Factors that determine selection of a cancer treatment location.

Abstract

e18880 Background: Cancer patients, who are already overwhelmed by their diagnosis and other decisions that need to be made, are also confronted with decisions regarding treatment options. Understanding factors that influence a cancer patient’s decision to select a treatment location are needed to optimize treatment decision-making and avoid financial toxicity. This study aimed to gather feedback from cancer patients to understand what factors influence their decision to choose a cancer treatment location. Methods: We conducted an online cross-sectional survey of 126 current and former cancer patients. We asked what factors influenced their decision to select their current or former cancer treatment center. The survey was conducted in 2022; descriptive statistics and percentages are reported. Results: Most patients were White (87%), female (74%), college-educated (70%) and resided in the suburbs (57%); hypertension (32%) was the most common comorbidity. The most common cancers were breast (48%), followed by colon or rectal (8%) and leukemia (8%). Roughly half of the patients selected the location for screening (51%), while someone else selected locations for diagnosis and staging (63%), treatment plans (64%) and treatment (45%). Of those who indicated that someone else chose their screening, diagnosis and staging, treatment plan and treatment locations, most reported their oncologist decided the diagnosis and staging (57%), treatment plan (86%) and treatment locations (90%). The wait time to receive treatment (89%) and distance from home or work (86%) were the two most important factors when selecting a cancer treatment location. Over half (57%) of patients said they would be “very willing” or “somewhat willing” to change treatment locations for a $0 copay/coinsurance offer. However, only 38% of respondents would be willing to change locations for a $0 copay/coinsurance offer if it meant they would have to change oncologists. 48% of patients were willing to drive 41-100 miles to a treatment location for a $0 copay/coinsurance offer. 74% of patients received an infusion as part of treatment; over half (57%) preferred to receive the infusion in a suite at a cancer center/clinic. Conclusions: While primary care physicians and oncologists share almost equally in selecting screening locations, oncologists are most often responsible for recommending a treatment location for the other three steps (diagnosis and staging, treatment plan and treatment) in the cancer treatment journey. When offered a $0 copay/coinsurance program during treatment, patients were willing to change locations, highlighting the impact of cost on selecting a cancer treatment location. However, patients were less likely to change locations if that meant changing their oncologist, highlighting the importance of trust and comfort in one’s oncologist.