TITLE:
On the Association between Travel Distance and Treatment Choice for Low-Risk Prostate Cancer: Results from a Rural State
AUTHORS:
Chris Hellekson, Grant Larson, Scott Poswilko, James Beal, Abe Sahmoun, J. Kyle Russo
KEYWORDS:
Low-Risk, Prostate Cancer, Rural, Brachytherapy, Prostatectomy, Young Men, Travel Distance
JOURNAL NAME:
Journal of Cancer Therapy,
Vol.7 No.9,
September
21,
2016
ABSTRACT: Background: Evidence suggests that cancer patients with increased travel burden to
treatment centers may have limited treatment options. Purpose: To
investigate the association between travel distance to a treatment facility and
initial treatment choice among young men with low-risk prostate cancer in a
rural state. Methods: A retrospective medical charts review was conducted
of young men (65 years or younger) newly diagnosed with low-risk prostate
cancer from January 1, 2005 through December 31, 2014 who were treated with
either active surveillance, radical prostatectomy, or brachytherapy at either
of the two major hospital systems in Bismarck, ND, USA. Results: Information on a random sample of 242 patients was studied. The majority of patients (66%) received
radical prostatectomy. Patients who received radical prostatectomy were
significantly younger (p-value 0.001). PSA at diagnosis, clinical stage, and Gleason score were not
associated with treatment choice (p-value = 0.06;
p-value = 0.1794; and p-value = 1.00; respectively). Adjusting for age at diagnosis,
PSA at diagnosis, and
treatment facility, treatment choice was not associated with travel distance
(p-value = 0.309).
Patients treated at St. Alexius facility
were more likely to undergo radical prostatectomy than Sanford health patients
(p-value Conclusions: We found no association between travel distance and
treatment choice for low-risk prostate cancer. Treatment choice was associated
with institution which may suggest institutional bias in patterns of care.