Cancer Treatment Closer to the Patient Reduces Travel Burden, Time Toxicity, and Improves Patient Satisfaction, Results of 546 Consecutive Patients in a Northern Italian District
Abstract
:1. Introduction
2. Materials and Methods
- −
- Patient’s clinical evaluation, non-invasive diagnostic tests (blood tests, electrocardiogram, ultrasound (US) of chest-abdomen and soft tissues);
- −
- Diagnostic-therapeutic us-guided procedures (fine needle aspiration-biopsy, paracentesis, thoracentesis).
Statistical Analysis
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
- Segel, J.E.; Lengerich, E.J. Rural-urban differences in the association between individual, facility, and clinical characteristics and travel time for cancer treatment. BMC Public Health 2020, 1, 196. [Google Scholar] [CrossRef] [PubMed]
- Charlton, M.; Schlichting, J.; Chioreso, C.; Ward, M.; Vikas, P. Challenges of Rural Cancer Care in the United States. Oncology 2015, 9, 633–640. [Google Scholar]
- Stoyanov, D.S.; Conev, N.V.; Donev, I.S.; Tonev, I.D.; Panayotova, T.V.; Dimitrova-Gospodinova, E.G. Impact of travel burden on clinical outcomes in lung cancer. Support Care Cancer 2022, 6, 5381–5387. [Google Scholar] [CrossRef]
- Racial Disparities in Cancer Outcomes, Screening, and Treatment. KAISER FAMILY FOUNDATION. 2022. Available online: https://www.kff.org/racial-equity-and-health-policy/issue-brief/racial-disparities-in-cancer-outcomes-screening-and-treatment/#:~:text=Research%20shows%20that%20the%20overall,certain%20types%20of%20cancer%20screening (accessed on 17 September 2023).
- Ambroggi, M.; Biasini, C.; Del Giovane, C.; Fornari, F.; Cavanna, L. Distance as a Barrier to Cancer Diagnosis and Treatment: Review of the Literature. Oncologist 2015, 12, 1378–1385. [Google Scholar] [CrossRef] [PubMed]
- Banerjee, R.; George, M.; Gupta, A. Maximizing Home Time for Persons with Cancer. JCO Oncol. Pract. 2021, 9, 513–516. [Google Scholar] [CrossRef]
- Ward, M.M.; Ullrich, F.; Matthews, K.; Rushton, G.; Tracy, R.; Bajorin, D.F.; Goldstein, M.A.; Kosty, M.P.; Bruinooge, S.S.; Hanley, A.; et al. Access to chemotherapy services by availability of local and visiting oncologists. JCO Oncol. Pract. 2014, 1, 26–31. [Google Scholar] [CrossRef]
- Onega, T.; Duell, E.J.; Shi, X.; Demidenko, E.; Goodman, D. Determinants of NCI cancer center attendance in Medicare patients with lung, breast, colorectal, or prostate cancer. J. Gen. Intern. Med. 2009, 2, 205–210. [Google Scholar] [CrossRef]
- Onega, T.; Duell, E.J.; Shi, X.; Wang, D.; Demidenko, E.; Goodman, D. Geographic access to cancer care in the U.S. Cancer 2008, 4, 909–918. [Google Scholar] [CrossRef]
- Henry, K.A.; McDonald, K. Geographic Access to Health Services. In Geographic Health Data: Fundamental Techniques for Analysis; CABI: Boston, MA, USA, 2013; pp. 142–164. [Google Scholar]
- Breugom, A.J.; Boelens, P.G.; van den Broek, C.B.; Cervantes, A.; Van Cutsem, E.; Schmoll, H.J.; Valentini, V.; van de Velde, C.J.H. Quality assurance in the treatment of colorectal cancer: The EURECCA initiative. Ann. Oncol. 2014, 25, 1485–1492. [Google Scholar] [CrossRef]
