Institute of Applied Health Sciences, University of Aberdeen, Polwarth Building, Foresterhill, Aberdeen, AB25 2ZD, UK.
Population Health Sciences Institute, Campus of Ageing and Vitality, Newcastle University, Newcastle, NE4 5PL, UK.
Health Place. 2023 Nov;84:103139. doi: 10.1016/j.healthplace.2023.103139. Epub 2023 Nov 16.
Limited data exist on the effect of travelling time on post-diagnosis cancer care and mortality. We analysed the impact of travel time to cancer treatment centre on secondary care contact time and one-year mortality using a data-linkage study in Scotland with 17369 patients. Patients with longer travelling time and island-dwellers had increased incidence rate of secondary care cancer contact time. For outpatient oncology appointments, the incidence rate was decreased for island-dwellers. Longer travelling time was not associated with increased secondary care contact time for emergency cancer admissions or time to first emergency cancer admission. Living on an island increased mortality at one-year. Adjusting for cancer-specific secondary care contact time increased the hazard of death, and adjusting for oncology outpatient time decreased the hazard of death for island-dwellers. Those with longer travelling times experience the cancer treatment pathway differently with poorer outcomes. Cancer services may need to be better configured to suit differing needs of dispersed populations.
关于旅行时间对诊断后癌症治疗和死亡率的影响，相关数据有限。我们通过苏格兰的一项数据链接研究，对 17369 名患者进行分析，以评估前往癌症治疗中心的旅行时间对二级护理联系时间和一年死亡率的影响。结果发现，旅行时间较长和居住在岛屿上的患者，其二级护理癌症接触时间的发生率更高。对于肿瘤门诊预约，居住在岛屿上的患者的发生率则有所降低。对于紧急癌症入院或首次紧急癌症入院的时间，较长的旅行时间与二级护理联系时间的增加无关。居住在岛屿上的患者一年后的死亡率增加。调整癌症特异性二级护理联系时间会增加死亡风险，而调整肿瘤门诊时间则会降低居住在岛屿上的患者的死亡风险。那些旅行时间较长的人在癌症治疗途径上有不同的体验，结果也更差。癌症服务可能需要更好地配置，以满足分散人群的不同需求。
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