People with cancer who live more than an hour from their nearest major hospital are diagnosed and treated faster than those who live closer, but are ‘significantly’ more likely to die, a new study has found.
The research, the first of its kind, has been described as a ‘cancer geography paradox’ by academics at the University of Aberdeen.
Experts say life expectancy might be lower for those who live in rural areas because longer travel distance may limit their treatment choices and influence whether they decide to take up follow-up care which would boost their chances of survival.
‘These contradictory findings on time to diagnosis and mortality are perplexing to say the least,’ said Dr Peter Murchie, clinical consultant at the University of Aberdeen, who led the study.
University of Aberdeen researchers have referred to their study findings as a ‘cancer geography paradox’ (stock photo)
‘It could be that living in rural areas where you have to travel further to receive treatment might limit treatment choices once a diagnosis has been made.
‘There is evidence that when faced with two treatment options, patients might weigh the costs in terms of time, expense and inconvenience of travel against the perceived benefits, for example, choosing surgery over chemotherapy to limit time in hospital.
‘Lengthy or difficult travel to a cancer centre or hospital could also result in less limit engagement with post-primary treatment follow-up, with consequent implications for the effective management of treatment effects and the identification of other follow-up needs.’
How the research was carried out
The team analysed data from more than 12,000 patients from across north-east Scotland, northern Scotland and the Northern Isles. They looked at travel time to the nearest major hospital, time taken for treatment to begin and their survival rates within a year.
People in the Northern Isles were 32 per cent more likely to start treatment within 62 days of their GP’s referral, compared to those living within 15 minutes of their treatment centre.
Those from the mainland living more than an hour’s travel from their cancer treatment centre were 42 per cent more likely to start treatment within 62 days of their GP referral than those who lived closer.
They also found Northern Isles residents were 72 per cent more likely to have their diagnosis and treatment started on the same or next day compared to those who lived nearby.
The team say the findings suggest more must be done to analyse how people with cancer interact with specialist services after they have been diagnosed.
The research, published in the British Journal of Cancer, is understood to be the first study anywhere to examine the impact of burden of travel on the cancer diagnostic process.