Mapping the Distribution and Challenges of Long-Distance Travel for Patients With Breast Cancer at the Uganda Cancer Institute.

Abstract

Purpose: Breast cancer is a major public health concern in Uganda, with limited research on its spatial distribution. With the increasing burden of breast cancer in Uganda, ensuring equitable access to care is crucial. This study investigates the spatial distribution of breast cancer cases across Uganda and describes travel distances patients travel to reach the Uganda Cancer Institute (UCI), the national cancer treatment center. By analyzing geographic patterns and disparities in accessibility, this research aims to inform targeted interventions for improved patient outcomes and a more equitable health care system.

Patients and methods: This retrospective study analyzed data from patients with breast cancer treated at UCI from 2009 to 2023. We geocoded patient addresses and calculated the travel distance from each residence to UCI. Spatial analysis was performed using Moran I statistic to assess clustering patterns in breast cancer distribution.

Results: This study mapped the residences of 1,926 patients with breast cancer. Over half (54.7%) were concentrated in the Central region, with a median distance to the UCI of 11.2 km. By contrast, patients from the Northern region faced a median journey of 291 km, highlighting a significant disparity in proximity to care. Distinct clusters of patients were identified beyond the capital, Kampala, notably in Mbale (Eastern region) and several towns within the Northern region (Arua, Adjumani, Gulu, and Lira), suggesting potential localized factors influencing breast cancer incidence.

Conclusion: This study highlights significant regional disparities in access to breast cancer care in Uganda, emphasizing the need for targeted interventions to improve health care access and reduce the burden of long-distance travel for patients in remote areas.