Association of Travel Time With Definitive Prostate Cancer Treatment: A United States Registry Cohort Study.

Authors

Filippo Dagnino, Stephan Korn, Danesha Daniels, Zhiyu Qian, Daniel Stelzl, Hanna Zurl, Klara Pohl, Mei-Chin Hsieh, Brenda Y Hernandez, Andrea Piccolini, Giovanni Lughezzani, Nicolò M Buffi, Stuart R Lipsitz, Amanda Reich, Joel S Weissman, Alexander P Cole, Quoc-Dien Trinh, Hari S Iyer

Published in

Cancer medicine. Volume 15. Issue 10. Pages e72376.

Abstract

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.
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.
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.
Higher travel time was associated with lower radiotherapy receipt, but higher surgery use in deprived and rural patients, warranting further investigation.

PMID:
42864849
Bibliographic data and abstract were imported from PubMed on 13 Oct 2026.

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