Examining the Effect of Travel Distance to Pediatric Cancer Centers and Rurality on Survival and Treatment Experiences: A Systematic Review.
| Autor: | Tarnasky AM; Duke University School of Medicine., Olivere LA; Duke University School of Medicine., Ledbetter L; Medical Center Library and Archives, School of Medicine., Tracy ET; Division of Pediatric Surgery, Duke University Medical Center, Durham, NC. |
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| Jazyk: | angličtina |
| Zdroj: | Journal of pediatric hematology/oncology [J Pediatr Hematol Oncol] 2021 Jul 01; Vol. 43 (5), pp. 159-171. |
| DOI: | 10.1097/MPH.0000000000002095 |
| Abstrakt: | Accessing pediatric cancer treatment remains problematic for rural families or those living at increased distances from specialized centers. Rural adult cancer patients or those living far removed from treatment may present with later stage disease, receive different treatments than their closer counterparts, and experience worsened survival. While the financial and psychosocial strain of increased travel is well documented, effects of travel distance on similar outcomes for pediatric cancer patients remain ill-defined. We conducted a systematic review to synthesize literature examining the effect of travel distance and/or rurality (as a proxy for distance) on pediatric cancer treatment experiences and survival outcomes. Included studies examined travel distance to specialized centers or rural status for patients above 21 years of age. Studies were excluded if they focused on financial or quality of life outcomes. We analyzed 24 studies covering myriad malignancies and outcomes, including location of care, clinical trial participation, and likelihood of receiving specialized treatments such as stem cell transplants or proton beam therapy. Most were retrospective, and 9 were conducted outside the United States. While some studies suggest rural patients may experience worsened survival and those traveling furthest may experience shorter hospitalization times/rates, the available evidence does not uniformly assert negative effects of increased distance. Competing Interests: The authors declare no conflict of interest. (Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.) |
| Databáze: | MEDLINE |
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