Travel time to cancer care as it relates to care access, transportation distress, and financial toxicity: Findings from the Cancer Experience Registry.

Abstract

1537 Background: Longer travel time to cancer care has been linked to worse prognosis and quality of life for patients. This study aims to examine how travel time to cancer care is associated with access to care, transportation-related distress, and financial toxicity. Methods: Participants in Cancer Support Community’s Cancer Experience Registry (CER) from Oct 2021-Dec 2025 reported sociodemographic and clinical information, financial toxicity (11-item FACIT-COST), travel time to cancer care (min/hr), transportation-related distress (1= not at all to 5= very seriously concerned ), and delays/barriers to accessing cancer care (yes/no). Descriptive findings and between-groups analyses (Chi-square) are presented. Results: 3,590 U.S. adults (75% women; 82% non-Hispanic (NH) White, 7% NH Black, 5% Hispanic/Latino, 5% multiple or other races; 18-95 years old [Mean=62.2, SD=13.1]) reported various cancer diagnoses (34% breast, 25% blood, 10% colorectal, 7% gynecologic, 25% other), with 54% in remission/NED, 18% localized, and 15% metastatic (time since diagnosis Median=3yrs). FACIT-COST indicates 52% with no financial toxicity, 26% mild, 20% moderate, and 2% severe financial toxicity (M=24.9, SD=12.0). For travel time, 67% of participants reported < 1hr, 23% 1–2hrs, 7% 3–4hrs, and 4% 5+hrs. 79% reported no transportation distress, while 10% were slightly concerned and 12% moderately to very seriously concerned. Over one-quarter (29%) reported ever experiencing a delay in cancer care. Among patients traveling <1hr to their care center, 24% reported experiencing delays/barriers, compared with 46% of those traveling 5+hrs (χ²=84.3, p<.001). Similarly, transportation-related distress increased with travel time: 84% of patients traveling <1hr reported no concern, whereas only 60% of those traveling 5+hrs reported no concern, with 29% reporting moderate to very serious concern (χ²=167.9, p<.001). Lastly, financial toxicity increased with travel burden: 43% of patients traveling <1hr reported mild-to-severe financial toxicity versus 64% of those traveling 5+hrs (χ²=63.7, p<0.001), and 85% of those reporting moderate to severe transportation distress also reported at least mild financial toxicity (χ²=388.4, p<0.001). Conclusions: Most patients surveyed reported living within 1hr of their care site and experienced little transportation distress; however, those who travel longer distances for care report higher rates of delays/barriers, greater transportation-related distress, and more financial toxicity. Collectively, these findings underscore that longer travel times are linked to both objective barriers and subjective distress, highlighting that travel burden may limit timely cancer care and worsen patient outcomes. Policy solutions that bring quality care closer to patients are essential to reduce travel burdens and distress.