Travel times and radiotherapy uptake in two English counties.
OBJECTIVES: To examine whether longer travel times for radiotherapy are associated with reduced overall uptake of radiotherapy treatment, or with reduced uptake of palliative as opposed to radical radiotherapy. DESIGN: Correlations of weighted average travel times for radiotherapy with overall radiotherapy uptake, and of travel times to one cancer centre with the ratio of palliative to radical radiotherapy at that centre. SETTING: The fourteen local authority (county) Districts of Bedfordshire and Hertfordshire. SUBJECTS: Residents of Bedfordshire and Hertfordshire registered by the Cancer Registries as attending hospital with a diagnosis of cancer, and registered as receiving radiotherapy treatment. Residents recorded by single cancer centre as receiving radical or palliative radiotherapy at that centre. RESULTS: There was no significant correlation between travel times for treatment and overall radiotherapy uptake (r = 0.40, P = 0.18), or with the ratio of palliative to radical radiotherapy at a single centre (r = -0.29, P = 0.34). Both measures of uptake showed considerable variability. Longest travel times were about one hour. CONCLUSIONS: Travel times up to one hour do not appear to reduce radiotherapy uptake, and the variability observed is likely to be due to other factors. The recommendation of the Chief Medical Officer's expert advisory group on cancers, that radiotherapy should be provided in larger cancer centres, is unlikely to result in lower radiotherapy uptake with travel times of this order.