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Drive Time to Physicians and Outcomes for Bladder Cancer
Sruthi L Muluk1, Coleman Drake2, Zhaojun Sun2
1University of Pittsburgh School of Medicine.
JU Open Plus
|May 14, 2025
Summary
Longer drives to cancer specialists delay treatment for muscle-invasive bladder cancer (MIBC) patients. Improving geographic access to urologists and oncologists is crucial for timely, guideline-concordant care.
Area of Science:
- Oncology
- Urology
- Health Services Research
Background:
- Muscle-invasive bladder cancer (MIBC) treatment timeliness impacts survival.
- Neoadjuvant chemotherapy and cystectomy are key treatments for MIBC.
- Geographic barriers may impede access to timely cancer care.
Purpose of the Study:
- To assess the association between travel burden and timely guideline-concordant care for MIBC patients.
- To investigate the impact of drive time to specialists on treatment receipt.
- To explore disparities in access to care based on socioeconomic factors.
Main Methods:
- Cross-sectional study using Pennsylvania Cancer Registry and PHC4 inpatient data (2010-2018).
- Included patients with a first MIBC diagnosis undergoing radical cystectomy.
- Analyzed drive times to nearest oncologist and urologist using CMS physician location data.
Main Results:
- Increased drive time to urologists correlated with lower likelihood of timely cystectomy.
- Longer travel to oncologists was linked to reduced neoadjuvant chemotherapy receipt.
- These effects were more pronounced in socioeconomically disadvantaged areas.
Conclusions:
- Drive time to specialists significantly impacts timely MIBC treatment.
- Geographic access is a critical factor in receiving guideline-recommended cancer care.
- Addressing travel barriers can improve cancer care access and outcomes.
