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CHICAGO, June 3, 2023 — A new study led by researchers at the American Cancer Society (ACS) and Roswell Park Comprehensive Cancer Center finds many cancer survivors in the United States with transportation barriers to care also report struggling financially and experiencing additional barriers to timely care. The research will be presented at this year’s annual meeting of the American Society of Clinical Oncology (ASCO) in Chicago, June 2-6.
Scientists, led by senior author Dr. Xuesong Han, scientific director, health services research at the American Cancer Society, and Dr. Changchuan Jiang, from Roswell Park Comprehensive Cancer Center and lead author of the research, identified more than 18,000 adults with a history of cancer from the 2011-2018 National Health Interview Survey. Transportation barriers were defined as a delay in care due to a lack of transportation over the past 12 months. Primary outcomes included 1) medical financial hardship (FH) in any of the three following domains: material (problems paying medical bills), psychological (worrying about medical bills), and behavioral hardship (delaying/forgoing care due to cost); 2) food insecurity (worrying food would run out); and 3) delayed care due to other factors (long wait times, inability to get an appointment quickly). Researchers estimated the proportion of survivors who report any financial hardship, food insecurity, or other factors that lead to care delays and compared the age-sex adjusted prevalence of these barriers among cancer survivors by whether or not they reported transportation barriers using logistic regression.
Study results showed 2.9% of survivors in the U.S. reported having transportation barriers to care. Survivors with transportation barriers were more likely to struggle financially, experience food insecurity, or other factors that lead to care delays than survivors without transportation barriers (86.0% vs 45.3%, p<0.001). Moreover, survivors with transportation barriers were more likely to experience medical financial hardship (73.2% vs 38.3%, p<0.001), including material (50.3% vs 27.1%, p<0.001), behavioral (57.5% vs 20.4%, p<0.001), and psychological (33.5% vs 15.4%, p<0.001) hardship than survivors without transportation barriers. Additionally, survivors with transportation barriers were more likely to experience food insecurity (43.9% vs 12.0%, p<0.001) and care delays due to other factors (45.6% vs. 11.6%, p<0.001).
Scientists note the findings highlight the importance of screening and addressing health-related social needs and comprehensive interventions to address barriers to care access in this vulnerable population of cancer survivors.
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