Spatial Analysis of Travel Distances for Persons with Common Cancers Seeking Care at a Tertiary Care Facility in South India: An Operational Research

Accessibility is an important determinant of healthcare facility utilization. However, there is limited data on patient travel distances to reach cancer treatment facilities. Therefore, this study aimed to determine the geographical location, travel distance and travel time to the cancer centre for persons with cancer (PWC) at a tertiary care facility in Southern India. The locations of PWC were geocoded utilizing ArcGIS World Geocoding Services, and network analysis was performed using the ArcGIS Pro Business Analyst Geoprocessing extension. Simple median regression was performed to assess the relationship between sociodemographic and clinical variables for both distance and time. Among 1306 persons with common cancer, the mean (SD) age was 51.7 (8.8) years, with 73.5% female, 65.3% residing in rural areas, majority (33% breast cancers), and 34% stage III]. Median travel distance (IQR) for PWC from their residences to the tertiary care facility was 96.2 (36.4-155.7) km, while the median travel time by driving was 154.8 (72.5-235.3) minutes. In 78 % cancer care centres were available within 25 km. Males, individuals residing in rural areas, those with late-stage cancer, and individuals with lip-oral, oesophageal, and stomach cancer tend to travel more than their counterparts for cancer care. The study concludes that more than three-fourths of patients with cancer travel longer distances despite having a nearby cancer care facility.