title: Radiotherapy in the Barwon South Western Region: a rural perspective.
abstract: BACKGROUND
  Cancer-related mortality rates are higher in rural areas compared with urban regions. Whether there are corresponding geographical variations in radiotherapy utilisation rates (RURs) is the subject of this study.
  
  
  METHODS
  RURs for the regional centre of Geelong and rural areas of the Barwon South Western Region were calculated using a population-based database (2009).
  
  
  RESULTS
  Lower RURs were observed for rural patients compared with the Geelong region for prostate cancer (15.7% vs 25.8%, P = 0.02), rectal cancer (32.8% vs 44.7%, P = 0.11), lymphoma (9.4% vs 26.2%, P = 0.05), and all cancers overall (25.6% vs 28.9%, P = 0.06). This lower rate was significant in men (rural, 19.9%; Geelong, 28.3%; P = 0.00) but not in women (rural, 33.6%; Geelong, 29.7%; P = 0.88). Time from diagnosis to radiotherapy was not significantly different for patients from the two regions. Tumour staging within the rural and Geelong regions was not significantly different for the major tumour streams of rectal, prostate and lung cancer (P = 0.61, P = 0.79, P = 0.43, respectively). A higher proportion of tumours were unstaged or unstageable in the rural region for lung (44% vs 18%, P < 0.01) and prostate (73% vs 57%, P < 0.01) cancer.
  
  
  CONCLUSIONS
  Lower RURs were observed in our rural region. Differences found within tumour streams and in men suggest a complexity of relationships that will require further study.
authors.affiliation: Barwon South Western Regional Integrated Cancer Services, Geelong, Victoria, Australia; Department of Medicine, Deakin University, Geelong, Victoria, Australia.
authors.forename: Margaret J
authors.initials: MJ
authors.lastname: Henry
authors.forename: Phil
authors.initials: P
authors.lastname: Jones
authors.forename: Kate
authors.initials: K
authors.lastname: Morrissy
authors.forename: Leigh M
authors.initials: LM
authors.lastname: Matheson
authors.forename: Graham
authors.initials: G
authors.lastname: Pitson
authors.forename: Pat
authors.initials: P
authors.lastname: Healy
authors.forename: Michael
authors.initials: M
authors.lastname: Coory
authors.forename: Rod
authors.initials: R
authors.lastname: Lynch
authors.forename: Adam
authors.initials: A
authors.lastname: Chapman
authors.forename: David
authors.initials: D
authors.lastname: Ashley
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000453:epidemiology* / Q000532:radiotherapy*; D015995:Prevalence; D020266:Radiotherapy, Conformal / Q000706:statistics & numerical data*; D012424:Rural Population / Q000706:statistics & numerical data*; D017678:Sex Distribution; D061665:Time-to-Treatment / Q000706:statistics & numerical data*; D014600:Utilization Review; D014739:Victoria / Q000453:epidemiology
keywords: cancer; population-based; radiotherapy utilisation rate; rural