Cancer survival in New South Wales (NSW) and the impact of distance from and access to cancer surgical services: a data linkage study
Year: 2015
Type: dissertation
Study design: Observational Study
Abstract: Cancer survival is poorer in rural NSW but specialist cancer surgical services are predominately located in the Sydney region. The aim of this thesis is to examine whether increasing distance from cancer surgical services affects access to those services and ultimately cancer survival. The method used was population based data linkage for patients diagnosed between 2000 and 2008 (data obtained from the NSW Central Cancer Registry database and linked to hospitalisations) and followed to the end of 2008. Distance was measured in kilometres from a person’s home to their hospital of surgery (bladder cancer) or the closest specialist hospital (ovarian and lung cancer) by using geographical coordinates. Associations were modelled using logistic regression and the hazard of death using Cox regression and the survival time parametric method (stpm2). The hazard of death decreased with distance for people with bladder cancer who had a cystectomy. People with ovarian and lung cancer who lived further from specialist surgical hospitals were much more likely to attend general hospitals, have advanced or unknown stage cancer at diagnosis and have limited or no surgery. Understanding the factors that impede referral to specialist surgical hospitals particularly those who live remotely is essential for optimal cancer survival.
Author: Elizabeth Tracey
Language: English
Subfield: Oncology
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W48559416