- Mordenti, P.; Proietto, M.; Citterio, C.; Vecchia, S.; Cavanna, L. La cura oncologica nel territorio. Esperienza nella Casa della Salute: Risultati preliminari nella provincia di Piacenza [The treatment of cancer patients near their residence in the territorial structure “Casa della salute”: Preliminary results in the province of Piacenza (Italy).]. Recenti Prog. Med. 2018, 6, 337–341. [Google Scholar] [CrossRef]
- Cavanna, L.; Citterio, C.; Di Nunzio, C.; Zaffignani, E.; Cremona, G.; Vecchia, S.; de Ponzio, M.; Riva, A.; Proietto, M.; Mordenti, P.; et al. Le cure oncologiche ed ematologiche sul territorio secondo il modello dell’ASL di Piacenza. Rendiconto di 4 anniconsecutivi [Territorial-based management of patients with cancer on active treatment following the Piacenza (north Italy) Model. Results of 4 consecutive years.]. Recenti Prog. Med. 2021, 12, 785–791. (In Italian) [Google Scholar] [CrossRef]
- De Zen, L.; Del Rizzo, I.; Ronfani, L.; Barbieri, F.; Rabusin, M.; Dall’amico, R.; Barbi, E.; Robazza, M. Safety and family satisfaction of a home-delivered chemotherapy program for children with cancer. Ital. J. Pediatr. 2021, 1, 43. [Google Scholar] [CrossRef] [PubMed]
- Ciardiello, F.; Arnold, D.; Casali, P.G.; Cervantes, A.; Douillard, J.-Y.; Eggermont, A.; Eniu, A.; McGregor, K.; Peters, S.; Piccart, M.; et al. Delivering precision medicine in oncology today and in future-The promise and challenges of personalised cancer medicine: A position paper by the European Society for Medical Oncology (ESMO). Ann. Oncol. 2014, 25, 1673–1678. [Google Scholar] [CrossRef]
- Kirkwood, M.K.; Bruinooge, S.S.; Goldstein, M.A.; Bajorin, D.F.; Kosty, M.P. Enhancing the American Society of Clinical Oncology workforce information system with geographic distribution of oncologists and comparison of data sources for the number of practicing oncologists. J. Oncol. Pract. 2014, 10, 32–38. [Google Scholar] [CrossRef] [PubMed]
- Dejardin, O.; Bouvier, A.M.; Herbert, C.; Velten, M.; Buemi, A.; Delafosse, P.; Maarouf, N.; Boutreux, S.; Launoy, G. Social and geographic disparities in access to reference care site for patients with colorectal cancer in France. Br. J. Cancer 2005, 92, 1842–1845. [Google Scholar] [CrossRef]
- Dejardin, O.; Remontet, L.; Bouvier, A.M.; Danzon, A.; Trétarre, B.; Delafosse, P.; Molinié, F.; Maarouf, N.; Velten, M.; Sauleau, E.A.; et al. Socioeconomic and geographic determinants of survival of patients with digestive cancer in France. Br. J. Cancer 2006, 95, 944–949. [Google Scholar] [CrossRef] [PubMed]
- Lejeune, C.; Sassi, F.; Ellis, L.; Godward, S.; Mak, V.; Day, M.; Rachet, B. Socio-economic disparities in access to treatment and their impact on colorectal cancer survival. Int. J. Epidemiol. 2010, 39, 710–717. [Google Scholar] [CrossRef]
- Campbell, N.C.; Elliott, A.M.; Sharp, L.; Ritchie, L.D.; Cassidy, J.; Little, J. Rural factors and survival from cancer: Analysis of Scottish cancer registrations. Br. J. Cancer 2000, 82, 1863–1866. [Google Scholar] [CrossRef]
- Halmin, M.; Bellocco, R.; Lagerlund, M.; Karlsson, P.; Tejler, G.; Lambe, M. Long-term inequalities in breast cancer survival—A ten year follow-up study of patients managed within a National Health Care System (Sweden). Acta Oncol. 2008, 47, 216–224. [Google Scholar] [CrossRef]
