Barriers to accessing radiation therapy in Canada: A systematic review

Radiation Oncology

Volumn 7, Issue 1, 2012, Pages

  Gillan, Caitlin ^a,b   Briggs, Kaleigh ^a   Pazos, Alejandro G ^c   Maurus, Melanie ^c   Harnett, Nicole ^a,b   Catton, Pamela ^a,b,c   Wiljer, David ^a,b,c  

^a PRINCESS MARGARET HOSPITAL   (Canada)

^b UNIVERSITY OF TORONTO   (Canada)

^c Wellness and Cancer Survivorship Centre   (Canada)

Author keywords

Access to treatment; Barriers; Radiation therapy; Referral; Utilization; Wait times

Indexed keywords

ARTICLE; CANADA; CANCER RADIOTHERAPY; CINAHL; EMBASE; HEALTH CARE SYSTEM; HUMAN; MEDLINE; SYSTEMATIC REVIEW (TOPIC); THEMATIC ANALYSIS;

ATTITUDE TO HEALTH; CANADA; GEOGRAPHY; HEALTH SERVICES ACCESSIBILITY; HEALTH SERVICES RESEARCH; HUMANS; NEOPLASMS; RADIOTHERAPY; SOCIAL CLASS; TIME FACTORS;

EID: 84867316758     PISSN: None     EISSN: 1748717X     Source Type: Journal    
DOI: 10.1186/1748-717X-7-167     Document Type: Article

References (90)

