Investigators have found that many U.S. cancer survivors with transportation barriers to care also reported struggling financially and experiencing additional barriers to timely care, according to new findings presented by Jiang et al at the 2023 ASCO Annual Meeting (Abstract 6534).
Study Methods and Results
In the new study, the investigators identified over 18,000 adult patients with a history of cancer using data from the 2011 to 2018 National Health Interview Survey. The investigators defined transportation barriers as delays in care as a result of a lack of transportation over the past 12 months.
The primary outcomes included medical financial hardships—including material (problems paying medical bills), behavioral (delaying/forgoing care due to cost), and psychological (worrying about medical bills) hardships—food insecurities, and delayed care caused by other factors such as long wait times or an inability to get an appointment quickly. The investigators estimated the proportion of cancer survivors who had any financial hardships, food insecurities, or delayed care and compared the age-sex adjusted prevalence of these barriers among cancer survivors who either reported or did not report transportation barriers using logistic regression.
The investigators revealed that 2.9% of U.S. cancer survivors reported having transportation barriers to care. These patients were found to be more likely to experience additional barriers to care compared with cancer survivors without transportation barriers (86.0% vs 45.3%, P < .001). Cancer survivors with transportation barriers were also more likely to experience medical financial hardships (73.2% vs 38.3%, P < .001)—including material (50.3% vs 27.1%, P < .001), behavioral (57.5% vs 20.4%, P .001), and psychological (33.5% vs 15.4%, P < .001) hardships—compared with cancer survivors without transportation barriers. Additionally, cancer survivors with transportation barriers were more likely to experience food insecurities (43.9% vs 12.0%, P < .001) and care delays caused by other factors (45.6% vs. 11.6%, P < .001).
Conclusions
The new findings highlighted the importance of addressing as well as screening for health-related social needs and comprehensive interventions in order to eliminate the barriers to care that many cancer survivors continue to face.
Disclosure: For full disclosures of the study authors, visit meetings.asco.org.