- Eaker, S.; Halmin, M.; Bellocco, R.; Bergkvist, L.; Ahlgren, J.; Holmberg, L.; Lambe, M.; on behalf of the Uppsala/Örebro Breast Cancer Group. Social differences in breast cancer survival in relation to patient management within a National Health Care System (Sweden). Int. J. Cancer 2009, 124, 180–187. [Google Scholar] [CrossRef] [PubMed]
- Gori, S.; Di Maio, M.; Pinto, C.; Alabiso, O.; Baldini, E.; Beretta, G.D.; Caffo, O.; Caroti, C.; Crinò, L.; De Laurentiis, M.; et al. Differences in the availability of new anti-cancer drugs for Italian patients treated in different regions. Results of analysis conducted by the Italian Society of Medical Oncology (AIOM). Tumori 2010, 96, 1010–1015. [Google Scholar] [PubMed]
- Rosato, R.; Sacerdote, C.; Pagano, E.; Di Cuonzo, D.; Baldi, I.; Bordon, R.; Ponti, A.; Bertetto, O.; Segnan, N.; Merletti, F.; et al. Appropriateness of early breast cancer management in relation to patient and hospital characteristics: A population based study in Northern Italy. Breast Cancer Res. Treat. 2009, 117, 349–356. [Google Scholar] [CrossRef] [PubMed]
- Groux, P.; Szucs, T. Geographic disparities in access to cancer care: Do patients in outlying areas talk about their access problems to their general practitioners and medical oncologists and how does that impact on the choice of chemotherapy? Eur. J. Cancer Care 2013, 6, 746–753. [Google Scholar] [CrossRef] [PubMed]
- Gamm, D.; Hutchison, L.; Dabney, B.; Dorsey, A. Rural Healthy People 2010: A Companion Document to Healthy People; The Texas A&M University System Health Science Center, School of Rural Public Health, Southwest Rural Health Research Center: College Station, TX, USA, 2003; Volume 1. [Google Scholar]
- Martinez-Donate, A.P.; Halverson, J.; Simon, N.-J.; Strickland, J.S.; Trentham-Dietz, A.; Smith, P.D.; Linskens, R.; Wang, X. Identifying health literacy and health system navigation needs among rural cancer patients: Findings from the Rural Oncology Literacy Enhancement Study (ROLES). J. Cancer Educ. 2013, 28, 573–581. [Google Scholar] [CrossRef] [PubMed]
- Community Oncology Alliance. Oncology Medical Home Initiative. Available online: http://www.communityoncology.org/ (accessed on 9 January 2023).
- Wardley, A.; Canon, J.L.; Elsten, L.; Murillo, C.P.; Crnjevic, T.B.; Fredriksson, J.; Piccart, M. Flexible care in breast cancer. ESMO Open 2021, 1, 100007. [Google Scholar] [CrossRef]
- Simion, L.; Rotaru, V.; Cirimbei, C.; Gales, L.; Stefan, D.-C.; Ionescu, S.-O.; Luca, D.; Doran, H.; Chitoran, E. Inequities in Screening and HPV Vaccination Programs and Their Impact on Cervical Cancer Statistics in Romania. Diagnostics 2023, 17, 2776. [Google Scholar] [CrossRef]
- Lee, H.; Shi, S.M.; Kim, D.H. Home time as a patient-centered 0 utcome in administrative claims data. J. Am. Geriatr. Soc. 2019, 2, 347–351. [Google Scholar] [CrossRef]
- Cinar, P.; Kubal, T.; Freifeld, A. Safety at the time of the COVID-19 pandemic: How to keep our oncology patients and healthcare workers safe. J. Natl. Compr. Canc. Netw. 2020, 18, 504–509. [Google Scholar] [CrossRef]
- American Society of Clinical Oncology: Cancer Treatment & Supportive Care. Available online: https://www.asco.org/asco-coronavirus-resources/care-individuals-cancerduring-covid-19/cancer-treatment-supportive-care. (accessed on 10 September 2023).
