ArticleCancer medicine2025
Impact of Travel Burden on Timeliness of Care and Overall Survival for Breast Cancer: A National Cancer Database Analysis.
Article in Cancer medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
2 citing papers in PubMed.
- A Population Based Analysis of Breast Cancer Outcomes Among Disaggregated Asian American and Pacific Islander Women.Annals of surgical oncology · 2026Article
- Impact of Travel Burden on Timeliness of Care and Overall Survival for Breast Cancer: A National Cancer Database Analysis.Cancer medicine · 2025Article
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Authors and funding
10 authors.
Funding
Abstract
introductionTimely treatment initiation is critical to clinical outcomes in breast cancer (BC). While social determinants of health are established drivers of disparities in the timeliness of care (ToC), the impact of travel burden remains less defined. This study evaluates associations between travel burden, ToC, and overall survival (OS) in a nationally representative BC cohort.
methodsWe analyzed 283,166 BC patients from the National Cancer Database (2004-2021) with documented great circle distance (GCD), categorized as ≤ 10, 10.1-20.0, and > 20 miles. Associations between GCD and ToC-defined as time from diagnosis to first treatment and categorized as < 8, 8-12, and > 12 weeks-were assessed using negative binomial models, and associations with OS were evaluated using Cox models.
resultsCompared to patients with GCD < 10 miles, patients with GCD > 20 miles experienced delays in ToC when diagnosed with early-stage disease, especially when undergoing surgery as first treatment (RR: 1.05, 95% CI: 1.04-1.06). Compared to treatment within 8 weeks of diagnosis, treatment initiation > 12 weeks had 24% higher mortality (HR: 1.24, 95% CI: 1.14-1.35), especially among patients receiving surgery (HR: 1.31, 95% CI: 1.19-1.43) and chemotherapy (HR: 1.30, 95% CI: 1.18-1.43). Even surgery within 8-12 weeks carried an elevated risk (HR: 1.09, 95% CI: 1.02-1.16). Metropolitan patients with GCD > 20 miles had a 12% lower mortality (HR: 0.88, 95% CI: 0.81-0.96) than those ≤ 10 miles away; no such differences were observed in urban or rural groups.
conclusionTravel burden influences BC ToC and OS through geographic, clinical, and facility factors, underscoring the need for tailored interventions that address local care capacity, patient demographics, and disease profiles.
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