Travel and Financial Burdens Play a Role in Cancer Care

The joint stressors of travel burdens and financial hardship can affect the care patients with cancer receive, according to a scoping review article published online in JNCI Cancer Spectrum.

“When considering the totality of the cancer burden, the material out-of-pocket costs of care, alongside transportation-related time and monetary cost of travel for appointments, all contribute to the out-of-pocket obligation placed onto patients,” wrote corresponding author Arrianna Marie Planey, MA, PhD, of the University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, and study coauthors. “These contribute to substantial distress and cost-coping behaviors that alter care.”

The review summarized findings from 98 peer-reviewed studies that focused on the intersection of cancer-related travel burdens and financial hardship. Researchers identified 5 themes that emerged from the body of research: cancer treatment choices, receipt of guideline-concordant care, cancer treatment outcomes, health-related quality of life, and propensity to participate in clinical trials.

According to the review, patients with greater financial hardship and travel burdens are more likely to receive cancer care at a local hospital than a specialized hospital and are perhaps less likely to receive guideline-concordant care. Patients with heavier travel burdens may choose single-visit surgical treatments over radiotherapy or chemotherapy requiring multiple visits. Follow-up care and surveillance screening can also be limited, with downstream effects on overall survival.

Financial hardship and time scarcity made worse by treatment-related travel can curb the ability of patients to engage in health-promoting activities and lessen their health-related quality of life, the review explained.

The same barriers to cancer care can extend to participation in clinical trials.

“To alleviate the distress of going through major medical care, health systems can respond by making the process of accessing care easier,” researchers wrote. “Policymakers, insurance payers, and patient navigators each hold authority to consolidate resources and prioritize the financial and logistic impact of accessing health care.”

Reference

Planey AM, Spees LP, Biddell CB, et al. The intersection of travel burdens and financial hardship in cancer care: a scoping review. JNCI Cancer Spectr. 2024;8(5):pkae093. doi:10.1093/jncics/pkae093