Does Distance Matter? Assessing the Relationship between Travel Distance Patients Encounter and their Uses of Recommended Screening Colonoscopy

Background: The cost of medical care is a tremendous burden to cancer patients. It is well established that cancer screening is cost effective and life saving. Recent clinical guidelines by the American Cancer Society (ACS) recommend that population aged over 50 years receive colorectal cancer screening. Colonoscopy is the most effective screening procedure. However, various studies suggest that travel distance imposes a significant burden for patients to use recommended cancer screening.

Objective: To explore whether distance from patient's home to the endoscopy center predicts the likelihood of screening colonoscopy use.

Data and Analysis: The study uses data collected for a project funded by the National Cancer Institute, through the South Carolina Cancer Disparities Community Network. We conducted patient chart reviews at 7 colonoscopy-trained primary care physician offices (selected by convenience sampling) in South Carolina. Consecutive patient charts of patients aged ≥50 years were retrieved using the billing databases, targeting 200 charts at each office. Of total 1322 patients, 897 had zip code and other data needed for analysis. ARC GIS software was used to calculate distance between patients' zip code centroids and the endoscopy center where their PCP performed colonoscopy. Distance is analyzed as a continuous variable. We use the fixed effect regression model, controlling for patient demographics including race, insurance status, frequency of office visits, and serious comorbidities. Variable recoding and model specification are underway. Results will be reported.

Policy Implications: This study contributes to a better understanding whether travel distance is an impediment of use of screening colonoscopy.