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Factors Associated With Radiotherapy Utilisation In New South Wales, Australia: Results From The 45 and Up Study.

M L Yap1, D L O'Connell2, D Goldsbury3

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PubMed
Summary

Radiotherapy use is lower than optimal, with specific patient groups less likely to receive it. Factors like age, gender, comorbidities, and distance from treatment centers influence access, highlighting a need for improved radiotherapy access through policy changes.

Keywords:
Cancerco-morbiditiesdistancehealth servicesradiotherapyutilisation

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Area of Science:

  • Oncology
  • Health Services Research
  • Epidemiology

Background:

  • Actual radiotherapy utilization rates often fall short of estimated optimal rates.
  • Factors contributing to this disparity in radiotherapy access remain largely unknown.
  • Understanding these factors is crucial for improving cancer care delivery.

Purpose of the Study:

  • To identify factors associated with radiotherapy receipt in a large cohort of cancer patients in New South Wales (NSW), Australia.
  • To investigate the influence of socio-demographic and health characteristics on radiotherapy utilization.
  • To inform strategies for enhancing radiotherapy access.

Main Methods:

  • Utilized data from the NSW 45 and Up Study (267,153 participants) with linkage to cancer registry and administrative health datasets.
  • Identified incident cancers and radiotherapy receipt (Medicare Benefits Schedule/NSW Admitted Patient Data Collection) for 17,873 patients.
  • Employed competing risks regression to analyze associations between patient characteristics and radiotherapy treatment.

Main Results:

  • Only 30.3% (5,414) of cancer patients received radiotherapy during a median follow-up of 5.3 years.
  • Patients less likely to receive radiotherapy included those aged <60 or 80+ years, females, individuals with a Charlson co-morbidity index of 1+, those needing assistance with daily tasks, and those living ≥100 km from a radiotherapy center.
  • Identified distinct subgroups of cancer patients with reduced likelihood of receiving radiotherapy.

Conclusions:

  • Significant disparities exist in radiotherapy utilization among cancer patients.
  • Specific patient subgroups face barriers to accessing radiotherapy.
  • Policy and advocacy interventions are necessary to improve equitable access to radiotherapy.