Cancer diagnostic delays and travel distance to health services

This nationwide study in Denmark investigated the association between distance to health services and intervals in the cancer diagnostic pathway, and whether this association was modified by the diagnostic difficulty of the cancer. Over 37,000 Danish cancer patients diagnosed between 2005-2016, who were enrolled in the Danish Cancer in Primary Care (CaP) cohort, were included. The CaP cohorts provided data on intervals assessed by both patients and GPs. Travel distances were calculated for each patients residence to their GP surgery and hospital of diagnosis, using the Geographical Information System (GIS). It was found that longer travel distance to the hospital of diagnosis was associated with a longer diagnostic interval and the association was strongest in the period before implementation of the Cancer Patient Pathways (CPP) in 2010. This association was primarily driven by cancer patients diagnosed with cancer types that were hard to diagnose. The median diagnostic intervals were longer in patients who were oldest, males, had a comorbidity score over 1 and had the longest distance to the hospital. It was found that the travel distance from the patient’s residence to the GP was not associated with time intervals along the diagnostic pathway. Interventions addressing this disparity for rural and remote patients are needed, specifically for hard to diagnose cancers.

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