What is it about?

This study assessed the impact of centralization of prostate cancer surgery and radiotherapy services on the choice of prostate cancer treatment. Using linked cancer registry data and administrative hospital-level data for 16,621 patients diagnosed with intermediate-risk prostate cancer, it was found that the relative proximity of alternative treatment options to a patient's residence is an independent predictor for the type of radical treatment received. Patients were less likely to receive radiotherapy if their nearest center offered surgery only and the extra travel time to a hospital providing radiotherapy was >15 min. Conversely, patients were more likely to receive radiotherapy if their nearest center offered radiotherapy and the extra travel time to a hospital providing surgery was >15 min. There was a negligible impact on the type of treatment received if centers providing alternative treatment options were ≤15 min travel time from each other. These findings demonstrate how the configuration of specialist services in the English NHS can influence the type of cancer treatment patients receive.

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Why is it important?

This research is important as it highlights the impact of the centralization of prostate cancer surgery and radiotherapy services on the choice of treatment for patients. It demonstrates that the relative proximity of these treatment options to a patient's residence is an independent predictor for the type of radical treatment received. This study emphasizes the need for centralization policies for prostate cancer to consider all treatments to avoid a negative impact on treatment choice. Key Takeaways: 1. The configuration of cancer services, specifically the relative proximity based on travel times to centres offering different prostate cancer treatment options, influences patients' choice of treatment. 2. Over half of men requiring prostate cancer treatment in the NHS do not have both RT and RP services co-located at their nearest treatment centre. 3. Patients were more likely to choose a treatment option available closest to them if the nearest centre offering the alternative treatment was over 15 min away. 4. The study emphasizes the need for centralization policies for prostate cancer to consider all treatments to avoid a negative impact on treatment choice.

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This page is a summary of: Impact of centralization of prostate cancer services on the choice of radical treatment, BJU International, July 2022, Wiley,
DOI: 10.1111/bju.15830.
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