ArticleInternational journal of cancer2019
Impact of cancer service centralisation on the radical treatment of men with high-risk and locally advanced prostate cancer: A national cross-sectional analysis in England.
Article in International journal of cancer, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed.
- Timing of radiotherapy (RT) after radical prostatectomy (RP): long-term outcomes in the RADICALS-RT trial (NCT00541047).Annals of oncology : official journal of the European Society for Medical Oncology · 2024Trial
- Timing of radiotherapy after radical prostatectomy (RADICALS-RT): a randomised, controlled phase 3 trial.Lancet (London, England) · 2020Trial
- How to tailor the radiotherapy after radical prostatectomy in the modern era of molecular imaging, genomic testing, and technology development?Reports of practical oncology and radiotherapy : journal of Greatpoland Cancer Center in Poznan and Polish Society of Radiation Oncology · 2025Review
- Geographic and socioeconomic variation in treatment of elderly prostate cancer patients in Norway - a national register-based study.Research in health services & regions · 2024Article
- Comparison of the treatment of men with prostate cancer between the US and England: an international population-based study.Prostate cancer and prostatic diseases · 2023Article
- Impact of centralization of prostate cancer services on the choice of radical treatment.BJU international · 2023Article
- Socioeconomic Status and Distance to Reference Centers for Complex Cancer Diseases: A Source of Health Inequalities? A Population Cohort Study Based on Catalonia (Spain).International journal of environmental research and public health · 2022Article
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- Risk stratification for prostate cancer management: value of the Cambridge Prognostic Group classification for assessing treatment allocation.BMC medicine · 2020Article
- Long-term Outcomes of Salvage Radiotherapy Using TomoTherapy With Image-guided Radiotherapy for Postoperative Prostate Cancer Patients.Cancer diagnosis & prognosisArticle
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Authors and funding
9 authors.
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Abstract
In many countries, specialist cancer services are centralised to improve outcomes. We explored how centralisation affects the radical treatment of high-risk and locally advanced prostate cancer in the English NHS. 79,085 patients diagnosed with high-risk and locally advanced prostate cancer in England (April 2014 to March 2016) were identified in the National Prostate Cancer Audit database. Poisson models were used to estimate risk ratios (RR) for undergoing radical treatment by whether men were diagnosed at a regional co-ordinating centre ('hub'), for having surgery by the presence of surgical services on-site, and for receiving high dose-rate brachytherapy (HDR-BT) in addition to external beam radiotherapy by its regional availability. Men were equally likely to receive radical treatment, irrespective of whether they were diagnosed in a hub (RR 0.99, 95% CI 0.91-1.08). Men were more likely to have surgery if they were diagnosed at a hospital with surgical services on site (RR 1.24, 1.10-1.40), and more likely to receive additional HDR-BT if they were diagnosed at a hospital with direct regional access to this service (RR 6.16, 2.94-12.92). Centralisation of specialist cancer services does not affect whether men receive radical treatment, but it does affect treatment modality. Centralisation may have a negative impact on access to specific treatment modalities.
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