Abstract PS4-11-23: Correlates of Distance Traveled to Treatment Centers Among Breast Cancer Patients: The Role of Race/Ethnicity and Insurance Status

Abstract Background: Black women and uninsured patients have a higher breast cancer mortality rate and are often diagnosed at more advanced stages. Prior research suggests transportation is a barrier to completing recommended treatment. This study examines whether race/ethnicity and insurance status are associated with the distance traveled to breast cancer diagnosis and treatment facilities. Methods: The study employed data from the National Cancer Database (NCDB) from 2013-2022 and included patients who were diagnosed with any stage of breast cancer at Commission on Cancer-certified centers in the United States. Patients with missing information on their racial/ethnic group, distance traveled, or insurance status were not included. Six ordinal categories of distance traveled (<5 miles, 5-9 miles, 10-24 miles, 25-49 miles, 50-99 miles, and >100 miles) were compared across racial/ethnic groups and insurance coverage groups. Z-tests were run to compare each proportion against the white patient group and privately insured patient group, and a chi squared test was run to determine if there was a correlation between insurance status and distance traveled and race/ethnicity status and distance traveled. Results: There was a significantly higher proportion of Black, Hispanic, and Asian American and Pacific Islander (AAPI) patients who traveled under 5 miles to their treatment compared to White patients. 18.8% of Black patients traveled under 5 miles compared to 13% of White patients. However, American Indian and Alaskan Native (AI/AN) patients had a greater proportion of patients that traveled over 100 miles to receive a diagnosis or treatment compared to White patients. Uninsured people were most correlated with shorter distance traveled to facilities, followed by Medicaid then Medicare patients. People with other forms of government insurance had a higher proportion than privately insured patients that traveled 50-99 miles and over 100 miles to facilities. Conclusion: There is a correlation between race/ethnicity and distance traveled and between insurance status and distance traveled with racial and ethnic minority groups and uninsured patients being more correlated with traveling smaller distances. Racial and ethnic minority groups and uninsured patients may lack tools for extensive travel. Even though racial and ethnic minority populations and people without private insurance travel less far than white patients, disparities remain. Further research into how disparities stem from structural racism and shape access to health providers is necessary. Disclaimer: The NCDB is a joint project of the Commission on Cancer of the American College of Surgeons and the American Cancer Society. The data used in the study are derived from a de-identified NCDB file. The American College of Surgeons and the Commission on Cancer have not verified and are not responsible for the analytic or statistical methodology employed, or the conclusions drawn from these data by the investigator Citation Format: D. Desai. Correlates of Distance Traveled to Treatment Centers Among Breast Cancer Patients: The Role of Race/Ethnicity and Insurance Status [abstract]. In: Proceedings of the San Antonio Breast Cancer Symposium 2025; 2025 Dec 9-12; San Antonio, TX. Philadelphia (PA): AACR; Clin Cancer Res 2026;32(4 Suppl):Abstract nr PS4-11-23.