title: Travelling all over the countryside: travel-related burden and financial difficulties reported by cancer patients in New South Wales and Victoria.
abstract: OBJECTIVE
  To describe travel burden and travel-related financial burden experienced by cancer patients over the first year after diagnosis.
  
  
  METHODS
  Population-based longitudinal cohort of recent adult cancer patients diagnosed with the eight most incident cancers recruited from New South Wales and Victorian Cancer Registries. Self-report survey data were collected at 6 and 12 months after diagnosis from 1410 participants (city: n = 890; regional/remote: n = 520).
  
  
  METHODS
  Travel time to cancer treatment, living away from home for treatment, travel-related treatment decisions, extent of financial issues, unmet need for financial help.
  
  
  RESULTS
  During the first 12 months after diagnosis, outer regional/remote residents had the greatest travel burden; 61% (n = 79) travelled at least 2 hours one way to receive treatment, and 49% (n = 66) lived away from home to receive treatment. Strongest associates of travel burden were living in regional/remote areas (odds ratio (OR) = 18.9-135.7), having received surgery (OR = 6.7) or radiotherapy (OR = 3.6). Between 6 and 12 months after diagnosis, 2% (n = 24) of patients declined cancer treatment because of the time it would take to get to treatment. Patients who travelled more than 2 hours or lived away for treatment reported significantly greater financial difficulties (38%; 40%) than those who did not (12%; 14%), even after adjusting for covariates.
  
  
  CONCLUSIONS
  Travel burden is greatest for rural patients, and is associated with greater financial burden. Appropriate and adequate provision of travel and accommodation assistance schemes remains paramount to achieving equitable delivery of cancer services.
authors.affiliation: Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, New South Wales, Australia. alison.zucca@newcastle.edu.au
authors.forename: Alison
authors.initials: A
authors.lastname: Zucca
authors.forename: Allison
authors.initials: A
authors.lastname: Boyes
authors.forename: Graham
authors.initials: G
authors.lastname: Newling
authors.forename: Alix
authors.initials: A
authors.lastname: Hall
authors.forename: Afaf
authors.initials: A
authors.lastname: Girgis
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D005260:Female; D005382:Financing, Personal; D006297:Health Services Accessibility; D006801:Humans; D008297:Male; D008875:Middle Aged; D020380:Needs Assessment; D009369:Neoplasms / Q000191:economics / Q000628:therapy; D009517:New South Wales; D016017:Odds Ratio; D010361:Patients / Q000523:psychology*; D014195:Travel / Q000191:economics*; D014739:Victoria; D055815:Young Adult