Association of Travel Time With Definitive Prostate Cancer Treatment: A United States Registry Cohort Study.
11 affiliations
- 1Department of Urology, Harvard Medical School, Brigham and Women's Hospital, Boston, Massachusetts, USA.
- 2Center for Surgery and Public Health, Harvard Medical School, Brigham and Women's Hospital, Boston, Massachusetts, USA.
- 3Department of Urology, Humanitas Research Hospital-IRCCS, Milan, Italy.
- 4Department of Biomedical Sciences, Humanitas University, Milan, Italy.
- 5Department of Urology, Medical University of Vienna, Vienna, Austria.
- 6Department of Urology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
- 7Department of Urology, Medical University of Graz, Graz, Austria.
- 8Louisiana Tumor Registry and Epidemiology and Population Health Program, School of Public Health at Louisiana State University Health Sciences Center, New Orleans, Louisiana, USA.
- 9University of Hawaii Cancer Center, Honolulu, Hawaii, USA.
- 10Department of Urology, UPMC, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
- 11Section of Cancer Epidemiology and Health Outcomes, Rutgers Cancer Institute, New Brunswick, New Jersey, USA.
Abstract
Purpose
Prostate 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
We 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
The 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
Higher travel time was associated with lower radiotherapy receipt, but higher surgery use in deprived and rural patients, warranting further investigation.
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BibTeX
@article{dagnino2026association,
title = {{Association of Travel Time With Definitive Prostate Cancer Treatment: A United States Registry Cohort Study.}},
author = {Filippo Dagnino and Stephan Korn and Danesha Daniels and Zhiyu Qian and Daniel Stelzl and Hanna Zurl and Klara Pohl and Mei-Chin Hsieh and Brenda Y Hernandez and Andrea Piccolini and Giovanni Lughezzani and Nicolò M Buffi and Stuart R Lipsitz and Amanda Reich and Joel S Weissman and Alexander P Cole and Quoc-Dien Trinh and Hari S Iyer},
journal = {Cancer medicine},
year = {2026},
month = oct,
doi = {10.1002/cam4.72376},
url = {https://europepmc.org/article/MED/42864849},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Association of Travel Time With Definitive Prostate Cancer Treatment: A United States Registry Cohort Study.
AU - Filippo Dagnino
AU - Stephan Korn
AU - Danesha Daniels
AU - Zhiyu Qian
AU - Daniel Stelzl
AU - Hanna Zurl
AU - Klara Pohl
AU - Mei-Chin Hsieh
AU - Brenda Y Hernandez
AU - Andrea Piccolini
AU - Giovanni Lughezzani
AU - Nicolò M Buffi
AU - Stuart R Lipsitz
AU - Amanda Reich
AU - Joel S Weissman
AU - Alexander P Cole
AU - Quoc-Dien Trinh
AU - Hari S Iyer
PY - 2026
DA - 2026/10/01
JO - Cancer medicine
DO - 10.1002/cam4.72376
UR - https://europepmc.org/article/MED/42864849
AB - Purpose Prostate 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 We 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 The 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 Higher travel time was associated with lower radiotherapy receipt, but higher surgery use in deprived and rural patients, warranting further investigation.
SN - 2045-7634
ER -