1. Zhang-Salomons J, Mackillop WJ. Estimating the lifetime utilization rate of radiotherapy in cancer patients: the Multicohort Current Utilization Table (MCUT) method. Comput Methods Programs Biomed 2008, 92:99-108. 10.1016/j.cmpb.2008.06.011, 18676052.
2. CSQI Radiation Therapy Treatment Utilization 2011, Toronto: CQCO, [cited December 15th, 2011]; Available from: http://www.csqi.on.ca/cms/one.aspx?portalId=89621&pageId=92611, CSQI.
3. Delaney G, Jacob S, Featherstone C, Barton M. The role of radiotherapy in cancer treatment: estimating optimal utilization from a review of evidence-based clinical guidelines. Cancer 2005, 104:1129-1137. 10.1002/cncr.21324, 16080176.
4. Scottish Executive Health Dept Radiotherapy Activity Planning Group Cancer in Scotland: Radiotherapy Activity Planning for Scotland 2011-2015 2005, Scotland: NHS, Scottish Executive Health Dept Radiotherapy Activity Planning Group.
5. Canadian Partnership Against Cancer (CPAC) System Performance Report 2010, Toronto: CPAC, Canadian Partnership Against Cancer (CPAC).
6. Benk V, Przybysz R, McGowan T, Paszat L. Waiting times for radiation therapy in Ontario. Can J Surg 2006, 49:16-21. 3207519, 16524138.
7. Cooke AL, Appell R, Suderman K, Fradette K, Latosinsky S. Radiation treatment waiting times for breast cancer patients in Manitoba, 2001 and 2005. Curr Oncol 2009, 16:58-64. 2768502, 19862362.
8. Reed AD, Williams RJ, Wall PA, Hasselback P. Waiting time for breast cancer treatment in Alberta. Can J Public Health 2004, 95:341-345.
9. Yavari P, Barroetavena MC, Hislop TG, Bajdik CD. Breast cancer treatment and ethnicity in British Columbia, Canada. BMC Cancer 2010, 10:154. 10.1186/1471-2407-10-154, 2882352, 20406489.
10. French J, McGahan C, Duncan G, Lengoc S, Soo J, Cannon J. How gender, age, and geography influence the utilization of radiation therapy in the management of malignant melanoma. Int J Radiat Oncol Biol Phys 2006, 66:1056-1063. 10.1016/j.ijrobp.2006.06.051, 16965863.
11. Ludbrook JJS, Truong PT, MacNeil MV, Lesperance M, Webber A, Joe H, Martins H, Lim J. Do age and comorbidity impact treatment allocation and outcomes in limited stage small-cell lung cancer? A community-based population analysis. Int J Radiat Oncol Biol Phys 2003, 55:1321-1330. 10.1016/S0360-3016(02)04576-5, 12654444.
12. Truong PT, Kader HA, Lacy B, Lesperance M, MacNeil MV, Berthelet E, McMurtrie E, Alexander S. The effects of age and comorbidity on treatment and outcomes in women with endometrial cancer. Am J Clin Oncol 2005, 28:157-164. 10.1097/01.coc.0000143049.05090.12, 15803010.
13. Samant RS, Fitzgibbon E, Meng J, Graham ID. Family physicians' perspectives regarding palliative radiotherapy. Radiother Oncol 2006, 78:101-106. 10.1016/j.radonc.2005.11.008, 16330118.
14. Tucker TL, Samant RS, Fitzgibbon EJ. Knowledge and utilization of palliative radiotherapy by pediatric oncologists. Curr Oncol 2010, 17:48-55. 2913829, 20697514.
15. Turnock B. Public Health: what it is and how it works 2009, Sudbury, MA: Jones and Bartlett Publishers, 4.
16. Morris AM, Rhoads KF, Stain SC, Birkmeyer JD. Understanding racial disparities in cancer treatment and outcomes. J Am Coll Surg 2010, 211:105-113. 10.1016/j.jamcollsurg.2010.02.051, 20610256.
17. Barnes EA, et al. Palliative radiotherapy for patients with bone metastases: Survey of primary care physicians. Radiother Oncol 2003, 67(2):221-223. 10.1016/S0167-8140(02)00366-3, 12812854.
18. Chow E, et al. Referring physicians' satisfaction with the rapid response radiotherapy programme: Survey results at the Toronto-Sunnybrook Regional Cancer Centre. Support Care Cancer 2000, 8(5):405-409. 10.1007/s005200050009, 10975690.
19. Chuah TK, et al. Management of primary rectal cancer by surgeons in Atlantic Canada: Results of a regional survey. Can J Surg 2010, 53(6):396-402. 2993032, 21092432.
20. Danielson B, et al. Palliative Radiotherapy for Women with Breast Cancer. Clin Oncol 2008, 20(7):506-512.
21. Dunscombe P, Roberts G. Radiotherapy service delivery models for a dispersed patient population. Clin Oncol 2001, 13(1):29-37.
22. Fitch MI, et al. Travelling for radiation cancer treatment: patient satisfaction. Can Oncol Nurs J 2005, 15(2):107-112.
