A new study indicates that patient travel distance to an appropriate treatment facility can impact whether radiation therapy is received.1

Although National Comprehensive Cancer Network (NCCN) guidelines call for trimodality therapy for stage II and stage III rectal cancer, many patients do not receive radiation therapy. A team of researchers, led by Chun Chieh Lin, PhD, MBA, director of health services research at the American Cancer Society, sought to evaluate possible travel burdens for patients with rectal cancer and the possible impact on radiation treatment.

The research team identified 26,845 patients with stage II (42%) or stage III (58%) rectal cancer via the National Cancer Data Base.

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All patients received cancer-related surgery within 6 months of their rectal cancer diagnosis. Travel distances from patient to treatment center were measured from the center of the patient’s postal region to the facility that provided treatment, and distances were separated into four groups: 0-12.49 miles, 12.5-49.9 miles, 50-249 miles, and 250+ miles.

The majority of patients (approximately 46%) fell into the 0 to 12.49 -mile range, closely followed by the 12.5 to 49.9 -mile range (40%). Patients involved in the study ranged in age from 18 years through 80 years.

Seventy percent of the patients received radiation therapy within either 90 days of surgery or 180 days of their diagnosis.

The research results indicate that travel distance to a treatment center was associated with the likelihood of the patient of receiving radiation therapy; an increased travel burden was linked to a lower likelihood of a patient receiving radiation therapy.

Patients who had to travel more than 50 miles for radiation therapy, compared with those seeking treatment within a 12.5-mile radius, showed a decreased likelihood of receiving radiation treatment (50-249 miles, adjusted odds ratio 0.75; ≥250 miles, adjusted odds ratio 0.46). The density level of radiation oncologists in a geographic area was not found to significantly affect the receipt of radiation therapy.

The results of this study were published in the International Journal of Radiation Oncology.


1. Lin CC, Bruinooge SS, Kirkwood MK, et al. Association between geographic access to cancer care and receipt of radiation therapy for rectal cancer. Int J Radiat Oncol Biol Phys. 2016;94(4):719-728.