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Transportation Barriers Linked to Worse Outcomes in Cancer Care

Delayed care due to lack of transport linked to increased emergency department use, mortality for adults with and without cancer history

By Elana Gotkine HealthDay Reporter

WEDNESDAY, April 26, 2023 (HealthDay News) — For adults with and without cancer history, delayed care due to lack of transportation is associated with increased emergency department use and all-cause mortality, according to a study published online April 25 in the Journal of the National Cancer Institute.

Changchuan Jiang, M.D., M.P.H., from the Roswell Park Comprehensive Cancer Center in Buffalo, New York, and colleagues examined the association between lack of safe, reliable, and affordable transportation and clinical outcomes among 28,640 adults with and 470,024 adults without a cancer history. Transportation barriers were defined as delays in care arising from lack of transportation.

The researchers found that transportation barriers were reported by 2.8 and 1.7 percent of adults with and without a cancer history, respectively. Overall, there were 7,324 and 40,793 deaths, respectively, in adults with and without a cancer history. Compared with adults without a cancer history or transportation barriers, those with a cancer history and transportation barriers reported the highest likelihood of emergency department use (adjusted odds ratio [aOR], 2.77) and all-cause mortality risk (adjusted hazard ratio [aHR], 2.28), followed by those without a cancer history and with transportation barriers (emergency department use: aOR, 1.98; all-cause mortality: aHR, 1.57) and those with cancer history but without transportation barriers (emergency department use: aOR, 1.39; all-cause mortality: aHR, 1.59).

“Transportation is a critical health-related social need affecting cancer care quality and equitable access to care,” Jiang said in a statement. “Our research shows that value-based, patient-centered approaches are needed to address this critical issue and ensure that no one is left behind in their cancer journey.”

One author disclosed financial ties to AstraZeneca.

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