TRANSPORTATION AS A BARRIER TO CANCER-TREATMENT

PURPOSE: Patients with cancer must overcome many psychological, social , and economic barriers to obtain needed treatment. Because of the nee d for repeated visits for cancer treatment on either an outpatient or an inpatient basis, one of the major issues that patients with cancer must confront is that of arranging for transportation to care. METHODS : This study compares the distance and mode of transportation to radio therapy and chemotherapy and perceptions of transportation as a barrie r to care among white, black, and Hispanic cancer patients receiving t reatment from a consortium of cancer treatment facilities in Texas. A mail questionnaire was developed to assess the perceived barriers to c ancer treatment for patients who had been diagnosed clinically with br east, colon, cervical, or prostate cancer, or lymphoma between 1989 an d 1993. A total of 910 surveys were mailed to prospective participants . Of the surveys mailed, 593 were returned, yielding a 65.2% response fate. By race, the respondents included whites (42%), blacks (40%), Hi spanics (15%), and Asian-Pacific Islanders (3%). Two respondents were 17 pears of age; the remaining respondents were 18 years or older. RES ULTS: This study shows that some patients may forgo needed treatment b ecause of problems with transportation. This mas perceived as an issue more for minority patients than for white patients. Black and Hispani c patients consistently reported that barriers such as distance, acces s to an automobile, and availability of someone to drive them to the t reatment center were potential major problems. The distance to the fac ilities was farther for whites than for blacks and Hispanics. Patients generally had to travel farther for chemotherapy than for radiotherap y CLINICAL IMPLICATIONS: Patients, particularly minorities, may opt to forgo needed care in the absence of available and affordable means of transportation to treatment facilities. These findings demonstrate th e need for healthcare providers to be aware of the transportation prob lems that patients with cancer experience in obtaining treatment. Heal thcare providers must work with patients, their families, and voluntee r agencies in the community to facilitate transportation to cancer tre atment services.