这项全国性研究调查了与转移性癌症患者进行全身抗癌治疗 (SACT) 的治疗地点相关的医院质量和患者因素。使用英国 NHS 的链接管理数据集，我们确定了 2016 年 1 月 1 日期间诊断为转移性乳腺癌和肠癌的所有患者2018 年 12 月 31 日，随后在诊断后 4 个月内接受了 SACT。使用地理信息系统 (ArcGIS) 调查了患者绕过最近医院的程度。使用条件逻辑回归模型来估计旅行时间、医院质量和患者特征对患者接受 SACT 的影响。 2,364 名被诊断患有转移性乳腺癌的女性 (22.9%) 中的 541 名，以及 10,050 名被诊断为转移性乳腺癌的女性中的 2,809 名 (28.0%)转移性肠癌绕过了最近提供 SACT 的医院。人们强烈倾向于在患者居住地附近的医院接受治疗 (p < 0.001)。然而，年龄较小的患者（乳腺癌 p = 0.043；肠癌 p < 0.001）或来自农村地区的患者（乳腺癌 p = 0.001；肠癌 p < 0.001）更有可能前往更远的医院。与结肠癌患者相比，诊断为直肠癌的患者更有可能前往更远的地方接受 SACT (p = 0.002)。患者更有可能前往综合癌症中心（肠癌 p = 0.019）和指定的实验癌症医学中心 (ECMC)，尽管后者关联并不显着。患者在再入院率最高的医院接受 SACT 的可能性较小（肠癌 p = 0.046）。接受初次 SACT 治疗的转移性癌症患者准备前往其他更远的医院接受治疗，并优先选择提供多模式的大型综合中心提供早期癌症临床试验的护理机构或医院。版权所有 © 2024 作者。由爱思唯尔有限公司出版。保留所有权利。

This national study investigated hospital quality and patient factors associated with treatment location for systemic anticancer treatment (SACT) in patients with metastatic cancers.Using linked administrative datasets from the English NHS, we identified all patients diagnosed with metastatic breast and bowel cancer between 1 January 2016 and 31 December 2018, who subsequently received SACT within 4 months from diagnosis. The extent to which patients bypassed their nearest hospital was investigated using a geographic information system (ArcGIS). Conditional logistic regression models were used to estimate the impact of travel time, hospital quality and patient characteristics on where patients underwent SACT.541 of 2,364 women (22.9%) diagnosed with metastatic breast cancer, and 2,809 of 10,050 (28.0%) patients diagnosed with metastatic bowel cancer bypassed their nearest hospital providing SACT. There was a strong preference for receiving treatment at hospitals near where patients lived (p < 0.001). However, patients who were younger (p = 0.043 for breast cancer; p < 0.001 for bowel cancer) or from rural areas (p = 0.001 for breast cancer; p < 0.001 for bowel cancer) were more likely to travel to more distant hospitals. Patients diagnosed with rectal cancer were more likely to travel further for SACT than patients with colon cancer (p = 0.002). Patients were more likely to travel to comprehensive cancer centres (p = 0.019 for bowel cancer) and designated Experimental Cancer Medicine Centres (ECMCs) although the latter association was not significant. Patients were less likely to receive SACT in hospitals with the highest readmission rates (p = 0.046 for bowel cancer).Patients with metastatic cancer receiving primary SACT are prepared to travel to alternative more distant hospitals for treatment with a preference for larger comprehensive centres providing multimodal care or hospitals which offer early phase cancer clinical trials.Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.