23. Fortin B, Goldberg MS, et al. Waiting time for radiation therapy in breast cancer patients in Quebec from 1992 to 1998: a study of surgically treated breast cancer patients in Quebec documents and helps to explain increased waiting times for radiation therapy. Healthcare Policy = Politiques de sante 2006, 1(2):152-167. 2585322, 19305663.
24. French J, et al. Inequities in Access: How Utilization of Palliative Radiation Therapy in British Columbia Varies with Geography. J Med Imag Radiat Sci 2008, 39(2):75-80.
25. Gray RE, et al. A consultation with Canadian rural women with breast cancer. Health Expect 2004, 7(1):40-50. 10.1046/j.1369-6513.2003.00248.x, 14982498.
26. Hebert-Croteau N, et al. A population-based study of the impact of delaying radiotherapy after conservative surgery for breast cancer. Breast Cancer Res Treat 2004, 88(2):187-196. 10.1007/s10549-004-0594-7, 15564801.
27. Huang J, et al. Factors affecting the use of palliative radiotherapy in Ontario. J Clin Oncol 2001, 19(1):137-144.
28. Johnston GM, et al. Radiotherapy wait times for patients with a diagnosis of invasive cancer, 1992-2000. Clin Invest Med 2004, 27(3):142-156.
29. Kerba M, et al. Defining the Need for Prostate Cancer Radiotherapy in the general population: a Criterion-based Benchmarking Approach. Clin Oncol 2010, 22(10):801-809.
30. Lavergne MR, et al. Variation in the use of palliative radiotherapy at end of life: Examining demographic, clinical, health service, and geographic factors in a population-based study. Palliat Med 2011, 25(2):101-110. 10.1177/0269216310384900, 20937613.
31. Li X, Butts C, et al. Utilization of oncology services and receipt of treatment: a comparison between patients with breast, colon, and rectal, or lung cancer. Ann Oncol 2010, 22(8):1902-1909.
32. Maddison AR, Asada Y, Urquhart R. Inequity in access to cancer care: A review of the Canadian literature. Cancer Causes Control 2011, 22(3):359-366. 10.1007/s10552-010-9722-3, 21221758.
33. Sutton DS, et al. The use of palliative radiotherapy for bone metastasis. Radiother Oncol 2010, 97(3):548-553. 10.1016/j.radonc.2010.09.015, 20971519.
34. Szumacher E, et al. Improving access to radiotherapy services in the Simcoe-Muskoka region of Ontario: needs assessment study. Can J Med Radiat Technol 2007, 38(3):7-16.
35. Taussky D, et al. Factors influencing treatment decisions in patients with low risk prostate cancer referred to a brachytherapy clinic. Can J Urol 2008, 15(6):4415-4420.
36. Tyldesley S, McGahan C. Utilisation of Radiotherapy in Rural and Urban Areas in British Columbia Compared with Evidence-based Estimates of Radiotherapy Needs for Patients with Breast, Prostate and Lung Cancer. Clin Oncol 2010, 22(7):526-532.
37. Johnston GM, et al. Variation in delivery of palliative radiotherapy to persons dying of cancer in Nova Scotia, 1994 to 1998. J Clin Oncol 2001, 19(14):3323-3332.
38. Wu JS, et al. Patterns of practice in palliative radiotherapy for painful bone metastases: impact of a regional rapid access clinic on access to care. Int J Radiat Oncol Biol Phys 2010, 78(2):533-538. 10.1016/j.ijrobp.2009.07.1716, 19910133.
39. Bairati I, et al. Women's perceptions of events impeding or facilitating the detection, investigation and treatment of breast cancer. Eur J Cancer Care 2006, 15(2):183-193.
40. Belyea J, et al. Wait times for head and neck cancer patients in the Maritime provinces. J Otolaryngol Head Neck Surg 2011, 40(4):318-322.
41. Chan K, et al. Investigating patient wait times for daily outpatient radiotherapy appointments (a single-centre study). J Med Imag Radiat Sci 2010, 41(3):145-151.
42. Cromwell IA, Johnson A, Mackillop W. The cost of waiting: Economic benefit of reducing waiting times for early breast cancer radiotherapy. Value Health 2009, 12(3):A48-A49.
43. D'Souza DP, et al. Waiting lists for radiation therapy: a case study. BMC Health Serv Res 2001, 1(1):3. 10.1186/1472-6963-1-3, 32176, 11319944.
44. Goldstein D, et al. Wait times in the diagnosis and treatment of head and neck cancer: Comparison between wait times in 1995 and 2005 - A prospective study. J Otolaryngol 2007, 36(6):336-343.
