A new study suggests that patients with diffuse large B-cell lymphoma (DLBCL) are willing to travel to distant cancer centers for treatment under certain conditions. Overall, patients’ willingness to travel was greater if follow-up care could be completed locally, although Black patients tended to be unlikely to travel longer distances for cellular therapy independently of follow-up care. These study results were published in JCO Oncology Practice.

The study was based on a survey given to patients with DLBCL undergoing treatment at 13 oncology practices. The survey featured questions on current travel patterns for oncology care, as well as questions directing patients to treatment plans based on pairs of hypothetical options for various aspects of treatment. Options related to travel time, follow-up arrangement, continuity of oncologist care, 2-year overall survival rates, and intensive care unit (ICU) admission rates. Participants were able to give an importance weight to each attribute, and these weights were incorporated into analyses.

The survey was given to 489 patients, 302 (62%) of whom provided valid responses. For treatment, most responders (62%) reportedly traveled between 30 and 90 minutes, and nearly one-fifth (19%) indicated some difficulties with transportation to their appointments. 


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White participants were more likely (92%) than Black participants (65%) to report either driving themselves to appointments or being driven. Black participants were more likely (30%) to report using public transit than White participants were (4%). Travel times of 1 hour or less were reported by 100% of Black participants, compared with 60% of White participants. Transportation problems, however, were more common for Black participants (45%) than White participants (17%).

Respondents’ sentiments about travel time to cancer care were impacted by follow-up care options. If follow-up care was given at the location where treatment was received, importance weights given by respondents indicated that longer travel times were less appealing. Contrarily, if follow-up care was available locally, travel time for initial treatment generally appeared to not be a factor in choice of treatment plan. By race, this pattern differed for Black participants, in that longer travel for initial treatment was less appealing regardless of the location of follow-up care. 

Continuity of care with a current oncologist, higher overall survival, and lower ICU admission rates were also factors that mattered to patients. Continuity of care with a current oncologist appeared to have greater importance to Black participants than to White participants.

“In summary, our findings suggest that shared follow-up care may increase patients’ willingness to travel to receive cellular therapies only available at distant cancer centers,” the study authors wrote in their report. “But that reducing the travel burden required for both initial treatment and follow-up care while also enhancing provider continuity may best facilitate equitable access.”

Disclosure: Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.

Reference

Frosch ZAK, Namoglu EC, Mitra N, et al. Willingness to travel for cellular therapy: the influence of follow-up care location, oncologist continuity, and race. JCO Oncol Pract. Published online September 15, 2021. doi:10.1200/OP.21.00312