- Mohile, S.; Dumontier, C.; Mian, H.; Loh, K.P.; Williams, G.R.; Wildes, T.M.; Boyd, K.; Ramsdale, E.; Pyne, S.; Magnuson, A.; et al. Perspectives from the Cancer and Aging Research Group: Caring for the vulnerable older patient with cancer and their caregivers during the COVID-19 crisis in the United States. J. Geriatr. Oncol. 2020, 11, 753–760. [Google Scholar] [CrossRef] [PubMed]
- Ambroggi, M.; Citterio, C.; Vecchia, S.; Riva, A.; Mordenti, P.; Cavanna, L. Impact of the COVID-19 pandemic on the oncologic activities (diagnosis, treatment, clinical trials enrollment) of a general hospital in a district with high prevalence of SARS-CoV-2 in Italy. Support Care Cancer 2022, 4, 3225–3231. [Google Scholar] [CrossRef] [PubMed]
- Wu, C. Systemic therapy for colon cancer. Surg. Oncol. Clin. N. Am. 2018, 2, 235–242. [Google Scholar] [CrossRef]
- Duma, N.; Davia, R.S.; Molina, J.R. Non-small cell lung cancer: Epidemiology, screening, diagnosis, and treatment. Mayo Clin. Proc. 2019, 8, 1623–1640. [Google Scholar] [CrossRef]
- Smyth, E.C.; Nilsson, M.; Grabsch, H.L.; van Grieken, N.C.; Lordick, F. Gastric cancer. Lancet 2020, 29, 635–648. [Google Scholar] [CrossRef] [PubMed]
- Gupta, R.; Amanam, I.; Chung, V. Current and future therapies for advanced pancreatic cancer. J. Surg. Oncol. 2017, 1, 25–34. [Google Scholar] [CrossRef] [PubMed]
- Boakye, D.; Gunther, K.; Niedermaier, T.; Haug, U.; Ahrens, W.; Nagrani, R. Associations between comorbidities and advanced stage diagnosis of lung, breast, colorectal and prostate cancer: A systematic review and meta-analysis. Cancer Epidemiol. 2021, 75, 102054. [Google Scholar] [CrossRef] [PubMed]
- Castor, C.; Landgren, K.; Hansson, H.; Hallström, I. A possibility for strengthening family life and health: Family members’ lived experience when a sick child receives home care in Sweden. Health Soc. Care Community 2018, 26, 224–231. [Google Scholar] [CrossRef]
Characteristics | Patients (n = 546) |
---|---|
Sex n (%) | |
female | 277 (50.73) |
male | 269 (49.27) |
Median age (IQR) (range) | 70.5 (3–77.25) (30–89) |
Primarytumor location n (%) | |
gastroenteric | 195 (35.71) |
genito-urinary | 84 (15.39) |
breast | 127 (23.26) |
lung | 81 (14.83) |
head and neck | 20 (3.66) |
other | 39 (7.14) |
Setting of treatment n (%) | |
early/localized/neoadjuvant/adjuvant | 164 (30.04) |
metastatic line | 382 (69.96) |
1’line | 303 (79.32) |
subsequent lines | 79 (20.68) |
Therapy n (%) | |
intravenous chemotherapy | 422 (77.29) |
intravenous immuno/chemiotherapy | 7 (1.28) |
intravenous immunotherapy | 34 (6.22) |
intramuscolar immunotherapy | 10 (1.83) |
target therapy | 73 (13.37) |
n. visits from 2 January 2021 to 31 December 2021 | 2254 |
n. infusion therapies from 2 January 2021 to 31 December 2021 | 3884 |
n. visits from 2 January 2022 to 30 June 2022 | 1117 |
n. infusion therapies from 2 January 2022 to 30 June 2022 | 1792 |
total visits | 3371 |
total infusion therapies | 5676 |
Distance from Patient’s Residence to Center of Care | p-Value | Time | p-Value | |||
---|---|---|---|---|---|---|
Median (IQR) (kms) | Range (kms) | Median (IQR) (min) | Range (min) | |||
Residence—nearest Community Hospital/CDS | 7 (3–12) | 1–35 | <0.001 | 16 (16–23) | 6–54 | <0.001 |
Residence—referral city hospital | 26 (23–38) | 11–79 | 44 (39–52) | 32–116 |
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Cavanna, L.; Citterio, C.; Mordenti, P.; Proietto, M.; Bosi, C.; Vecchia, S. Cancer Treatment Closer to the Patient Reduces Travel Burden, Time Toxicity, and Improves Patient Satisfaction, Results of 546 Consecutive Patients in a Northern Italian District. Medicina 2023, 59, 2121. https://doi.org/10.3390/medicina59122121
Cavanna L, Citterio C, Mordenti P, Proietto M, Bosi C, Vecchia S. Cancer Treatment Closer to the Patient Reduces Travel Burden, Time Toxicity, and Improves Patient Satisfaction, Results of 546 Consecutive Patients in a Northern Italian District. Medicina. 2023; 59(12):2121. https://doi.org/10.3390/medicina59122121
Chicago/Turabian StyleCavanna, Luigi, Chiara Citterio, Patrizia Mordenti, Manuela Proietto, Costanza Bosi, and Stefano Vecchia. 2023. "Cancer Treatment Closer to the Patient Reduces Travel Burden, Time Toxicity, and Improves Patient Satisfaction, Results of 546 Consecutive Patients in a Northern Italian District" Medicina 59, no. 12: 2121. https://doi.org/10.3390/medicina59122121