Exploring associations between travel burden, clinical features, and outcomes from head and neck cancer in Scotland, UK

The association between geography and HNC in Scotland is complex and differs from previous studies in other cancers. Patients with the longest travel time had lower risk of advanced stage at presentation and reduced one-year mortality with no apparent difference in HPV-prevalence or treatment access. In context these findings suggest that travelling time disadvantage is not uniform across cancer types and highlights the need for cancer site-specific approaches to monitoring and reducing inequalities. This large, population-based analysis provides the most comprehensive assessment of HNC and geography in Scotland to date. Findings challenge assumptions of consistent travel time disadvantage and can inform policy on equitable cancer care delivery in the pre-pandemic era.