{ "abstract": "Purpose\n\nProstate cancer (PCa) mortality disparities are partly driven by unequal access to care. Transportation barriers may limit access to definitive treatment. We studied how driving travel time affects receipt of definitive PCa treatment.Materials and methods\n\nWe conducted a cohort study of men with non-metastatic PCa (2000-2015; follow-up through 2018) across the metropolitan area cancer registries of seven US states. Travel time was estimated using Google Maps isochrones representing driving time thresholds to reach the hospital appended to geomasked residential addresses. Outcomes were \"no treatment,\" \"radical surgery,\" or \"radiotherapy\". Covariate-adjusted multinomial logistic regression with interaction terms assessed modification by sociodemographic factors.Results\n\nThe study included 132,939 men, of whom 37.0% received no treatment, 41.0% underwent surgery, and 22.0% received radiotherapy. Longer driving time (≥ 90 min vs. < 30 min) was associated with higher radical prostatectomy (aOR: 1.08, 95% CI: 1.03, 1.12), but lower radiotherapy (0.72, 95% CI: 0.69-0.76). Subgroup analyses revealed higher surgery associated with longer driving times among those in nSES Q1 (aOR: 1.33, 95% CI: 1.21-1.45) vs. Q5 (aOR: 0.94, 95% CI: 0.86-1.04), those in low (aOR: 1.16, 95% CI: 1.09-1.24) vs. high (aOR: 1.03, 95% CI: 0.98-1.09) population density areas, and those with regional (aOR: 1.30, 95% CI: 1.14-1.48) vs. localized (aOR: 1.05, 95% CI: 1.00-1.09) disease. Longer driving time was mostly associated with lower odds of radiotherapy across sociodemographic subgroups.Conclusions\n\nHigher travel time was associated with lower radiotherapy receipt, but higher surgery use in deprived and rural patients, warranting further investigation.", "abstract_shown": true, "affiliations": [ "Department of Urology, Harvard Medical School, Brigham and Women's Hospital, Boston, Massachusetts, USA.", "Center for Surgery and Public Health, Harvard Medical School, Brigham and Women's Hospital, Boston, Massachusetts, USA.", "Department of Urology, Humanitas Research Hospital-IRCCS, Milan, Italy.", "Department of Biomedical Sciences, Humanitas University, Milan, Italy.", "Department of Urology, Medical University of Vienna, Vienna, Austria.", "Department of Urology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.", "Department of Urology, Medical University of Graz, Graz, Austria.", "Louisiana Tumor Registry and Epidemiology and Population Health Program, School of Public Health at Louisiana State University Health Sciences Center, New Orleans, Louisiana, USA.", "University of Hawaii Cancer Center, Honolulu, Hawaii, USA.", "Department of Urology, UPMC, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.", "Section of Cancer Epidemiology and Health Outcomes, Rutgers Cancer Institute, New Brunswick, New Jersey, USA." ], "article_type": "research article", "arxiv": null, "author_total": 18, "authors": [ { "affs": [ 0, 1, 2, 3 ], "name": "Filippo Dagnino", "orcid": "0009-0001-2710-6898" }, { "affs": [ 0, 1, 4 ], "name": "Stephan Korn", "orcid": "0000-0002-3962-6049" }, { "affs": [ 0, 1 ], "name": "Danesha Daniels" }, { "affs": [ 0, 1 ], "name": "Zhiyu Qian", "orcid": "0000-0001-9953-3074" }, { "affs": [ 0, 1, 5 ], "name": "Daniel Stelzl", "orcid": "0009-0003-4507-3414" }, { "affs": [ 0, 1, 6 ], "name": "Hanna Zurl" }, { "affs": [ 0, 1, 6 ], "name": "Klara Pohl", "orcid": "0009-0001-6740-4005" }, { "affs": [ 7 ], "name": "Mei-Chin Hsieh", "orcid": "0000-0001-7842-1225" }, { "affs": [ 8 ], "name": "Brenda Y Hernandez", "orcid": "0000-0003-0132-4042" }, { "affs": [ 0, 1, 2, 3 ], "name": "Andrea Piccolini", "orcid": "0009-0004-6601-1244" }, { "affs": [ 2, 3 ], "name": "Giovanni Lughezzani" }, { "affs": [ 2, 3 ], "name": "Nicolò M Buffi" }, { "affs": [ 1 ], "name": "Stuart R Lipsitz", "orcid": "0000-0003-2619-1389" }, { "affs": [ 1 ], "name": "Amanda Reich", "orcid": "0000-0001-5922-4154" }, { "affs": [ 1 ], "name": "Joel S Weissman", "orcid": "0000-0002-4990-6263" }, { "affs": [ 0, 1 ], "name": "Alexander P Cole", "orcid": "0000-0002-0049-8529" }, { "affs": [ 9 ], "name": "Quoc-Dien Trinh", "orcid": "0000-0003-3857-9276" }, { "affs": [ 10 ], "name": "Hari S Iyer", "orcid": "0000-0002-7596-9049" } ], "bibtex": "https://research.draconitic.com/paper/brgxnj79q9n0n.bib", "cited_by": 0, "doi": "10.1002/cam4.72376", "fulltext_url": "https://europepmc.org/articles/PMC13658929", "id": "brgxnj79q9n0n", "issns": [ "2045-7634" ], "landing_url": "https://europepmc.org/article/MED/42864849", "language": "eng", "licence": "CC-BY-NC-ND", "licence_label": "CC BY-NC-ND", "licence_source": "article", "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/", "metadata_licence": null, "native_subjects": [ [ "lcc", "RC254-282" ], [ "openalex", "2740|Prostate Cancer Diagnosis and Treatment" ] ], "openalex": "W7221600371", "pdf_url": "https://europepmc.org/articles/PMC13658929?pdf=render", "pmcid": "PMC13658929", "pmid": "42864849", "published": "2026-10-01", "publisher": "Wiley", "ris": "https://research.draconitic.com/paper/brgxnj79q9n0n.ris", "sources": [ { "first_seen": "2026-10-30T12:19:16Z", "native_id": "MED:42864849", "source": "europepmc", "url": "https://europepmc.org/article/MED/42864849" }, { "first_seen": "2026-10-30T13:44:27Z", "native_id": "1e3d4548e98042bc8609b2052f80c724", "source": "doaj", "url": "https://doi.org/10.1002/cam4.72376" } ], "subjects": [ { "field": "medicine", "origin": "lcc:RC254-282", "subfield": "oncology" } ], "title": "Association of Travel Time With Definitive Prostate Cancer Treatment: A United States Registry Cohort Study.", "title_text": "Association of Travel Time With Definitive Prostate Cancer Treatment: A United States Registry Cohort Study.", "type": "peer-reviewed", "updated_at": "2026-10-30T13:44:27Z", "url": "https://research.draconitic.com/paper/brgxnj79q9n0n", "venue": "Cancer medicine", "versions": [] }