Geographical disparities in access to cancer management and treatment services in England.
This study seeks to examine the extent to which cancer services are geographically located according to cancer incidence, and assess the association with cancer survival. We identified hospital sites serving English PCTs (Primary Care Trusts) with the management and treatment of breast, lung and colorectal cancer. Geographical access was estimated as travel time in minutes from LSOAs (Lower Super Output Areas) to the nearest hospital site and aggregated to PCT level. Correlations between PCT level mean travel times and cancer cases were estimated using Spearman's rank correlation. Associations between PCT level mean travel times and cancer relative survival rates were estimated using linear regression with adjustment for area deprivation and for a PCT level measure of the reported ease of obtaining a doctor's appointment. We found that cancer services tended to be located farther from areas with more cancer cases, and longer average travel times are associated with worse survival after adjustment for age, sex, year and area deprivation. This suggests that geographical access to cancer services remains a concern in England.
Norwich Medical School, University of East Anglia, UK. Electronic address: P.Murage@uea.ac.uk.
Peninah
P
Murage
Airedale NHS Foundation Trust, UK.
S Michael
SM
Crawford
Norwich Medical School, University of East Anglia, UK.
Max
M
Bachmann
Norwich Medical School, University of East Anglia, UK.
Andy
A
Jones
D001336:Automobiles; D001943:Breast Neoplasms / Q000453:epidemiology / Q000532:radiotherapy; D002173:Cancer Care Facilities; D015179:Colorectal Neoplasms / Q000453:epidemiology / Q000532:radiotherapy; D003430:Cross-Sectional Studies; D004739:England / Q000453:epidemiology; D005260:Female; D005843:Geography; D006297:Health Services Accessibility; D054625:Healthcare Disparities; D006801:Humans; D016014:Linear Models; D008175:Lung Neoplasms / Q000453:epidemiology / Q000532:radiotherapy; D008297:Male; D009369:Neoplasms / Q000453:epidemiology / Q000532:radiotherapy*; D011320:Primary Health Care; D013222:State Medicine; D013534:Survival; D013997:Time Factors; D014195:Travel / Q000706:statistics & numerical data*