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10.1038/bjc.2017.180 http://scihub22266oqcxt.onion/10.1038/bjc.2017.180 C5537495!5537495 !28641316     free     free     free Warning: file_get_contents(https://eutils.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&id=28641316 &cmd=llinks): Failed to open stream: HTTP request failed! 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A cancer geography paradox? Poorer cancer outcomes with longer travelling times to healthcare facilities despite prompter diagnosis and treatment: a data-linkage study |pdf=|usr=}}{{28641316 }} gab.com Text A cancer geography paradox Poorer cancer outcomes with longer travelling times to healthcare facilities despite prompter diagnosis and treatment: a data-linkage study JO: Br J Cancer http://www.kidney.de/pget.php?&tw=1&pmid=28641316 #FOAvip BACKGROUND: Rurality and distance from cancer treatment centres have been shown to negatively impact cancer outcomes, but the mechanisms remain obscure. METHODS: We analysed the impact of travel time to key healthcare facilities and mainland/island residency on the cancer diagnostic pathway (treatment within 62 days of referral, and within 31 days of diagnosis) and 1-year mortality using a data-linkage study with 12?339 patients. RESULTS: After controlling for important confounders, mainland patients with more than 60?min of travelling time to their cancer treatment centre ((OR 1.42; 95% CI 1.25-1.61) and island dwellers (OR 1.32; 95% CI 1.09-1.59) were more likely to commence cancer treatment within 62 days of general practitioner (GP) referral and within 31 days of their cancer diagnosis compared with those living within 15?min. Island-dweller patients were more likely to have their diagnosis and treatment started on the same or next day (OR 1.72; 95% CI 1.31-2.25). Increased travelling time to a cancer treatment centre was associated with increased mortality to 1 year (30-59?min (HR 1.21; 95% CI 1.05-1.41), >60?min (HR 1.18; 95% CI 1.03-1.36), island dweller (HR 1.17; 95% CI 0.97-1.41). CONCLUSIONS: Island dwelling and greater mainland travel burden was associated with more rapid cancer diagnosis and treatment following GP referral even after adjustment for advanced disease; however, these patients also experienced a survival disadvantage compared with those living nearer. Cancer services may need to be better configured to suit the different needs of dispersed populations. Twit Text FOAVip A cancer geography paradox Poorer cancer outcomes with longer travelling times to healthcare facilities despite prompter diagnosis and treatment: a data-linkage study ????Br J Cancer http://www.kidney.de/pget.php?&tw=1&pmid=28641316 #FOAvip Twit Text # Free Paper on # # # # # LINK http://www.kidney.de/pget.php?&tw=1&pmid=28641316 #FOAvip English Wikipedia <ref>{{Cite pmid|28641316 }}</ref> A cancer geography paradox? Poorer cancer outcomes with longer travelling times to healthcare facilities despite prompter diagnosis and treatment: a data-linkage study #MMPMID28641316 Turner M ; Fielding S ; Ong Y ; Dibben C ; Feng Z ; Brewster DH ; Black C ; Lee A ; Murchie P Br J Cancer 2017[Jul]; 117 (3 ): 439-449 PMID28641316 show ga BACKGROUND: Rurality and distance from cancer treatment centres have been shown to negatively impact cancer outcomes, but the mechanisms remain obscure. METHODS: We analysed the impact of travel time to key healthcare facilities and mainland/island residency on the cancer diagnostic pathway (treatment within 62 days of referral, and within 31 days of diagnosis) and 1-year mortality using a data-linkage study with 12?339 patients. RESULTS: After controlling for important confounders, mainland patients with more than 60?min of travelling time to their cancer treatment centre ((OR 1.42; 95% CI 1.25-1.61) and island dwellers (OR 1.32; 95% CI 1.09-1.59) were more likely to commence cancer treatment within 62 days of general practitioner (GP) referral and within 31 days of their cancer diagnosis compared with those living within 15?min. Island-dweller patients were more likely to have their diagnosis and treatment started on the same or next day (OR 1.72; 95% CI 1.31-2.25). Increased travelling time to a cancer treatment centre was associated with increased mortality to 1 year (30-59?min (HR 1.21; 95% CI 1.05-1.41), >60?min (HR 1.18; 95% CI 1.03-1.36), island dweller (HR 1.17; 95% CI 0.97-1.41). CONCLUSIONS: Island dwelling and greater mainland travel burden was associated with more rapid cancer diagnosis and treatment following GP referral even after adjustment for advanced disease; however, these patients also experienced a survival disadvantage compared with those living nearer. Cancer services may need to be better configured to suit the different needs of dispersed populations. |*Health Services Accessibility [MESH] |*Medical Record Linkage [MESH] |Aged [MESH] |Female [MESH] |Humans [MESH] |Male [MESH] |Middle Aged [MESH] |Neoplasms/diagnosis/*mortality/*therapy [MESH] |Referral and Consultation [MESH] |Residence Characteristics [MESH] |Time Factors [MESH]A cancer geography paradox? Poorer cancer outcomes with longer travell(epmc).pdf DeepDyve Pubget Overpricing