title: A Quantitative Analysis of the Relationship Between Radiation Therapy Use and Travel Time.
abstract: OBJECTIVE
  To model and quantify the relationship between radiation therapy (RT) use and travel time to RT services.
  
  
  METHODS
  Population-based registries and databases were used to identify both incident cancer patient and patients receiving RT within 1 year of diagnosis (RT1y) in British Columbia, Canada, between 1992 and 2011. The effects of age, gender, diagnosis year, income, prevailing wait time, and travel duration for RT on RT1y were assessed. Significant factors from univariate analyses were included in a multivariable logistic regression model. The shape of the travel time-RT1y curve was represented by generalized additive and segmented regression models. Analyses were conducted for breast, lung, and genitourinary cancer separately and for all cancer sites combined.
  
  
  RESULTS
  After adjustment for age, gender, diagnosis year, income, and prevailing wait times, increasing travel time to the closest RT facility had a negative impact RT1y. The shape of the travel time-RT1y curve varied with cancer type. For breast cancer, the odds of RT1y were constant for the first 2 driving hours and decreased at 17% per hour thereafter. For lung cancer, the odds of RT1y decreased by 16% after 20 minutes and then decreased at 6% per hour. Genitourinary cancer RT1y was relatively independent of travel time. For all cancer sites combined, the odds of RT1y were constant within the first 2 driving hours and decreased at 7% per hour thereafter.
  
  
  CONCLUSIONS
  Travel time to receive RT has a different impact on RT1y for different tumor sites. The results provide evidence-based insights for the configuration of catchment areas for new and existing cancer centers providing RT.
authors.affiliation: British Columbia Cancer Agency, Vancouver, British Columbia, Canada.
authors.forename: Emma
authors.initials: E
authors.lastname: Liu
authors.affiliation: British Columbia Cancer Agency, Vancouver, British Columbia, Canada.
authors.forename: Pablo
authors.initials: P
authors.lastname: Santibáñez
authors.affiliation: Sauder School of Business, University of British Columbia, Vancouver, British Columbia, Canada.
authors.forename: Martin L
authors.initials: ML
authors.lastname: Puterman
authors.affiliation: British Columbia Cancer Agency, Vancouver, British Columbia, Canada.
authors.forename: Leah
authors.initials: L
authors.lastname: Weber
authors.affiliation: British Columbia Cancer Agency, Vancouver, British Columbia, Canada.
authors.forename: Xiang
authors.initials: X
authors.lastname: Ma
authors.affiliation: Sauder School of Business, University of British Columbia, Vancouver, British Columbia, Canada.
authors.forename: Antoine
authors.initials: A
authors.lastname: Sauré
authors.affiliation: British Columbia Cancer Agency, Vancouver, British Columbia, Canada.
authors.forename: Ivo A
authors.initials: IA
authors.lastname: Olivotto
authors.affiliation: British Columbia Cancer Agency, Vancouver, British Columbia, Canada.
authors.forename: Ross
authors.initials: R
authors.lastname: Halperin
authors.affiliation: British Columbia Cancer Agency, Vancouver, British Columbia, Canada.
authors.forename: John
authors.initials: J
authors.lastname: French
authors.affiliation: British Columbia Cancer Agency, Vancouver, British Columbia, Canada. Electronic address: styldesl@bccancer.bc.ca.
authors.forename: Scott
authors.initials: S
authors.lastname: Tyldesley
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000532:radiotherapy*; D001955:British Columbia; D002173:Cancer Care Facilities / Q000706:statistics & numerical data* / Q000600:supply & distribution; D005260:Female; D062305:Geographic Mapping; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006801:Humans; D008175:Lung Neoplasms / Q000532:radiotherapy*; D008297:Male; D008875:Middle Aged; D011878:Radiotherapy / Q000706:statistics & numerical data; D012959:Socioeconomic Factors; D013997:Time Factors; D014195:Travel / Q000706:statistics & numerical data; D014565:Urogenital Neoplasms / Q000532:radiotherapy*