ArticleBMC cancer2025
The association of travel distance and other patient characteristics with breast cancer stage at diagnosis and treatment completion at a rural Rwandan cancer facility.
Article in BMC cancer, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.
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Who cites it
10 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Stage at Diagnosis and Molecular Subtype Distribution of Breast Cancer in Sub-Saharan Africa: A Systematic Review.Cancer reports (Hoboken, N.J.) · 2026Pooled it
- Paving the way for more accessible cancer care in low-income countries with optimization.Health care management science · 2026Article
- Total treatment interval and quality of life of women living with breast cancer in Ethiopia: the mediating role of financial toxicity.Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation · 2026Article
- Association between time to treatment and financial toxicity among women with breast cancer in Ethiopia: a multicentre study in a low-resource setting.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2026Article
- Transportation-related factors, cancer screening, and stage at diagnosis: A scoping review.PloS one · 2026Article
- Travel Distance and Its Impact on Wait Time for Positron Emission Tomography-Computed Tomography in Patients with Cancers.International journal of environmental research and public health · 2025Article
- Impact of Travel Burden on Timeliness of Care and Overall Survival for Breast Cancer: A National Cancer Database Analysis.Cancer medicine · 2025Article
- Early experience scaling up a breast cancer early detection initiative integrated with cervical cancer screening in Rwanda.BMJ global health · 2025Article
- Travel burden increases the risk of advanced stage at diagnosis of breast cancer in Kashgar, China.Scientific reports · 2025Article
- Breast Cancer Genetic Services in a South African Setting: Proband Testing, Cascading and Clinical Management.Cancer medicine · 2025Article
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Authors and funding
19 authors.
Funding
Abstract
backgroundButaro Cancer Center of Excellence (BCCOE) was founded to serve Rwanda's rural low-income population, providing subsidized cancer diagnosis and treatment with transport stipends for the lowest-income patients. We examined whether travel distance to BCCOE was associated with advanced-stage diagnoses and treatment completion.
methodsWe conducted a retrospective cohort study using medical record data from BCCOE patients with pathologically-confirmed breast cancer from 2012-2016. Women with no prior surgery were included in the stage analysis; those with non-metastatic disease were included in the treatment analysis. We calculated travel distances using spatial analytic software and used multivariable logistic regression to examine the association of distance and other patient characteristics with late-stage diagnoses and treatment completion within one year of diagnosis.
resultsThe analytic cohort for stage included 426 patients; 75.1% had late-stage (stage 3 or 4) disease. In univariable analyses, patients residing in BCCOE's surrounding district had a lower proportion of late-stage diagnoses compared to those residing outside the district (57.9% v 76.8%, p = 0.02). In adjusted analyses, odds of late-stage diagnosis were 2.46 (95% CI:1.21-5.12) times higher among those in distance quartile 4 (> 135.8 km) versus 1 (< 55.7 km); the effect of distance was less strong in sensitivity analyses excluding patients from BCCOE's surrounding district. Patients from sectors with > 50% poverty had 2.33 times higher odds of late-stage diagnoses (95% CI:1.07-5.26) relative to those with poverty < 30%. In the treatment completion cohort (n = 348), 49.1% of patients completed surgery and chemotherapy within a year. In adjusted analyses, travel distance and poverty were not linearly associated with treatment completion.
conclusionsAt Rwanda's first public cancer facility, sector-level poverty and longer travel distances were associated with late-stage breast cancer diagnoses, but less clearly associated with treatment completion, perhaps partly due to travel stipends provided to the lowest-income individuals undergoing treatment. Our findings support further investigation into wider use of travel stipends to facilitate early diagnosis and treatment completion.
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