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10.1038/bjc.2017.180 http://scihub22266oqcxt.onion/10.1038/bjc.2017.180 C5537495!5537495!28641316     free     free     free Warning: file_get_contents(https://eutils.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&id=28641316&cmd=llinks): Failed to open stream: HTTP request failed! 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A cancer geography paradox? Poorer cancer outcomes with longer travelling times to healthcare facilities despite prompter diagnosis and treatment: a data-linkage study |pdf=|usr=}}{{28641316}} gab.com Text A cancer geography paradox Poorer cancer outcomes with longer travelling times to healthcare facilities despite prompter diagnosis and treatment: a data-linkage study JO: Br J Cancer http://www.kidney.de/pget.php?&tw=1&pmid=28641316 #FOAvip Background:: Rurality and distance from cancer treatment centres have been shown to negatively impact cancer outcomes, but the mechanisms remain obscure. Methods:: We analysed the impact of travel time to key healthcare facilities and mainland/island residency on the cancer diagnostic pathway (treatment within 62 days of referral, and within 31 days of diagnosis) and 1-year mortality using a data-linkage study with 12?339 patients. Results:: After controlling for important confounders, mainland patients with more than 60?min of travelling time to their cancer treatment centre ((OR 1.42; 95% CI 1.25?1.61) and island dwellers (OR 1.32; 95% CI 1.09?1.59) were more likely to commence cancer treatment within 62 days of general practitioner (GP) referral and within 31 days of their cancer diagnosis compared with those living within 15?min. Island-dweller patients were more likely to have their diagnosis and treatment started on the same or next day (OR 1.72; 95% CI 1.31?2.25). Increased travelling time to a cancer treatment centre was associated with increased mortality to 1 year (30?59?min (HR 1.21; 95% CI 1.05?1.41), >60?min (HR 1.18; 95% CI 1.03?1.36), island dweller (HR 1.17; 95% CI 0.97?1.41). Conclusions:: Island dwelling and greater mainland travel burden was associated with more rapid cancer diagnosis and treatment following GP referral even after adjustment for advanced disease; however, these patients also experienced a survival disadvantage compared with those living nearer. Cancer services may need to be better configured to suit the different needs of dispersed populations. Twit Text FOAVip A cancer geography paradox Poorer cancer outcomes with longer travelling times to healthcare facilities despite prompter diagnosis and treatment: a data-linkage study ????Br J Cancer http://www.kidney.de/pget.php?&tw=1&pmid=28641316 #FOAvip Twit Text # Free Paper on # # # # # LINK http://www.kidney.de/pget.php?&tw=1&pmid=28641316 #FOAvip English Wikipedia <ref>{{Cite pmid|28641316}}</ref> A cancer geography paradox? Poorer cancer outcomes with longer travelling times to healthcare facilities despite prompter diagnosis and treatment: a data-linkage study #MMPMID28641316 Turner M; Fielding S; Ong Y; Dibben C; Feng Z; Brewster DH; Black C; Lee A; Murchie P Br J Cancer 2017[Jul]; 117 (3): 439-49 PMID28641316show ga Background:: Rurality and distance from cancer treatment centres have been shown to negatively impact cancer outcomes, but the mechanisms remain obscure. Methods:: We analysed the impact of travel time to key healthcare facilities and mainland/island residency on the cancer diagnostic pathway (treatment within 62 days of referral, and within 31 days of diagnosis) and 1-year mortality using a data-linkage study with 12?339 patients. Results:: After controlling for important confounders, mainland patients with more than 60?min of travelling time to their cancer treatment centre ((OR 1.42; 95% CI 1.25?1.61) and island dwellers (OR 1.32; 95% CI 1.09?1.59) were more likely to commence cancer treatment within 62 days of general practitioner (GP) referral and within 31 days of their cancer diagnosis compared with those living within 15?min. Island-dweller patients were more likely to have their diagnosis and treatment started on the same or next day (OR 1.72; 95% CI 1.31?2.25). Increased travelling time to a cancer treatment centre was associated with increased mortality to 1 year (30?59?min (HR 1.21; 95% CI 1.05?1.41), >60?min (HR 1.18; 95% CI 1.03?1.36), island dweller (HR 1.17; 95% CI 0.97?1.41). Conclusions:: Island dwelling and greater mainland travel burden was associated with more rapid cancer diagnosis and treatment following GP referral even after adjustment for advanced disease; however, these patients also experienced a survival disadvantage compared with those living nearer. Cancer services may need to be better configured to suit the different needs of dispersed populations. äA cancer geography paradox? Poorer cancer outcomes with longer travell(epmc).pdf DeepDyve Pubget Overpricing