Travel Time to Treating Facility and Mortality in Men With Prostate Cancer

Area of Science:

• Epidemiology
• Health Services Research
• Oncology

Background:

• Geographic access to prostate cancer care impacts patient outcomes.
• Traditional measures like straight-line distance may not reflect actual travel burden.
• Understanding travel time's role is crucial for equitable cancer care.

Purpose of the Study:

• To assess the association between estimated travel time to treatment facilities and mortality in prostate cancer patients.
• To investigate if travel time influences all-cause and prostate cancer-specific mortality.

Main Methods:

• Retrospective cohort study using data from a nationally representative cancer registry.
• Included 159,943 men diagnosed with prostate cancer between 2000-2015 across multiple US states.
• Estimated travel time using geocodes and road network data; analyzed mortality using Cox regression.

Main Results:

• Patients with longer travel times (≥30 minutes) had a statistically significant lower risk of all-cause mortality (aHR, 0.91; 95% CI, 0.89-0.93).
• Longer travel times were also associated with a lower risk of prostate cancer-specific mortality (aHR, 0.90; 95% CI, 0.86-0.95).
• These associations remained consistent across most subgroups analyzed.

Conclusions:

• Longer travel time to prostate cancer treatment facilities is associated with reduced mortality.
• This may indicate benefits of care centralization in specialized centers.
• Findings highlight the need to address access barriers, like transportation, to prevent diagnostic delays.