relationship between travel distance and subsequent line therapies. RESULTS: The median age of 264 eligible patients was 62 years [interquartile range (IQR): 53-72]. The patients who received salvage systemic therapy had a median distance to travel of 60.0 km (IQR: 4.7-144) compared with 88.1 km (IQR: 4.8-189) if they did not receive second- or third-line therapy (P=0.06). In multivariate analysis distance to the cancer center <100 km, odds ratio (OR) 1.69 (95% CI: 1.003-2.84), no metastasectomy, OR 1.89 (95% CI: 1.03-3.46), and absence of comorbid illness as per Charlson comorbid index, OR 1.45 (95% CI: 1.19-1.77) were correlated with the use of second- and subsequent line therapies. CONCLUSIONS: Our result revealed that travel distance to the cancer center greater than 100 km was associated less frequent use of second or subsequent line therapies in patients with metastatic colorectal cancer.
BACKGROUND: Salvage palliative chemotherapy in metastatic colorectal cancer has been associated with significant improvement in survival. However, not all patients receive all available therapies. Travel burden can affect patient access and use of future therapy. The present study aims to determine relationship between travel distance (TD) and salvage palliative chemotherapy in patients with metastatic colorectal cancer. METHOD: A patient cohort diagnosed with metastatic colorectal cancer during 2006-2010 in the province of Saskatchewan, Canada was studied. Logistic regression analyses were performed to assess relationship between travel distance and subsequent line therapies. RESULTS: The median age of 264 eligible patients was 62 years [interquartile range (IQR): 53-72]. The patients who received salvage systemic therapy had a median distance to travel of 60.0 km (IQR: 4.7-144) compared with 88.1 km (IQR: 4.8-189) if they did not receive second- or third-line therapy (P=0.06). In multivariate analysis distance to the cancer center <100 km, odds ratio (OR) 1.69 (95% CI: 1.003-2.84), no metastasectomy, OR 1.89 (95% CI: 1.03-3.46), and absence of comorbid illness as per Charlson comorbid index, OR 1.45 (95% CI: 1.19-1.77) were correlated with the use of second- and subsequent line therapies. CONCLUSIONS: Our result revealed that travel distance to the cancer center greater than 100 km was associated less frequent use of second or subsequent line therapies in patients with metastatic colorectal cancer.
Authors: Maria O Celaya; Judy R Rees; Jennifer J Gibson; Bruce L Riddle; E Robert Greenberg Journal: Cancer Causes Control Date: 2006-08 Impact factor: 2.506
Authors: Anneke T Schroen; David R Brenin; Maria D Kelly; William A Knaus; Craig L Slingluff Journal: J Clin Oncol Date: 2005-10-01 Impact factor: 44.544
Authors: John F Scoggins; Catherine R Fedorenko; Sara M A Donahue; Dedra Buchwald; David K Blough; Scott D Ramsey Journal: J Rural Health Date: 2011-03-31 Impact factor: 4.333
Authors: Audrey Alforque Thomas; Pamela Gallagher; Alan O'Céilleachair; Alison Pearce; Linda Sharp; Michal Molcho Journal: Support Care Cancer Date: 2014-09-02 Impact factor: 3.603
Authors: Chun Chieh Lin; Suanna S Bruinooge; M Kelsey Kirkwood; Christine Olsen; Ahmedin Jemal; Dean Bajorin; Sharon H Giordano; Michael Goldstein; B Ashleigh Guadagnolo; Michael Kosty; Shane Hopkins; James B Yu; Anna Arnone; Amy Hanley; Stephanie Stevens; Dawn L Hershman Journal: J Clin Oncol Date: 2015-08-24 Impact factor: 44.544
Authors: Nader N Massarweh; Yi-Ju Chiang; Yan Xing; George J Chang; Alex B Haynes; Y Nancy You; Barry W Feig; Janice N Cormier Journal: J Clin Oncol Date: 2014-02-10 Impact factor: 44.544
Authors: Laura-Mae Baldwin; Yong Cai; Eric H Larson; Sharon A Dobie; George E Wright; David C Goodman; Barbara Matthews; L Gary Hart Journal: J Rural Health Date: 2008 Impact factor: 4.333