Travel distance and potential disparities in palliative radiotherapy access for cancer patients in Victoria, Australia.

Background: Palliative radiotherapy (PRT) is crucial for improving quality of life in patients with advanced-staged cancer. This large data analysis investigates the travel distances and potential disparities in PRT access especially focusing on the burden of excess travel for palliative cancer patients in Victoria, Australia.

Methods: Using a state-wide linked dataset from the PRedicting the health economic IMPact of new and current Cancer Treatments (PRIMCAT) research program, we analysed the estimated road travel distance (ERTD) and potential excess travel distance (PETD) as well as received radiotherapy fractions for 29,807 PRT patients being treated from 2010-2019. We examined disparities by socioeconomic status (SEIFA) and remoteness (RA) of the residential area of PRT patients, and receiving treatment at a public or private centre.

Results: The average one-way ERTD for all PRT patients was 43 km, with variations based on SEIFA and RA. Patients in the lowest SEIFA quintile and those living in outer regional areas had the longest ERTD. Approximately 50% did not receive treatment at the closest facility, with a mean PETD of 27.9 km for private and 24.3 km for public facility patients. Fractionation patterns showed no significant reduction in the number of fractions with increased travel distance. Patients at private facilities received more fractions on average (8.49) compared to those at public facilities (5.91).

Conclusion: This study highlights potential disparities in PRT access in Victoria, with patients living in socioeconomically disadvantaged and remote regions facing longer travel distances and excess travel. These findings underscore the need for strategic referral practices and further research to optimise equitable access to PRT.