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Rural people are receiving lower rates of radiation therapy for cancer than those in urban centres, new research has shown.
The University of Otago research compared access for rural and urban New Zealanders to radiotherapy for breast, prostate and lung cancers, compared with their urban counterparts and found a gap.
They found significant locality and equity differences with rates of people receiving radiotherapy lower for women with breast cancer aged over 75 living in small towns, and for rural non-Māori women aged 45 to 64.
Rural Māori aged 75 and over with lung cancer also received curative radiotherapy at a rate 66% lower than their urban counterparts.
Rebekah Doran, the clinical director of Rural Health Network, says having identified the problem, the next stop was to go out to those communities to determine what those obstacles were.
“The best people to ask are those who live there,” she says.
The network would be happy to assist finding those reasons which she says could be cost, access to transport, time off work or needing accommodation during treatment.
A solution could be to extend the network of radiotherapy centres to provide better access for cancer sufferers.
The research’s lead author Dr Stephen Withington of Otago’s Centre for Rural Health, says accessing radiation therapy was a challenge for rural cancer patients.
“One third of people with cancer in New Zealand are treated with radiation, but radiation therapy centres and specialist oncology services are generally located in major urban centres, which adds the burden of travel and being treated away from whānau onto patients.”
The study found that some rural people received radiotherapy treatment at rates higher than their urban cousins.
Why rural people are not accessing radiation therapy needs to be determined says Rebekah Doran, the clinical director of Rural Health Network.
This included rural men with prostate cancer, 47% higher, and rural men and women with lung cancer, both about 90% higher.
“This may represent personal choice in the case of prostate cancer, or greater need from higher incidence of cancer and later diagnosis in the case of lung cancer, but more research is required,” says Withington.
Radiotherapy rates for Māori women aged under 45 with breast cancer were lower than their non-Māori counterparts in the same geographical zone and age group.
This was especially true in the most remote areas where rates were 50% lower.
He says lower radiotherapy rates in breast cancer generally correlate with higher rates of total mastectomy as opposed to breast conserving surgery which is generally accompanied by radiotherapy.
“This suggests that fewer rural women and fewer younger Māori women with breast cancer are having breast conserving surgery than their urban counterparts,” says Withington.
Doran says recent changes in the way data was collected ensured health service gaps could be identified which was crucial for rural areas.
“We would not have this information 10 years ago,” she said.