45. Groome PA, et al. Laryngeal Cancer Treatment and Survival Differences across Regional Cancer Centres in Ontario, Canada. Clin Oncol 2011, 23(1):19-28.
46. Groome PA, et al. Explaining Socioeconomic Status Effects in Laryngeal Cancer. Clin Oncol 2006, 18(4):283-292.
47. Kavanagh AG, Lee JC, Donnelly B. Time to treatment of prostate cancer through the Calgary Prostate Institute rapid access clinic. Can J Urol 2008, 15(2):3975-3979.
48. Keyes M, et al. Health-related quality of life in patients on radiotherapy waiting lists (multiple letters) [2]. Clin Oncol 2002, 14(4):329-330.
49. Rayson D, et al. Comparison of elapsed times from breast cancer detection to first adjuvant therapy in Nova Scotia in 1999/2000 and 2003/04. Cmaj 2007, 176(3):327-332. 10.1503/cmaj.060825, 1780076, 17261829.
50. Samant RS, et al. Barriers to palliative radiotherapy referral: a Canadian perspective. Acta Oncol 2007, 46(5):659-663. 10.1080/02841860600979005, 17562442.
51. Stevens C, Bondy SJ, Loblaw DA. Wait times in prostate cancer diagnosis and radiation treatment. Can Urol Assoc J 2010, 4(4):243-248. 10.5489/cuaj.09122, 2910767, 20694099.
52. Sullivan T. Waiting for cancer care: exploiting our national laboratory. Can J Surg 2006, 49(1):12-14. 3207512, 16524136.
53. French J, McGahan C. Measuring patient satisfaction with radiation therapy service delivery. Healthc Manage Forum 2009, 22(4):40-50. 10.1016/S0840-4704(10)60141-X, 20166520.
54. Barbera L, et al. Defining the need for radiotherapy for lung cancer in the general population: a criterion-based, benchmarking approach. Med Care 2003, 41(9):1074-1085. 10.1097/01.MLR.0000083742.29541.BC, 12972847.
55. Choo R, et al. Survey of radiation oncologists: practice patterns of the management of stage I seminoma of testis in Canada and a selected group in the United States. Can J Urol 2002, 9(2):1479-1485.
56. De Sa E, et al. Continued success of the rapid response radiotherapy program: A review of 2004-2008. Support Care Cancer 2009, 17(7):757-762. 10.1007/s00520-009-0585-7, 19184124.
57. Danjoux C, et al. An innovative rapid response radiotherapy program to reduce waiting time for palliative radiotherapy. Support Care Cancer 2006, 14(1):38-43. 10.1007/s00520-005-0822-7, 15856333.
58. Dayes IS, et al. Cross-border referral for early breast cancer: An analysis of radiation fractionation patterns. Curr Oncol 2006, 13(4):124-129. 1891182, 17576453.
59. Giddings A. Treatment interruptions in radiation therapy for head-and-neck cancer: rates and causes. J Med Imag Radiat Sci 2010, 41(4):222-229.
60. Gorey KM, et al. Income and long-term breast cancer survival: comparisons of vulnerable urban places in Ontario and California. Breast J 2010, 16(4):416-419. 2919557, 20443784.
61. Kollmannsberger C, et al. Evolution in management of testicular seminoma: Population-based outcomes with selective utilization of active therapies. Ann Oncol 2011, 22(4):808-814. 10.1093/annonc/mdq466, 20926549.
62. Kwon JS, et al. Patterns of practice and outcomes in intermediate- and high-risk stage I and II endometrial cancer: a population-based study. Int J Gynecol Cancer 2007, 17(2):433-440. 10.1111/j.1525-1438.2007.00812.x, 17309565.
63. Randal J. Canada faces shortage of radiation therapists. J Natl Cancer Inst 2000, 92(3):186-188. 10.1093/jnci/92.3.186, 10655428.
64. Gorey KM, et al. Wait times for surgical and adjuvant radiation treatment of breast cancer in Canada and the United States: greater socioeconomic inequity in America. Clin Invest Med 2009, 32(3):E239-E249. 2910751, 19480739.
65. Bagnell S, et al. Practice patterns of Canadian urologists in the management of stage I testicular seminoma. Can J Urol 2004, 11(2):2194-2199.
66. Chua B, et al. Original article increased use of adjuvant regional radiotherapy for node-positive breast cancer in British Columbia. Breast J 2004, 10(1):38-44. 10.1111/j.1524-4741.2004.09605.x, 14717758.
67. Elit L, et al. Patterns of care in the initial management of women with vulvar cancers in Ontario. Eur J Gynaecol Oncol 2009, 30(5):503-505.
68. Elit L, et al. Patterns of care for the initial management of cervical cancer in Ontario. Eur J Gynaecol Oncol 2009, 30(5):493-496.
