New research showed that cancer survivors who delayed care due to a lack of transportation were more likely to use the emergency room (ER), according to the study published by Jiang et al in the Journal of Clinical Oncology. They also had the highest risks of all-cause and cancer-specific mortality. These findings were also presented at the 2022 ASCO Quality Care Symposium (Abstract 70).
Study Details and Findings
Xuesong Han, PhD
Researchers, led by senior author and epidemiologist Xuesong Han, PhD, Health Services Researcher in the Department of Surveillance & Health Equity Science at the American Cancer Society, identified cohorts of close to 30,000 cancer survivors and almost 500,000 adults without a cancer history from the 2000–2018 National Health Interview Survey (NHIS) linked to the recently released NHIS Mortality Files. Transportation barriers were measured as medical care delays during the past 12 months as a result of a lack of transportation. Outcomes included the lack of a routine location for care, ER use during the past 12 months, all-cause mortality, and cancer-specific mortality. Their association with transportation barriers was estimated using weighted multivariable logistic and Cox proportional hazards regressions, respectively. The models were adjusted for age, sex, race, educational attainment, health insurance, comorbidities, region, year of the survey, and functional limitations, as well as the time since cancer diagnosis, and cancer types—including breast, colorectal, prostate, and others.
The study results showed that 2.8% of cancer survivors and 1.7% of adults without a cancer history reported delays in care because of transportation barriers. Cancer survivors with transportation barriers had the strongest associations with ER use; followed by adults without a cancer history who had transportation barriers, and individuals with and without a history of cancer who had transportation barriers. Similarly, transportation barriers were associated with the highest risk of all-cause and cancer-specific mortality among cancer survivors.
The study authors stressed that efforts are needed to mitigate transportation barriers in vulnerable cancer survivor communities.
Disclosure: For full disclosures of the study authors, visit ascopubs.org.
