Abstract 67: Quantifying Transportation Barriers in Rwandan Patients Seeking Treatment for Breast Cancer

Abstract

Abstract Purpose: Comprehensive cancer care in many sub-Saharan African countries is concentrated within a few centers. With only two comprehensive treatment facilities in Rwanda, travel distance, travel time, and travel cost may represent underappreciated barriers to accessing cancer treatment. Here we describe travel and transportation experiences of patients receiving curative breast cancer treatment at Butaro Cancer Center of Excellence (BCCOE). Methods: A cross-sectional telephone survey assessing contributors of care-continuum delays was administered to female patients receiving curative breast cancer treatment. Between July and November 2020, 89 (75%) of eligible patients were reached by phone, all of whom provided verbal consent and voluntarily participation. Patient demographic information and transportation experience were descriptively summarized. Results Participants had a median age of 48 years, and they represented all five Rwandan provinces. Twenty-one patients (24%) belonged to the lowest of the four socioeconomic “ubudehe” strata, as defined by the local government, while none were in the highest stratum. Few patients' households owned transportation vehicles with only one owning a private car, 4 (4%) owning a motorbike, and 23 (26%) owning a bicycle. Most patients, 84 (94%) utilized public transport buses for a portion of their travel, while 48 (54%) utilized motorbikes. Median one-way travel time from patients' home to BCCOE was 7 hours (interquartile range: 6-8 hours). The median cost of transportation for each round-trip was RWF12000, approximately $12 USD, which equates to 75% of a Rwandan adult's total monthly consumption. Transportation costs were noted as a significant barrier by 43 patients (46%), and 35 (39%) received financial support from outside their household to pay for transportation. Conclusion Transportation time and cost are significant burdens on patients receiving breast cancer treatment in Rwanda. Studies are needed to evaluate strategies for alleviating these burdens, such as comprehensive transportation financial support and innovative care delivery with telemedicine. Citation Format: Temidayo Fadelu, Cam Nguyen, Nicaise Nsabimana, Evariste Bigirimana, Vestine Mukandayisenga, Hubert Tuyishime, Lawrence Shulman, Timothy Rebbeck. Quantifying Transportation Barriers in Rwandan Patients Seeking Treatment for Breast Cancer [abstract]. In: Proceedings of the 9th Annual Symposium on Global Cancer Research; Global Cancer Research and Control: Looking Back and Charting a Path Forward; 2021 Mar 10-11. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2021;30(7 Suppl):Abstract nr 67.