How Travel Burdens Affect Cancer Treatment Outcomes

The American Association for Cancer Research's annual progress report, released this week, included a shocking statistic. Among older adults with newly diagnosed cancer, rural residents have a 78% higher one-year mortality compared to urban residents. This statistic might be surprising to many in the healthcare industry, but it's not for those living in rural or semi-rural areas.  

Nearly a decade ago, a dear friend, a never-smoker, was diagnosed with stage IV lung cancer. Her husband worked long hours as a chef, she had a young son in school, and we lived (still do) in a semi-rural community more than an hour's drive from New York City, where a team of specialists were treating her. Especially in the beginning, she often had a couple of appointments a week, resulting in increased travel costs and more co-pays. It took a village to meet all of my friend's needs and get her to her appointments. Several local grade school PTA members and I worked together to figure out childcare arrangements, driver availability (someone confident enough to handle NYC traffic), and appointment scheduling.

Geography or location is one of many social determinants of health. In one study published in the Oncologist in 2015, researchers reviewed 47 studies on the burden of travel from a patient's home to their healthcare providers where they received cancer treatment. They found that patients who traveled more than 50 miles to receive care tended to have more advanced stages of cancer at diagnosis, lower treatment compliance, were less likely to receive appropriate treatment, had poorer treatment outcomes, and had a lower quality of life. Increased travel also added to their overall treatment costs.

The study's authors suggested that healthcare providers should be more mindful of the burden of travel on rural patients. Cancer patients often need healthcare services every week, depending on the severity of the disease, or month, for many years. Providers might consider travel distance when selecting patient treatment protocols and the need for streamlining appointments. Healthcare networks might also analyze SDOH patient data for the placement of radiation facilities or regional cancer centers for infusions.

Much of cancer care these days is about delivering personalized medicine to manage or cure disease. Treatment planning also needs to weigh what works for patients and their caregivers, whether it's feasible to travel to a center for care, and how often.

~Vicky Que, VP of Content Strategy