E. Frew et al., Estimating time and travel costs incurred in clinic based screening: flexible sigmoidoscopy screening for colorectal cancer, J MED SCREE, 6(3), 1999, pp. 119-123
Objectives-To identify the characteristics of mode of travel to screening c
linics; to estimate the time and travel costs incurred in attending; to inv
estigate whether such costs are Likely to bias screening compliance.
Setting-Twelve centres in the trial of flexible sigmoidoscopy screening for
colorectal cancer, drawn fi om across Great Britain.
Method-Analysis of 3525 questionnaires completed by screening subjects whil
e attending clinics. Information supplied included sociodemographic charact
eristics, modes of travel, expenses, activities forgone owing to attendance
, and details of companions.
Results-More than 80% of subjects arrived at the clinics by car, and about
two thirds were accompanied. On average, the clinic visit involved a 14.4 m
ile (22.8 km) round trip, requiring 130 minutes. Mean travel costs amounted
to pound 6.10 per subject. The mean gross direct non-medical and indirect
cost per subject amounted to pound 16.90, and the mean overall gross cost p
er attendance was pound 22.40. Compared with the Great Britain population a
s a whole, nonmanual classes were more strongly represented, and the self e
mployed less strongly represented, among the attendees.
Conclusions-In relation to direct medical costs, the time and travel costs
of clinic based screening can be substantial, may influence the overall cos
t effectiveness of a screening programme, and may deter potential subjects
from attending.