ESTRO 2024 - Abstract Book

S2785

Interdisciplinary - Health economics & health services research

ESTRO 2024

For this analysis, the “PRedicting the health economic IMPact of new and current CAncer Treatments” (PRIMCAT) comprehensive linked dataset was used, which is a multi-institution research initiative taking a data-driven modelling approach for understanding and forecasting cancer treatment utilisation in Australia, led by the Cancer Health Services Research Unit at the University of Melbourne. The entire cohort includes patients aged ≥18 years diagnosed with cancer and treated with radiotherapy between 1/2010 to 12/2019. We included breast, lung, prostate, and colorectal cancer types. For each patient, data linkage includes a range of datasets managed by state and federal health departments including the Victorian Radiotherapy Minimum Dataset. Travel distance between postcode of a patient’s home address and the radiotherapy centres were calculated using the Google Distance Matrix API, based on de-identified patient information and treating facility data. The study analysed both, the realised travel distance and excess travel distance for cancer patients undergoing PRT. Excess travel distance was defined as the difference between the actual radiotherapy treatment centre and any closer treatment centre. Out of 201,804 unique patient IDs from the PRIMCAT database, there were 81,197 patient-radiotherapy courses available. 29,807 (36.7%) of these were palliative-intended and eligible for this analysis. We included 13,515 (45.3%) female and 16,292 (54.7%) male patients. The primary tumour type was breast cancer in 5,856 (7.2%) cases, lung cancer in 15,339 (51.5%) cases, prostate cancer in 5,975 (20.0%) cases and colorectal cancer inn 3,667 (12.3%) cases. All PRT patients travelled an average of 41.5 km one-way, with a median travel distance of 16.3 km. The largest distance travelled was 723.1 km. The mean travel distance was 37.9 km (median: 14.8 km) for women and 46.0 km (median: 18.6 km) for men and with maximum travel distances of 723.1 km and 630.2 km respectively. For breast cancer, mean travel distances were 36.0 km (median: 14.1 km) with max. 723.1 km and for lung cancer, mean travel distances were 43.6 km (median: 18.1 km) with max. 630.2 km. Men with prostate cancer had a mean distance of 46.6 km (median: 19.3 km) and a max. distance of 598.4 km. Colorectal cancer patients travelled a mean distance of 46.7 km (median: 18.1 km) with a max. of 600.4 km). 24,004 (80.1%) patients travelled past a closer facility. The average excess travel of these patients was 24.3 km (median: 11.4 km) with a max. distance of 467.9 km. Female patients had shorter excess travel compared to male patients (mean 22.4 vs. 26.4 km, median 9.7 vs. 13.6 km respectively). Breast cancer patients had the shortest excess travel of 20.3 km in average (median: 7.8 km) compared to mean travel excess of lung 25.4 (median 11.9) km, prostate 27.3 (median 14.8) km, and colorectal cancer patients 27.5 (median 11.7) km. Results:

Conclusion:

Palliative cancer patients in Victoria, Australia travel a notable distance up to 723.1 km to receive their treatment. 80.1% of palliative patients in our study travelled past a closer centre. Palliative breast cancer patients travelled the shortest distances, regarding actual travel distance as well as excess travel. PRT has the potential to alleviate the symptoms of advanced incurable cancer and should be accessible equitably. To further understand travel patterns and identify reasons for excess travel of palliative cancer patients, qualitative consumer-based analyses are underway. By gaining a deeper understanding of these factors, the aim is to develop health service interventions and amend clinical referral patterns and policies to streamline the delivery of palliative care and minimise the need for long-distance travel.