Educational Objective: At the conclusion of this presentation, the participants should be able to describe the influence of regional variation and patient travel in vestibular schwannoma care.
Objectives: Vestibular schwannomas (VS) are relatively rare tumors, thus nationwide investigations have largely been limited to secondary analyses. Herein, we survey VS patients nationally to investigate regional differences and trends of travel for VS care. Study Design: Cross-sectional online survey.
Methods: A comprehensive self-reported survey was distributed online between February 2020 and June 2021 via the Acoustic Neuroma Association (ANA) to patient members residing in the United States with a self-reported history of sporadic, radiographically confirmed VS.
Results: United States geographic representation was diverse with respondents from 46 states. Of those who answered to geographic region (n=208), a plurality was from the South (n=73, 35.1%) and lived in rural areas (n=80, 38.5%). Median distance traveled for care was 50 miles (range: 1-3500 miles) and the majority (n=125/213, 58.7%) of respondents received local care (less than 100 miles). Across all regions, distance traveled was negatively correlated with patients' age (r=-0.15, p < 0.05). Southern (ρ=0.16, p=0.02) and rural (ρ=0.31, p < 0.01) respondents were more likely to travel over 100 miles as compared to other regions. Patients who travelled over 100 miles tended to pursue treatment at an academic center (ρ=0.17, p=0.02) and desired invasive or surgical treatment (ρ=0.29, p < 0.01).
Conclusions: Younger and Southern or rural based patients tend to travel farther to seek VS care, and those who did travel tended to seek microsurgical resection at an academic center. The expansion of care into more diverse regional centers may help offset the burden of travel for VS patients.