69. Gorey KM, et al. Breast cancer care in the Canada and the United States: Ecological comparisons of extremely impoverished and affluent urban neighborhoods. Health Place 2010, 16(1):156-163. 10.1016/j.healthplace.2009.09.011, 2908703, 19840902.
70. Ng A, et al. An examination of utilization of adjuvant and salvage radiosurgery for the treatment of brain metastasis. Int J Radiat Oncol Biol Phys 2010, 1:S285.
71. Puts MTE, et al. Characteristics of older newly diagnosed cancer patients refusing cancer treatments. Support Care Cancer 2010, 18(8):969-974. 10.1007/s00520-010-0883-0, 20419496.
72. Schwartz KL, et al. Continued undertreatment of older men with localized prostate cancer. Urology 2003, 62(5):860-865. 10.1016/S0090-4295(03)00690-3, 14624909.
73. Clavel S, et al. Adjuvant regional irradiation after breast-conserving therapy for early stage breast cancer: a survey of Canadian radiation oncologists. Clin Oncol (R Coll Radiol) 2010, 22(1):39-45.
74. French J. Introduction to the principles of bioethics. Can J Med Radiat Technol 2006, 37(1):31-38.
75. Hislop TG, et al. Local and regional therapy for women with breast cancer in British Columbia. Breast J 2003, 9(3):192-199. 10.1046/j.1524-4741.2003.09310.x, 12752627.
76. Kerba M, et al. Defining the Need for Breast Cancer Radiotherapy in the General Population: a Criterion-based Benchmarking Approach. Clin Oncol 2007, 19(7):481-489.
77. Ong S, et al. Predictors of referral for adjuvant therapy for colorectal cancer. Can J Surg 2005, 48(3):225-229. 3211554, 16013627.
78. Tyldesley S, et al. Association between age and the utilization of radiotherapy in Ontario. Int J Radiat Oncol Biol Phys 2000, 47(2):469-480. 10.1016/S0360-3016(00)00440-5, 10802375.
79. Fitzgibbon EJ, et al. Awareness and use of the Rapid Palliative Radiotherapy Program by family physicians in Eastern Ontario: A survey. Curr Oncol 2006, 13:27-32. 1891168, 17576438.
80. Tucker TL, Fitzgibbon E, Samant R. A national survey of Canadian pediatric oncologists of barriers in the delivery of palliative radiotherapy to children with cancer. J Palliat Care 2006, 22(3):236.
81. Tyldesley S, Roques TW, Erridge S. General practitioner assessment of stage and performance status in lung cancer patients at a population level: Implications for prognosis and radiotherapy needs analyses. Lung Cancer 2007, 57(3):381-388. 10.1016/j.lungcan.2007.03.024, 17485136.
82. Fairchild A, Ghosh S. Referring practitioners' self-rated versus actual knowledge about Palliative radiotherapy. Support Care Cancer 2009, 17(7):965.
83. Gorey KM, et al. The supply of physicians and care for breast cancer in Ontario and California, 1998 to 2006. Can J Rural Med 2011, 16(2):47-54. 3174215, 21453604.
84. Barbera L, et al. Defining the need for radiotherapy for lung cancer in the general population: a criterion-based, benchmarking approach. Medical Care 2003, 41(9):1074-1085. 10.1097/01.MLR.0000083742.29541.BC, 12972847.
85. Barnes EA, et al. Involvement of family physicians in the care of cancer patients seen in the palliative Rapid Response Radiotherapy Program. J Clin Oncol 2007, 25(36):5758-5762. 10.1200/JCO.2007.13.3082, 18089872.
86. Rose A, et al. Development and testing of the health care system distrust scale. J Gen Intern Med 2004, 19(1):57-63. 10.1111/j.1525-1497.2004.21146.x, 1494688, 14748861.
87. Kumar S, et al. Influence of patient's perceptions, beliefs and knowledge about cancer on treatment decision making in Pakistan. Asian Pac J Cancer Prev 2010, 11(1):251-255.
88. Chen YP, et al. Causes of interruption of radiotherapy in nasopharyngeal carcinoma patients in Taiwan. Jpn J Clin Oncol 2000, 30(5):230-234. 10.1093/jjco/hyd059, 10857501.
89. Bickell NA, et al. Underuse of breast cancer adjuvant treatment: patient knowledge, beliefs, and medical mistrust. J Clin Oncol 2009, 27(31):5160-5167. 10.1200/JCO.2009.22.9773, 2773474, 19770368.
90. Halkett GK, Kristjanson LJ, Lobb EA. 'If we get too close to your bones they'll go brittle': women's initial fears about radiotherapy for early breast cancer. Psychooncology 2008, 17(9):877-884. 10.1002/pon.1298, 18033696.