Travel distance is associated with stage at presentation and laryngectomy rates among patients with laryngeal cancer. Academic Article uri icon

Overview

abstract

  • BACKGROUND: The impact of travel distance on stage at presentation and management strategies of laryngeal squamous cell carcinoma (SCC) is unknown. We investigated this relationship. METHODS: Retrospective review of patients with laryngeal SCC in the National Cancer Data Base from 2004 to 2016. Multivariate analysis determined relationships between travel distance, sociodemographic, geographic, and hospital factors. Logistic regression determined the influence of travel distance on T-stage and overall stage at presentation, and receipt of total laryngectomy. RESULTS: Sixty thousand four hundred and thirty-nine patients were divided into groups based on distance to treatment: short (<12.5 miles); intermediate (12.5-49.9 miles); and long (>50 miles). Increased travel was associated with T4-stage (intermediate vs. short OR 1.11, CI 1.04-1.18, p = 0.001; long vs. short OR 1.5, CI 1.36-1.65, p < 0.001), and total laryngectomy (intermediate vs. short OR 1.40, CI 1.3-1.5, p ≤ 0.001; long vs. short OR 2.52, CI 2.28-2.79, p ≤ 0.001). In T4 disease, total laryngectomy was associated with improved survival compared to nonsurgical treatment (HR 0.75, CI 0.70-0.80, p < 0.001) regardless of travel distance. CONCLUSION: Longer travel distance to care is associated with increased stage at presentation, rate of laryngectomy, and improved survival in advanced laryngeal SCC. Health policy efforts should be directed towards improving early access to diagnosis and care.

publication date

  • August 14, 2021

Research

keywords

  • Health Services Accessibility
  • Laryngeal Neoplasms
  • Laryngectomy
  • Squamous Cell Carcinoma of Head and Neck
  • Travel

Identity

PubMed Central ID

  • PMC9473446

Scopus Document Identifier

  • 85112362103

Digital Object Identifier (DOI)

  • 10.1002/jso.26643

PubMed ID

  • 34390494

Additional Document Info

volume

  • 124

issue

  • 8