Long-Distance Travel for Cancer Care Is Linked to Later-Stage Breast Cancer Diagnosis
The longer a woman with breast cancer has to travel to reach a comprehensive cancer center, the more likely she is to have later-stage disease at diagnosis, and the more likely she is to have a mastectomy, according to study by medical student Krishan Jethwa and colleagues from the University of North Dakota School of Medicine and Health Sciences in Grand Forks, North Dakota. The study results were presented today at the 12th Annual AACR International Conference on Frontiers in Cancer Prevention Research in National Harbor, Maryland (Abstract B15).
Mr. Jethwa and his colleagues analyzed demographic and clinical data on 260 women diagnosed with breast cancer between January 1, 2007, and December 31, 2007, who were treated at a comprehensive cancer center in Fargo, North Dakota. The women were aged 29 to 94—with an average age of 60—at diagnosis and resided predominately in southeastern North Dakota and southwestern Minnesota. All the women were white and none had a prior cancer history.
Study Method
The researchers used the Mantel-Haenszel test for linear association to compare distance category to breast cancer stage and treatment and found that travel distance was linked to both stage at diagnosis and surgery type. The further the distance, the more likely women were to have a mastectomy. They did not find an association between distance and age at diagnosis, treatment with radiotherapy, or 5-year survival.
The researchers concluded that improvements in access to cancer treatment may be necessary for women living in rural areas. “Travel in this part of the country can be long and difficult, especially during the winter,” said Mr. Jethwa in a statement. “While investigating the public health implications of this, we found that women who live farther from a comprehensive cancer center were more likely to be diagnosed with later-stage disease. This highlights the need for improved access to screening and treatment for rural populations.”
Mr. Jethwa reported no potential conflicts of interest.
Institutional review boards of both the Sanford Health System and the University of North Dakota approved the study.
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