Travel distance and season of diagnosis affect treatment choices for women with early-stage breast cancer in a predominantly rural population (United States)
Travel distance and season of diagnosis affect treatment choices for women with early-stage breast cancer in a predominantly rural population (United States)
复制标题
DOI：
10.1007/s10552-006-0025-7
复制
发表时间：
2006-08-01
影响因子：
2.3
通讯作者：
Greenberg, E. Robert
中科院分区：
文献类型：
--
作者：
Celaya, Maria O.;Rees, Judy R.;Greenberg, E. Robert
目的目前对早期乳腺癌的护理标准包括保乳手术(BCS)加术后放疗或乳房切除术。影响选择治疗类型的因素有很多。在北方的农村地区，冬季的日常辐射旅行可能会很困难。我们调查了邻近放射治疗设施(RTF)和诊断季节是否会影响新汉普郡早期乳腺癌妇女的治疗选择。方法使用基于人群的癌症登记，我们确定了1998-2000年间新汉普郡所有被诊断为I期或II期乳腺癌的女性居民。我们用多元Logistic回归分析了影响治疗选择的因素。结果新汉普郡患有早期乳腺癌的女性如果生活在离转移灶越远的地方，她们选择BCS的可能性就越小(P<；0.001)。在那些选择最佳选择的人中，居住在距离癌症中心20英里的妇女(P=0.002)和那些在冬季确诊的妇女使用放射治疗的可能性较小(P=0.031)。结论我们的研究结果表明，由于冬季旅行进行放射治疗的困难，新罕布夏州相当一部分早期乳腺癌患者接受的治疗不是最理想的。未来的治疗规划战略应考虑在寒冷的农村地区护理的这些障碍。
Objective Current standards of care for early-stage breast cancer include either breast-conserving surgery (BCS) with post-operative radiation or mastectomy. A variety of factors influence the type of treatment chosen. In northern, rural areas, daily travel for radiation can be difficult in winter. We investigated whether proximity to a radiation treatment facility (RTF) and season of diagnosis affected treatment choice for New Hampshire women with early-stage breast cancer.Methods Using a population-based cancer registry, we identified all women residents of New Hampshire diagnosed with stage I or II breast cancer during 1998-2000. We assessed factors influencing treatment choices using multivariate logistic regression.Results New Hampshire women with early-stage breast cancer were less likely to choose BCS if they live further from a RTF (P < 0.001). Of those electing BCS, radiation was less likely to be used by women living > 20 miles from a RTF (P = 0.002) and those whose diagnosis was made during winter (P = 0.031).Conclusions Our findings indicate that a substantial fraction of women with early-stage breast cancer in New Hampshire receive suboptimal treatment by forgoing radiation because of the difficulty traveling for radiation in winter. Future treatment planning strategies should consider these barriers to care in cold rural regions.