Aims: To investigate if the establishment of a rural radiotherapy service in the geographically sparse area of Western NSW Local Health District (WNSWLHD) has changed the demographic profile, cancer type, treatment intent and number of patients treated.

Methods: Data were collected on every WNSWLHD patient 17 years of age and above who received radiotherapy in either 2010 or 2012 in NSW or ACT. The age, gender, treatment intent, cancer type and residential town were recorded.  Of the 1745 records received, 505 did meet the criteria, 4% were missing the participant’s cancer type and 5% were missing the participant’s treatment intent. Missing data did not influence the results.

Results: The number of patients who accessed radiation increased from 573 to 667 between 2010 and 2012 (x²(1)=6.0, p=0.014). The corresponding radiotherapy utilisation (RTU) rates were 29.3% in 2010 and 33.4% in 2012, an improvement of 4.1%(p=0.01, 95%CI 0.008-0.07). Patients travelled 128.5km less for treatment in 2012 than 2010 (338.7km vs 210.2km, CI 111km-145.5km, p>0.0001) and lived an average of 20km closer to the new the service (143.3km vs 123.6km, CI 7km-32km, p=0.002). All regions had an improvement in RTU rates apart from the remote region which decreased by 9% (31% to 20% in 2012). The number of palliative treatments increased significantly only within the Orange region, which is where the new service is situated (95% CI 1.2-3.0, p=0.004). Male treatments also significantly increased as there were 81 new treatments (292 vs 373, x²(1)=9.6, p=0.002) as did patients with a respiratory cancer (66 vs 97, x²(1)=8.7, p=0.003).

Conclusions:  A new radiotherapy service in a sparsely populated health district significantly changed the pattern of radiotherapy use by those who lived in the Orange region and for those living in the Remote region, treatment rates worsened.