Distance, Insurance and Number of Oncologists Limit Access To Chemotherapy

Anna Lin, MBA, PHD Senior Epidemiologist, Health Services Research American Cancer Society, Inc. 250 Williams St. Atlanta, GA 30303MedicalResearch.com Interview with:
Anna Lin, MBA, PHD
Senior Epidemiologist, Health Services Research
American Cancer Society, Inc.
250 Williams St.
Atlanta, GA 30303

Medical Research: What is the background for this study?

Dr. Lin: Evidence-based guidelines recommend the use of adjuvant chemotherapy in patients with Stage III colon cancer within 90 days of colectomy to improve disease-free and overall survival; however, a substantial proportion of patients do not receive this treatment.  Geographic access to care may be associated with receipt of chemotherapy but has not been fully examined.

Medical Research: What are the main findings?

Dr. Lin: The main findings of this study indicate that patients traveling more than 50 miles were less likely to receive adjuvant chemotherapy for Stage III node-positive colon cancer.  In addition, patients who had either no insurance or public (non-private) insurance and resided in areas with low density of oncologists were less likely to receive adjuvant chemotherapy.

Medical Research: What should clinicians and patients take away from your report?

Dr. Lin: While it is reassuring that most patients in this study received adjuvant chemotherapy on time, the fact that increased travel burden was associated with a decreased likelihood of receiving chemotherapy, regardless of insurance status is concerning. It tells us expanded insurance coverage, while important, might not fully address the barriers to patients receiving guideline-recommended treatment.

Medical Research: What recommendations do you have for future research as a result of this study?

Dr. Lin: Future research can perform in-depth analyses in areas that have a low number of oncologists, to help analyze how interventions to decrease geographic barriers might improve access to cancer treatment.


Association Between Geographic Access to Cancer Care, Insurance, and Receipt of Chemotherapy: Geographic Distribution of Oncologists and Travel Distance

Chun Chieh Lin, Suanna S. Bruinooge, M. Kelsey Kirkwood, Christine Olsen,Ahmedin Jemal, Dean Bajorin, Sharon H. Giordano, Michael Goldstein,B. Ashleigh Guadagnolo, Michael Kosty, Shane Hopkins, James B. Yu, Anna Arnone,Amy Hanley, Stephanie Stevens, and Dawn L. Hershman

JCO JCO.2015.61.1558; published online on August 24, 2015;

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Anna Lin, MBA, PHD (2015). Distance, Insurance and Number of Oncologists Limit Access To Chemotherapy